Nocturnal heart rate variability is lower in temporomandibular disorder patients tvhan in healthy, pain-free individuals

Chete M. Eze-Nliam, Phillip J. Quartana, Angela M. Quain, Michael T. Smith

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Aims: To determine whether patients with a painful myofascial temporomandibular disorder (TMD) have diminished nocturnal heart rate variability (HRV), a marker of autonomic nervous system (ANS) dysfunction, relative to healthy, pain-free controls. Methods: Participants with myofascial TMD and healthy, pain-free volunteers underwent nocturnal polysomnography studies during which HRV indices were measured. Multiple linear regression analyses were used to determine whether TMD status exerted unique effects on HRV. Results: Ninety-five participants (n = 37 TMD; n = 58 controls) were included in the analyses. The TMD group had a lower standard deviation of R-R intervals (89.81 ± 23.54 ms versus 107.93 ± 34.42 ms, P ≤ .01), a lower root mean squared successive difference (RMSSD) of R-R intervals (54.78 ± 27.37 ms versus 81.88 ± 46.43 ms, P < .01), and a lower high frequency spectral power (2336.89 ± 1224.64 ms2 versus 2861.78 ± 1319 ms2, P = .05) than the control group. The ratio of the low-frequency (LF) to the highfrequency (HF) spectral power was higher in the TMD group (2.47 ± 2 versus 1.38 ± 0.65, P < .01). The differences in RMSSD (91.21 ms versus 112.03 ms, P = .05) and LF:HF ratio (0.71 versus 0.32, P < .01) remained significant after controlling for age and psychological distress. Conclusion: Myofascial TMD patients revealed lower nocturnal HRV than healthy, pain-free controls. Further research should focus on processes that address this ANS imbalance, which may potentially lead to effective therapeutic interventions.

Original languageEnglish (US)
Pages (from-to)232-239
Number of pages8
JournalJournal of Oral and Facial Pain and Headache
Issue number3
StatePublished - 2011


  • Autonomic dysfunction
  • Chronic pain syndrome
  • Heart rate variability
  • Sympathetic hyperactivity
  • Temporomandibular disorder

ASJC Scopus subject areas

  • Dentistry (miscellaneous)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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