Excessive Daytime Sleepiness and Oral Behaviors: A Pilot Investigation Among Patients With Temporomandibular Disorders

Abstract

Objective: To explore the relationship between excessive daytime sleepiness (EDS) and oral behaviors of patients with temporomandibular disorders (TMD).

Methods: A total of 567 TMD patients were included in the pilot study. The Oral Behavior Checklist (OBC) was employed to evaluate the oral behaviors of participants, and the Epworth Sleepiness Scale was utilized to assess EDS. Besides, the seven-item generalized anxiety disorder (GAD-7) and nine-item Patient Health Questionnaire (PHQ-9) were applied to assess the severity of anxiety and depression. All assessment tools were used in validated Chinese versions. Statistical analyses were conducted appropriately to detect the possible differences and correlations.

Results: Compared with non-EDS counterparts, TMD patients with EDS exhibited higher OBC scores and OBC level (p < 0.05). Binary logistic analyses demonstrated a significant correlation between EDS and OBC level (odds ratio (OR) = 1.780, p = 0.031). Specifically, “Awake grinding” (OR = 6.854, p = 0.020), “Awake clenching” (OR = 2.190, p = 0.012), and “Press tongue forcibly against teeth” (OR = 3.477, p = 0.032) were identified to be positively correlated with EDS in TMD patients.

Conclusions: Elevated OBC scores and oral behavior level were associated with the presence of EDS in TMD patients. Behaviors including awake grinding, awake clenching, and press tongue forcibly against teeth may serve as reliable predictors of EDS in individuals with TMD. Addressing these parafunctional oral behaviors could potentially yield therapeutic benefits in the comprehensive management of TMD patients. Longitudinal trials in the future are worthwhile for a further validation.