Relationship Between Posture During Sleep, Otological Symptoms, Psychological Factors, Bruxism, and Sleep Disturbances in Patients with Temporomandibular Disorder: A Clinical Trial Focused on Self-Care

Objective: To evaluate the effects of posture during sleep on otological symptoms (such as tinnitus and ear fullness), psychological factors, bruxism, and sleep disorders in patients with temporomandibular disorders (TMD) undergoing an educational intervention based on self-care. Methods: Prospective single-arm clinical trial with 36 participants diagnosed with joint TMD and self-reported otological symptoms. Patients were stratified into three groups based on self-reported posture during sleep: “Never Had the Habit” (without mandibular support), “Kept the Habit” (with mandibular support), and “Quit the Habit” (with support, but quit). The intervention consisted of an initial 90-minute session and two 40-minute reinforcement sessions, focusing on sleep hygiene, self-management strategies for bruxism, and management of psychological factors. Data was collected at four time points: baseline (T0), 30 days (T1), 60 days (T2), and 180 days (T3). Statistical analysis used repeated measures ANOVA with Greenhouse-Geisser correction and post-hoc comparisons with Bonferroni. Effect sizes were calculated using partial eta-square (η²p). Results: There was a significant reduction in tinnitus intensity over time (F (3, 99) =56.2; p