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Charles R. Carlson


The aim of this study was to investigate whether chronic daily headache (CDH) and temporomandibular disorders (TMD) patients present with different psychological and sleep quality characteristics. Sixty seven patients diagnosed with CDH according to Silberstein et al.s classification criteria were matched by age, sex, pain intensity, and pain duration with 67 patients who had a primary diagnosis of myofascial pain (MP), and 67 patients with a primary diagnosis of TMJ intracapsular pain (IC) according to the Research Diagnostic Criteria for TMD. The CDH group was comprised of three mutually exclusive diagnostic groups, that is transformed migraine (n=35), chronic tension-type headache (n=26), and other CDH (n=6). All CDH sub-groups showed similar psychological and sleep quality profiles. All patients completed a battery of psychological and sleep quality questionnaires. The CDH and MP groups revealed higher levels of psychological distress than the IC group on most psychological domains. The MP group also revealed numerically higher levels of psychological distress in most psychological domains than the CDH group, although these differences where not statistically significant. We did not find statistically significant differences between the three groups on post traumatic stress symptoms either. Sleep quality was significantly worse in the MP group than in the CDH and IC groups. These results are discussed in the context of multimodal patient evaluation and treatments that are necessary for successful clinical management.