Systematic Review and Meta-analysis: Temporomandibular Disorders (TMD) and Sleep Apnea

Abstract

Background:
Temporomandibular disorders (TMD) and obstructive sleep apnea (OSA) are prevalent conditions that significantly impact an individual's quality of life. While both conditions are common, their coexistence and potential interactions have not been fully explored. This systematic review and meta-analysis aim to evaluate the association between TMD and OSA, and the effectiveness of interventions in managing these co-occurring conditions.

Objectives:
To assess the prevalence of TMD in patients with OSA and examine the role of various interventions, including oral appliances and physiotherapy, in improving symptoms of TMD and OSA.

Methods:
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search was conducted in PubMed, Cochrane Library, Scopus, and Web of Science databases from October 1999 up to October 2024. Observational studies, randomized controlled trials (RCTs), and cohort studies were included. Data on the prevalence, comorbidity rates, and efficacy of interventions were extracted. The Cochrane Risk of Bias Tool was used to evaluate RCTs, and the Newcastle-Ottawa Scale was applied for assessing the quality of observational studies.

Results:
A total of 10 RCTs and several observational studies were included in the meta-analysis. The prevalence of TMD in OSA patients was significantly higher compared to the general population. Mandibular advancement devices and physiotherapy showed a moderate improvement in reducing symptoms of TMD and OSA. However, the efficacy varied depending on patient characteristics and the severity of both conditions.

Conclusions:
There is a significant association between TMD and OSA, with a higher prevalence of TMD in OSA patients. Interventions such as oral appliances and physiotherapy appear effective in managing both conditions, though further research is warranted to refine treatment protocols.