Association of simple snoring and myogenous temporomandibular disorders based on polysomnographic examination

This study aims to evaluate the association between objectively measured snoring characteristics and masticatory muscle pain in patients with myogenous temporomandibular disorders (TMD), while excluding patients with obstructive sleep apnea.

This prospective study included 184 patients (mean age: 33.92 ± 10.05 years; 71.2% female) who underwent overnight polysomnography (PSG) and standardized TMD assessments. Snoring was quantified using acoustic recordings and parameters derived from PSG. Muscle pain intensity was assessed in the bilateral masseter and temporalis muscles. Correlation analyses and group comparisons were performed to examine the relationships between snoring characteristics (e.g., snore index, train frequency, and audio volume) and pain outcomes.

No significant associations were found between primary snoring parameters and pain intensity. However, several snoring metrics,particularly those measured during specific body positions and sleep stages, especially during nonsupine rapid eye movement (REM) sleep-showed significant negative correlations with pain, mainly in the left masseter and temporalis muscles. Notably, higher snore intensity was associated with lower muscle pain, suggesting a potential modulatory effect. These relationships were lateralized and dependent on body position. Multivariate analysis did not identify independent predictors of pain. Although no direct link was observed between overall snoring and masticatory muscle pain, certain snoring patterns,particularly during nonsupine REM sleep-were inversely related to pain intensity.

These findings suggest a possible protective or modulatory role of snoring in TMD-related muscle pain and highlight the complex influences of sleep stage, body position, and laterality.

Information on clinical trial registration can be found at ClinicalTrials.gov (identifiers: NCT03083405, NCT04214561).