Associations between pain, depression, and sleep disturbance have been docu
mented in several chronic pain patient samples. The current study assessed
the prevalence and magnitude of sleep disturbance in a sample of 128 orofac
ial pain patients referred for clinical evaluation and tested linkages betw
een sleep, depression, anxiety. and pain using cross-sectional and longitud
inal data. Seventy-seven percent of the patients reported reduced sleep qua
ntity since pain onset. In cross-sectional analyses, reduced sleep quantity
was associated with depression and pain. Reduced sleep quality was associa
ted with negative affect. Longitudinally, initial depression and pain predi
cted sleep at time two and initial pain predicted negative affect. Sleep di
d not predict pain. Results support the hypothesis that pain, rather than s
leep disturbance, increases negative affect across time, whereas negative a
ffect is more a cause of concurrent reduced sleep quality than is pain. The
results highlight the importance of assessing for sleep disturbance in oro
facial pain patients.