A Qualitative Systematic Review of the Association of Sleep Disturbances with Burning Mouth Syndrome: An Overlooked Relationship

Objectives: To review the relevant literature to assess if patients with burning mouth syndrome (BMS) are more prone to have sleep disturbances than general population. Methods: The literature search for relevant articles was from July 2020 to March 2021. A systematic search of PubMed, Embase, Google Scholar, Cochrane library, Dentistry & Oral Sciences Source, and Scopus was conducted to search for relevant studies. The quality of studies was assessed in accordance with the Joanna Briggs Institute’s guidelines and using the software SUMARI – The System for the Unified Management, Assessment and Review of Information. Confidence in the findings was assessed using the GRADE‐CERQual approach. Results: A total of 1064 studies were initially identified from the search; 6 studies, two cross-sectional and 4 case controls, met the inclusion criteria and were selected for this systematic review. Sleep disturbances was a required outcome measured in selected studies evaluating symptoms of BMS. For studies that were included in the final analyses, BMS was found to relate to several dimensions of sleep including sleep disturbance and duration (n=6), sleep affecting day-time function (n=4), sleep quality (n=6), sleep efficiency (n=4), and ability to fall asleep (n=4). Consistent evidence of moderate confidence found that BMS was associated with greater sleep disturbance, reduced sleep quality, increased time taken to fall asleep, reduced sleep efficiency, and poor day-time function. Whereas evidence of low confidence was found regarding the association of BMS with reduced sleep duration. Conclusions: Although the presented studies could not establish a direct causal relationship between BMS and sleep disturbances, it revealed that sleep disturbance can be a risk factor or/and an aggravator of BMS symptoms. Medications and psychological management strategies to improve sleep may be considered in future research for managing BMS patients