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

## TL;DR

The study finds that certain snoring patterns during specific sleep stages may be linked to lower muscle pain in people with temporomandibular disorders.

## Contribution

It identifies specific snoring metrics during nonsupine REM sleep that inversely correlate with masticatory muscle pain.

## Key findings

- Snoring metrics during nonsupine REM sleep showed significant negative correlations with muscle pain.
- Higher snore intensity was associated with lower pain in left masseter and temporalis muscles.
- The relationships were lateralized and dependent on body position during sleep.

## Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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. Clinical Trial
Registration: Information on clinical trial registration can be found at
www.ClinicalTrials.gov (identifiers:
NCT03083405, NCT04214561).