Paradoxical Insomnia, a Chronic Insomnia Subtype in Patients with Temporomandibular Disorder

Author

Christy Chan, CUNY City CollegeFollow

Date of Award

2023

Document Type

Thesis

Department

Psychology

First Advisor

Boris Dubrovsky

Second Advisor

Maude Bouchard

Third Advisor

Vivien Tartter

Keywords

Temporomandibular Disorder, Sleep State Misperception, Paradoxical Insomnia, Daytime Dysfunction, Polysomnography, Pittsburgh Sleep Quality Index

Abstract

The purpose of this secondary data analysis study is to determine: 1) if individuals with Temporomandibular Disorder (TMD) present subjective-objective discrepancies in sleep parameters derived from the Pittsburgh Sleep Quality Index (PSQI) to their respective polysomnography (PSG) counterparts for the presence of sleep misperception and 2) to examine specific PSQI-sleep measures that showed significantly higher rates of disturbance in TMD participants in relation to subjective daytime dysfunction and objectively short sleep. The first hypothesis is that there will be an absence of subjective-objective correspondence on specific sleep measures only in TMD participants, while in control participants, it is expected that there is a subjective-objective correspondence present. The second hypothesis is that there will be a pattern among TMD participants where subjective poor sleep is related to poor self-reported daytime dysfunction but not objectively short sleep duration. Results indeed indicated that TMD participants who reported sleep disturbance on the PSQI did not have corresponding sleep disturbance on the PSG, specifically in sleep efficiency (SE) and wake after sleep onset (WASO). Moreover, the misperception of SE and WASO in TMD participants was not related to objectively short sleep but appears to be related to daytime dysfunction. These findings point to a chronic insomnia subtype called paradoxical insomnia, where individuals may mistake their sleep for wakefulness and a bidirectional link between subjective daytime function and sleep. Future studies should further examine the effect of cognitive behavioral therapy for insomnia in treating the orofacial pain and associated daytime symptoms on self-reported sleep in TMD.

Recommended Citation

Chan, Christy, "Paradoxical Insomnia, a Chronic Insomnia Subtype in Patients with Temporomandibular Disorder" (2023). CUNY Academic Works.
https://academicworks.cuny.edu/cc_etds_theses/1090