青少年颞下颌关节盘前移位患者的睡眠质量及其影响因素调查

An investigation of the sleep quality status of adolescent patients with temporomandibular joint anterior disc displacement and its influencing factors

目的探讨青少年颞下颌关节盘前移位患者睡眠质量现状及其相关影响因素。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。采用便利抽样法,应用一般资料调查表、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、中国中学生心理健康量表(mental health inventroy of middle-school students,MMHI-60)和疼痛视觉模拟评分量表(visual analogue scale,VAS)对上海某三级甲等医院口腔外科门诊就诊的120例青少年颞下颌关节盘前移位患者进行调查,采用描述性分析、单因素分析、相关性分析及回归分析探讨相关影响因素。结果本研究中青少年颞下颌关节盘前移位患者PSQI得分为(7.77±4.63)分;不同学业压力、夜磨牙的患者其睡眠质量的差异具有统计学意义(P<0.01);PSQI得分与疼痛得分呈正相关(r=0.45,P<0.001),疼痛影响睡眠质量;与MMHI-60量表得分呈正相关(r=0.74,P<0.001),心理健康者睡眠质量较好;回归分析结果显示,学业压力(OR=2.511,95%CI=1.307~4.828)、夜磨牙(OR=3.694,95%CI=1.394~9.791)、疼痛得分(OR=2.104,95%CI=1.095~4.041)、心理得分(OR=1.039,95%CI=1.021~1.058)为睡眠质量的影响因素。结论青少年颞下颌关节盘前移位患者的睡眠质量普遍较低,学业压力、夜磨牙、疼痛和心理健康状况是睡眠质量的影响因素。

Objective To survey the current situation and analyze the relevant influencing factors of sleep quality in adolescent patients with temporomandibular joint anterior disc displacement.Methods This study has been reviewed and approved by the Ethics Committee,and informed consent has been obtained from patients.A convenience sampling method was used to investigate 120 adolescent patients with temporomandibular joint anterior disc displacement in the outpatient department of stomatology in a grade A tertiary hospital in Shanghai using the general data questionnaire,the Pittsburgh sleep quality index scale(PSQI),the Chinese middle school student mental health scale(MMHI⁃60)and the pain visual analog scale(VAS).Descriptive analysis,single factor analysis,correlation analysis and multiple regression analysis were used to explore the relevant influencing factors.Results The PSQI score of adolescent patients with temporomandibular joint anterior disc displacement in this study was 7.77±4.63.There was a statistically significant difference in sleep quality among patients with different academic pressures and levels of sleep bruxism(P<0.05).The sleep quality score was positively correlated with the pain score(r=0.45,P<0.001)and positively correlated with the psychological score(r=0.74,P<0.001).The degree of pain can affect the patient's sleep quality,and those with good mental health have better sleep quality.The results of regression analysis showed that academic stress(OR=2.511,95%CI=1.307~4.828),bruxism(OR=3.694,95%CI=1.394~9.791),pain score(OR=2.104,95%CI=1.095~4.041)and psychological score(OR=1.039,95%CI=1.021~1.058)were statistically significant.Conclusion The sleep quality of adolescent patients with temporomandibular joint anterior disc displacement is generally poor.Academic pressure,sleep bruxism,pain and mental health are the influencing factors of sleep quality.