Sleep Disorders and Chronic Orofacial Pain

TLDR: It is important that the orofacial pain clinician be aware of comorbid sleep disorders and a multidisciplinary and integrative approach should be used to manage these patients.

Abstract: Sleep disturbances have been linked to chronic pain disorders and it has been suggested that they affect each other in a circular fashion. However, with the exception of sleep bruxism and temporomandibular disorders, very little is known about the interaction between sleep and specific orofacial pain disorders. We aimed to review and evaluate the existing knowledge about the relationship between orofacial pain and sleep disorders. Furthermore, to elaborate on management options for patients with orofacial pain and sleep disorders. Orofacial pain disorders such as temporomandibular disorders, burning mouth syndrome, and painful post-traumatic trigeminal neuropathy are reciprocally related to disturbances in sleep quality. Furthermore, in the case of temporomandibular disorders, it has been shown that sleep quality disturbances occur before pain onset. Regarding sleep bruxism, the recent literature seems to indicate that when sleep bruxism is assessed objectively (i.e., polysomnography), most sleep bruxism parameters do not seem to be able to explain temporomandibular disorder occurrence. Finally, very few studies have assessed the effect sleep quality improvement has on chronic orofacial pain parameters such as intensity and frequency. In general, there is a lack of studies assessing the relationship between sleep disturbances and orofacial pain disorders, the exception being the relationship between sleep bruxism and TMD. The few studies that exist suggest an association between orofacial pain disorders and decreased sleep quality. As such, it is important that the orofacial pain clinician be aware of comorbid sleep disorders and a multidisciplinary and integrative approach should be used to manage these patients.