Sleep disturbances, which are commonly reported in Temporomandibular disorder (TMD), may confer increased risk for the development, progression, and persistence of pain through changes in homeostatic regulatory mechanisms including the immune system. The primary purpose of the current pilot study was to examine case-control differences in subjective and objective sleep measures and its relationship with the inflammatory cytokine, Interleukin 6 (IL-6). Twenty-five individuals with TMD and 24 healthy controls completed a sleep diary and actigraphy (ActiGraph wGT3X; non-dominat wrist) over a 7-day period. On day 7, blood was collected for analysis of IL-6 levels. Group differences in IL-6 and self-reported sleep quality (0–4 scale) and efficiency in addition to actigraphy-based measures (sleep efficiency; wake after sleep onset, WASO) were averaged and evaluated as dependent variables in analyses of covariance controlling for body mass index (BMI). Data was presented as means and 95% confidence intervals (CI). Associations between sleep and IL-6 were assessed with partial correlations. Self-reported sleep differed between TMD and healthy controls (HC) such that TMD participants reported poor sleep quality (TMD: 3.39, 3.34-3.45 95%CI; HC: 3.86, 3.81-3.91 95%CI; p<0.001) and lower sleep efficiency (TMD: 86.81, 86.23-87.38 95%CI; HC: 91.99, 91.44-92.56 95%CI; p<0.001). In addition, similar differences were observed for actigraphy-based outcomes including poorer sleep efficiency (TMD: 82.73, 82.32-83.14 95%CI; HC: 85.40, 85.00-85.79 95%CI; p<0.001) and longer WASO (TMD: 76.53, 74.50-78.55 95%CI; HC: 56.74, 54.78-58.68 95%CI; p<0.001) in TMD participants compared to HC. TMD participants also had higher levels of IL-6 (TMD: 13.49, 13.06-13.94 95%CI; HC: 3.67, 3.25-4.09 95%CI; p<0.001). Additionally, IL-6 was associated with self-reported measures whereby higher levels of IL-6 were associated with poorer sleep quality (r=-0.27, p=0.02) and efficiency (r=-0.42, p<0.001). Associations with actigraphy outcomes were not significant. The current study supports previous studies that individuals with chronic pain commonly report disturbed sleep, which may contribute to clinical pain through a pro-inflammatory imbalance (i.e., enhanced IL-6 roduction). While further analysis regarding the discrepancy between objective and subjective parameters on IL-6 is needed, sleep behaviors should be considered as a method to manage TMD. K99DE022368 (NIDCR)
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