Problems of sleep, depression, quality of life in adolescents with TMD diagnosis

Original Research

Contemp Pediatr Dent 2021:2(2):101-112

Problems of sleep, depression, quality of life in adolescents with TMD diagnosis

OrcidKarla Christina Amaral de Pinto Costa1, OrcidStela Maris Wanderley Rocha2 OrcidDanilo Antonio Duarte3 OrcidKelly Maria Silva Moreira4 OrcidJosé Carlos Pettorossi Imparato5 OrcidVictor Cavallaro Bottesini6OrcidGiselle Rodrigues de Santanna7


1.Postgraduate student. Department of Pediatric Dentistry, São Leopoldo Mandic College. Campinas, Brazil

2. Professor. Department of Stomatology, Federal University of Alagoas. Alagoas. Brazil

3. Professor. Department of Pediatric Dentistry, São Leopoldo Mandic College. Campinas, Brazil

4.Postgraduate student. Department of Pediatric Dentistry, State University of Campinas. Piracicaba, Brazil

5. Professor. Department of Pediatric Dentistry, University of São Paulo. São Paulo, Brazil

6. Undergraduate student. Department of Pediatric Dentistry, School of Dentistry, APCD. São Paulo, Brazil ( Correspondence:

7. Professor. Department of Pediatric Dentistry, São Leopoldo Mandic College. Campinas, Brazil


Adolescents with TMD are at a greater risk of developing depression and they suffer a greater impact of these on their quality of life.

The quality of life can be affected by an inappropriate level of sleep, which might cause social withdrawal, anxiety and low self-esteem.

More attention should be given to this patient group by preventing and controlling the progression of dysfunction as well as providing more comprehensive treatment and multidisciplinary interaction.


Aim: To verify the relationship between temporal-mandibular dysfunction (TMD) with depression, sleep, sleepiness and quality of life in adolescents aged 13 to 18 years old. Methods: Thirty-eight adolescents being seen at the UFAL Dental Clinic (Federal University of Alagoas), for TMD, and qualifying according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD), participated in the study. Two instruments were used to investigate sleep quality: the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS); the Oral Health Impact Profile (OHIP-14) for quality-of-life assessment; and the Beck Depression Inventory (BDI-II) for depression assessment. Pearson’s correlation coefficient was used for the relationship of numerical variables. For the means tests, the Student t test was applied (using, when necessary, the Welch correction). For the analyses, the Bonferroni correction was considered. Results: After calculation, αBonferroni correction was applied equal to 0,0005. Of the total number of participants (56% female and 44% male), with a mean age of 14.7). In all comparisons between groups (with and without TMD), there were statistically significant indices for adolescents with TMD in relation to: depression (p=5.6∙10-11), quality of life (p=4.3∙10-12), sleep quality (p=5.0∙10-10), and somnolence (p=0.0002). From the correlation matrix, it was observed that all correlations were significantly positive and moderate. Conclusions: Adolescents with a diagnosis of TMD presented an increase of depression and somnolence, as well as impairment of sleep quality and quality of life, and these same variables can influence on the onset of TMD.

Keywords: Adulthood; Temporomandibular Dysfunction; Temporomandibular Joint

Copyright © 2021 Contemporary Pediatric Dentistry


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29 July 2021


07 September 2021

Online First:

08 September 2021