In the months before TMD onset, sleep quality (A) and perceived stress (B) worsened for participants who became incident cases, relative to noncases. Plotted values are mean (± standard error; se) Sleep Quality Numeric Rating score, which has a potential range of 0 to 10 (A) and mean (± se) PSS score, which has a potential range of 0 to 40 (B). Data are from a nested case-control study of 258 future cases and noncase pairs matched according to study site, baseline PSS score, and number of completed Quarterly Health Update questionnaires. Statistically significant differences between future incident cases and noncases in perceived stress and sleep quality were evident in the 2 or 3 quarters before censoring as indicated by asterisk (*) symbols.