The Presence of Temporomandibular Disorder is Associated With an Elevated Risk of Concomitant Sleep Apnea

Temporomandibular disorders (TMDs) and obstructive sleep apnea (OSA) are prevalent conditions that frequently co-occur. It remains unclear if the presence of TMD is more likely to be associated with an increased risk of OSA.

The purpose of the study was to measure the association between TMD and OSA.

The researchers implemented a prospective cross-sectional study. Patients presenting to the Department of Oral and Maxillofacial Surgery at Mashhad Dental School with a Diagnostic Criteria for Temporomanibular Disorder (DC/TMD)-confirmed diagnosis were screened and enrolled. Control subjects were identified from the same clinical setting and were age- and sex-matched individuals seeking routine dental care who did not meet the DC/TMD criteria for any TMD diagnosis.

The primary predictor variable was the TMD status, coded as present (TMD group) or absent (control group).

The primary outcome was the risk of OSA, measured as a continuous score (range 0 to 8) using the STOP-BANG questionnaire.

The covariates included demographics (age, sex), anthropometric (body mass index, neck circumference), medical history (hypertension), maximum mouth opening, the presence of joint sounds, and the occurrence of mandibular deviation during movement.

Nonparametric tests (Mann-Whitney U and χ² tests) compared groups. Multiple linear regression-independent predictors of the STOP-BANG score compared within the TMD group. The results report effect sizes with 95% CI. P < .05 was considered statistically significant.

The sample was composed of 100 subjects with a mean age of 35.5 ± 13.8 years; 46 (46%) were male. There were 50 subjects in the TMD group and 50 subjects in the non-TMD group, respectively. The TMD group had a significantly higher mean STOP-BANG score than the non-TMD group (3.1 ± 1.9 vs 1.6 ± 1.9; mean difference: 1.5, 95% CI: 0.9 to 2.1, P < .001). High OSA risk, defined as a STOP-BANG score of ≥3, was significantly more prevalent in the TMD group (24 vs 4%; odds ratio = 7.6, 95% CI: 1.6 to 35.1, P = .004).

Subjects with TMD demonstrate a substantially elevated risk for OSA. These findings support integrating routine sleep apnea screening, using tools like the STOP-BANG questionnaire, into standard TMD clinical evaluation.