ASSOCIATION OF STRESS, ANXIETY AND DEPRESSION WITH SLEEP QUALITY IN PATIENTS WITH MYOFASCIAL PAIN: A CROSS-SECTIONAL QUESTIONNAIRE STUDY

Abstract

Background: Myofascial Pain Syndrome (MPS) is a common musculoskeletal disorder featuring hypersensitive trigger points within muscle and fascia. Current research increasingly points to psychological factors and sleep problems as key elements affecting how MPS develops and responds to treatment. We designed this study to examine connections between psychological well-being (stress, anxiety, depression) and sleep quality among individuals with myofascial pain. Methods: A cross-sectional questionnaire study involving 71 myofascial pain patients who met Laskin's diagnostic criteria was conducted. Participants were drawn from the Department of Oral Medicine and Radiology at D.Y. Patil Deemed to be University School of Dentistry, Navi Mumbai. Assessment tools included the Perceived Stress Scale-14 (PSS-14), Beck Anxiety Scale (BAS), Beck Depression Scale (BDS), and Pittsburgh Sleep Quality Index (PSQI). We used descriptive statistics, Chi-square tests, and Spearman correlations for analysis, with significance defined as p ≤ 0.05. Results: The participant group included 35 males (49.3%) and 36 females (50.7%). Moderate stress appeared in 66.2% of participants, while 52.1% showed moderate anxiety. Depressive symptoms affected 63.4% of the sample (borderline clinical depression: 35.2%, mild mood disturbance: 28.2%). Poor sleep quality was reported by 97.2% of participants. Depression showed a significant association with sleep quality (p = 0.039), while stress (p = 0.168) and anxiety (p = 0.226) did not reach statistical significance. Nevertheless, all three psychological measures correlated positively with sleep quality scores: stress (r = 0.542, p < 0.001), anxiety (r = 0.661, p < 0.001), and depression (r = 0.640, p < 0.001). Anxiety produced the strongest correlation with sleep problems. Conclusion: Patients with myofascial pain face considerable psychological distress and poor sleep. The strong correlations we observed between stress, anxiety, depression, and worsening sleep quality emphasize the importance of integrated psychological assessment and multidisciplinary care for this population.