Sleep-related respiratory impairment and psychosocial stress in patients with persistent orofacial pain: A cross-sectional exploratory study

Dent Med Probl. 2026 Jan-Feb;63(1):73-86. doi: 10.17219/dmp/195283.

ABSTRACT

BACKGROUND: Sleep-related breathing disorders (SRBD), including obstructive sleep apnea (OSA) and habitual snoring, can substantially impair quality of life (QoL). However, evidence regarding their impact in patients with orofacial pain (OFP) remains limited. Although disentangling the specific consequences of SRBD from the overlapping conditions is challenging, validated psychometric instruments provide a valuable means of screening for associated biopsychosocial burdens, such as depression and anxiety.

OBJECTIVES: The aim of the present study was to investigate potential associations between respiratory distress caused by SRBD, using self-report data and psychometric variables as indicators of psychosocial stress, and the overall well-being in individuals with OFP.

MATERIAL AND METHODS: Anonymized data from 415 patients was analyzed. The participants were screened and categorized according to the presence or absence of respiratory distress. Psychometric measures were examined descriptively. Based on the responses (positive or negative) to the screening question, group differences were evaluated within subgroups matched for sex, age decade, employment status, body mass index (BMI), and typical pain intensity. Associations between the variables were subsequently analyzed using multiple regression models.

RESULTS: Most patients were female (n = 290; 69.9%), aged 20-59 years (n = 296; 71.3%), workers (n = 246; 59.3%), with a normal weight (n = 255; 61.4%) and without any respiratory distress (n = 324; 78.1%). Most patients who reported respiratory distress were female (n = 57; 62.6%), and more than a half were 40-59 years old (n = 49; 53.8%). For all domains of psychosocial stress, the percentage of patients reaching a clinically relevant score was higher for the group with respiratory distress, except for the Dysmorphic Concern Questionnaire (DCQ). Significant effects of typical pain intensity were observed across all questionnaires except DCQ, the Injustice Experience Questionnaire (IEQ), the Patient Health Questionnaire9 (PHQ-9), and the Patient Health Questionnaire for Stress (PHQ-Stress).

CONCLUSIONS: In this cross-sectional study, about 22% of the evaluated patients reported some form of SRBD. Moreover, SRBD were associated with higher psychometric scores, suggesting a close relationship between sleep-related respiratory difficulties and psychosocial impairment.

PMID:41797720 | DOI:10.17219/dmp/195283