Self-Reports of Pain-Related Awakenings in Persistent Orofacial Pain Patients

Aims: To assess whether pain-related awakenings occur with persistent orofacial pain conditions and whether it is related to pain severity. Methods: Reports of pain-related awakening were prospectively collected at initial interview, prior to treatment, during a 24-month period from 328 patients with orofacial pain. The pain conditions were diagnosed according to the International Headache Society, the American Academy of Orofacial Pain, and the Research Diagnostic Criteria for Temporomandibular Disorders. Results: Pain-related awakening was significantly correlated to pain intensity (odds ratio [OR] 1.5, 95% confidence intervals [CI] 1.3-1.8; P .001), the total muscle tenderness score (OR 1.1, 95% CI 1.01-1.14; P = .03), and the presence of lacrimation (OR 4.6, 95% CI 1.7-12.3; P = .002) but not to the clinical diagnosis. Two groups of patients were specifically examined; patients with masticatory myofascial pain (MMP) and patients with classical trigeminal neuralgia (CTN). Twenty-eight of the 120 MMP patients (23.3%) reported pain-related awakening and this was associated with a high muscle tenderness score (OR 1.13, 95% CI 1.01-1.3; P = .02) and unilaterality of pain (OR 3.9, 95% CI 1.2-12.3; P = .02). Seven of the 31 patients with CTN (22.6%) reported pain-related awakenings. Continuous background pain was the most significant parameter associated with awakening (OR 26, 95% CI 1.1-594; P .05). Conclusion: Persistent orofacial pain often induced pain-related awakening and this was significantly associated with pain intensity. Keywords: myofascial pain, sleep, trigeminal neuralgia