Clinical Oral Investigations

, Volume 23, Issue 2, pp 667–672 | Cite as

Chronic stress and temporalis muscle activity in TMD patients and controls during sleep: a pilot study in females

  • Marc SchmitterEmail author
  • Alexandra Kares-Vrincianu
  • Horst Kares
  • Carolin Malsch
  • Hans Jürgen Schindler
Original Article



The aim of this study was to assess the correlation between chronic stress and temporalis muscle activity during four nights.

Material and methods

Forty-four female subjects were recruited in five dental practices located in different areas of the federal state of Saarland, Germany (dental practice network in Saarland). The following inclusion criteria were used: female, aged between 18 and 65, no somatization or depression, and no pain medication, graded chronic pain status < 3. Both subjects reporting about sleep bruxism and subjects negating sleep bruxism during anamnesis were included. Anamnestic issues, sleep bruxism, anxiety, and chronic stress were assessed using validated questionnaires. Temporalis muscle activity was measured for four nights using a portable electromyographic device. Correlation coefficient was used to assess the correlation (Spearman-correlation) between chronic stress and number of temporalis muscle episodes/hour and between anxiety and the number of episodes/hour.


The analysis showed that the factors “work overload” (adulthood chronic stress because of too many demands at work) and “pressure to perform” (necessity to be successful at work) were significantly correlated with the number of temporalis muscle episodes per hour. In contrast, anxiety was not correlated with temporalis muscle episodes per hour.


Work-related chronic stress seems to be associated with an increased level of temporalis muscle activity during sleep.

Clinical relevance

During anamnesis, work-related aspects should be assessed in females presenting with sleep-bruxism.


Electromyography Psychosocial Sleep bruxism Work environment Masticatory muscle Anxiety 



We would like to thank Mrs. Malsch for the statistical support. The authors received no financial support and declare no potential conflicts of interest with respect to the authorship and/or publication of this article.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Marc Schmitter
    • 1
    Email author
  • Alexandra Kares-Vrincianu
    • 1
    • 2
  • Horst Kares
    • 2
  • Carolin Malsch
    • 3
    • 5
  • Hans Jürgen Schindler
    • 1
    • 4
  1. 1.Department of ProsthodonticsUniversity of WürzburgWürzburgGermany
  2. 2.Private Dental Practice Network SaarlandSaarbrückenGermany
  3. 3.Institute of Clinical Epidemiology and BiometryUniversity of WürzburgWürzburgGermany
  4. 4.Research Group Biomechanics, Institute for MechanicsKarlsruhe Institute of Technology (KIT)KarlsruheGermany
  5. 5.Comprehensive Heart Failure CenterUniversity Hospital of WürzburgWürzburgGermany

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