*4.5.2 Masticatory muscle disorders*

	- a.Myalgia
		- i.Local myalgia
		- ii.Myofascial pain
		- iii.Myofascial pain with referral
	- b.Tendonitis
	- c.Myositis
		- i.Non-infective
		- ii.Infective
	- d.Spasm
	- a.Muscle
	- b.Tendon
	- a.Jaw
		- i.Malignant
		- ii.Benign
	- b.Soft tissues of head, face and neck
		- i.Malignant
		- ii.Benign
	- a.Orofacial dyskinesia
		- i.Abnormal involuntary movements

**95**

*Sleep and Orofacial Pain: Physiological Interactions and Clinical Management*

6.Masticatory muscle pain attributed to systemic/central disorders

Cervical pain disorders represent a very common group of musculoskeletal conditions that can greatly influence the head structures. We can divide it in two groups: those that primarily originate in the muscles and those that predominantly originate in the cervical spine. These structures very commonly refer pain to the

There are also some associated structures that can cause orofacial pain such as the eyes, ears, the nasal-paranasal sinus complex, the salivary glands, and the throat. In these cases, the orofacial pain is a heterotopic pain. At the same time, systemic diseases like oromandibular dystonia, multiple sclerosis, and Lyme disease, often have orofacial manifestations. The importance of an accurate differential

**5. General considerations about clinical and epidemiological aspects of** 

Clinical evidence on sleep-general pain interaction comes essentially from insomnia patients. The severity of the insomnia is associated with pain sensitivity. In a recent study, we showed that prevalence of insomnia in orofacial pain patients was almost 40%; in more than 600 clinical patients, approximately 1 in 6 suffered from relevant insomnia corroborating this important relationship between pain and sleep disturbance [57]. In a review on comorbidities of chronic facial pain and obstructive sleep apnea, Olmos also stated that sleep disturbances may impact orofacial pain in a bidirectional way [58]. Patients with obstructive sleep apnea (OSA) or with other respiratory problems during sleep, one of the most common causes of disturbed and insufficient sleep, may actually present with more pain-related complaints and we have recently showed that in a large sample of patients with temporomandibular disorders and chronic orofacial pain 22% of patients presented with snoring which

*DOI: http://dx.doi.org/10.5772/intechopen.86770*

b.Oromandibular dystonia

i.Acute

a.Fibromyalgia

*4.5.3 Masticatory muscle disorders*

*4.5.4 Associated structures*

1.Coronoid hyperplasia

**4.6 Cervical pain disorders**

orofacial region [44, 56].

diagnosis is obviously tremendous.

**sleep-pain interaction**

1.Headache attributed to TMD

ii.Deformans

b.Centrally mediated myalgia

**4.7 Extracranial and systemic causes of orofacial pain**


*Sleep and Orofacial Pain: Physiological Interactions and Clinical Management DOI: http://dx.doi.org/10.5772/intechopen.86770*

b.Oromandibular dystonia

i.Acute

*Updates in Sleep Neurology and Obstructive Sleep Apnea*

1.Muscle pain limited to the orofacial region

iii.Myofascial pain with referral

i.Local myalgia

ii.Myofascial pain

i.Non-infective

ii.Infective

*4.5.2 Masticatory muscle disorders*

a.Myalgia

b.Tendonitis

c.Myositis

d.Spasm

a.Muscle

b.Tendon

3.Hypertrophy

4.Neoplasms

a.Jaw

i.Malignant

i.Malignant

a.Orofacial dyskinesia

ii.Ataxia

iii.Subacute

ii.Benign

5.Movement disorders

b.Soft tissues of head, face and neck

i.Abnormal involuntary movements

ii.Benign

2.Contracture

**94**

ii.Deformans

6.Masticatory muscle pain attributed to systemic/central disorders

a.Fibromyalgia

b.Centrally mediated myalgia

*4.5.3 Masticatory muscle disorders*

1.Headache attributed to TMD

*4.5.4 Associated structures*

1.Coronoid hyperplasia
