Investigating pain‑specific sleep disturbances in 3 orofacial pain conditions: Trigeminal neuropathic pain, temporomandibular disorders and orofacial pain presentation of primary headaches

Sleep disturbances are common in orofacial pain (OFP), yet most studies focus on individual conditions. Whether factors associated with sleep disturbance differ across neuropathic, musculoskeletal, and headache-related OFP remains unclear. To assess demographic, clinical, pain-related, and psychological factors associated with sleep disturbance within each OFP diagnostic category. This cross-sectional study included 333 patients with OFP, predominantly chronic in nature: painful temporomandibular disorders (TMD; n=123), trigeminal neuropathic pain (TNP; n=134), and orofacial presentations of primary headache disorders (OFPHD; n=76). Sleep disturbance was assessed using the Chronic Pain Sleep Inventory (CPSI). Associations between sleep disturbance and demographic, clinical, pain-related, and psychological factors were examined using univariate and multivariate analyses. Pain-related functional interference was consistently associated with sleep disturbance across diagnostic groups. Female sex was independently associated with sleep disturbance in TNP, whereas pain intensity and duration were independently associated with sleep disturbance in TMD. Patients with OFPHD reported particularly high levels of pain-related nocturnal awakening. These findings support the assessment of sleep as a core component of OFP management and suggest that subgroup-specific factors should be considered when evaluating and addressing sleep-related problems in this population.