Relationships between orofacial pain and sleep: Analysis of UK biobank and genome-wide association studies data

Abstract

Background/purpose: Orofacial pain is common in dental practices. This study aimed to explore relationships between orofacial pain and sleep using the UK Biobank dataset and, based on epidemiological associations, to investigate the causal association using genome-wide association studies data.

Materials and methods: First, a cross-sectional study was conducted with 196,490 participants from UK Biobank. Information on pain conditions and sleep traits was collected. Multivariable models were used to explore the relationships with odds ratio (OR). Second, Mendelian randomization analyses were conducted using data for orofacial pain, including temporomandibular joint disorders-related pain (n = 377,277) and atypical facial pain (n = 331,749), and sleep traits, including sleep duration (n = 446,118), short sleep (n = 411,934), long sleep (n = 339,926), snoring (n = 359,916), ease of getting up (n = 385,949), insomnia (n = 453,379), daytime dozing (n = 452,071), daytime napping (n = 452,633), and chronotype (n = 403,195).

Results: The cross-sectional study confirmed the bidirectionality between pain and sleep. Participants experiencing pain all over the body showed a significant association with an unhealthy sleep pattern (OR = 1.18, P < 0.001) and other sleep traits (P < 0.05). Risks of chronic orofacial pain were associated with sleep duration in a non-linear relationship (P = 0.032). The Mendelian randomization analyses indicated that long sleep was causally associated with temporomandibular joint disorders-related pain (OR = 6.77, P = 0.006).

Conclusion: The relationship between pain and sleep is bidirectional. Long sleep is found to be causally associated with chronic orofacial pain.

Keywords: Orofacial pain; Public health; Sleep; Temporomandibular joint disorders.

Figure 1

The flow chart of the study. Abbreviations: UKB: UK biobank; MR: Mendelian randomization; TMD: Temporomandibular joint disorders.

Figure 2

(A) Distribution of sleep scores and sleep duration among different groups. (B) Proportion of sleep traits by different groups. Notes: ∗∗∗P < 0.001.

Figure 3

(A) Poisson regression analysis of sleep scores and different pain conditions. (B) Multinomial logistic regression analysis of pain condition groups and sleep traits. Abbreviations: OR: Odds ratio; CI: Confidence interval.

Figure 4

(A) Restricted cubic spline model of sleep duration and acute orofacial pain. (B) Restricted cubic spline model of sleep duration and chronic orofacial pain. Abbreviations: OR: Odds ratio; CI: Confidence interval.

Figure 5

(A) Bidirectional Mendelian randomization (MR) analyses of orofacial pain's causal associations with sleep traits. (B) Multivariable MR analyses of sleep traits on temporomandibular joint disorders-related pain with adjustment for body mass index and type 2 diabetes. Abbreviations: OR: Odds ratio; CI: Confidence interval; TMD: Temporomandibular joint disorders.