Sleep apnea symptoms and risk of temporomandibular disorder: OPPERA cohort

A. E. Sanders, G. K. Essick, R. Fillingim, C. Knott, R. Ohrbach, J. D. Greenspan, L. Diatchenko, W. Maixner, R. Dubner, E. Bair, V. E. Miller, G. D. Slade

Research output: Contribution to journalArticlepeer-review


The authors tested the hypothesis that obstructive sleep apnea (OSA) signs/symptoms are associated with the occurrence of temporomandibular disorder (TMD), using the OPPERA prospective cohort study of adults aged 18 to 44 years at enrollment (n = 2,604) and the OPPERA case-control study of chronic TMD (n = 1,716). In both the OPPERA cohort and case-control studies, TMD was examiner determined according to established research diagnostic criteria. People were considered to have high likelihood of OSA if they reported a history of sleep apnea or ≥ 2 hallmarks of OSA: loud snoring, daytime sleepiness, witnessed apnea, and hypertension. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence limits (CL) for first-onset TMD. Logistic regression estimated odds ratios (OR) and 95% CL for chronic TMD. In the cohort, 248 individuals developed firstonset TMD during the median 2.8-year follow-up. High likelihood of OSA was associated with greater incidence of first-onset TMD (adjusted HR = 1.73; 95% CL, 1.14, 2.62). In the casecontrol study, high likelihood of OSA was associated with higher odds of chronic TMD (adjusted OR = 3.63; 95% CL, 2.03, 6.52). Both studies supported a significant association of OSA symptoms and TMD, with prospective cohort evidence finding that OSA symptoms preceded first-onset TMD.

Original languageEnglish (US)
Pages (from-to)70S-77S
JournalJournal of Dental Research
Issue numberSUPPL. 7
StatePublished - May 20 2013
Externally publishedYes


  • Autonomic effect
  • Casecontrol studies
  • Chronic pain
  • Cohort studies
  • Epidemiology
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Dentistry(all)


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