1. In this cross-sectional study, there was a significant association between insufficient sleep duration and the presence of moderate or severe periodontitis and tooth loss.
2. Furthermore, both insufficient and excessive sleep were associated with increasing periodontitis.
Evidence Rating Level: 3 (Average)
Periodontitis is a highly prevalent condition and is the main cause of tooth loss. Periodontitis and tooth loss can precipitate other problems, such as sleep disruption, low mood, and cognitive impairments. Sleep loss can be an outcome of periodontitis and tooth loss but can also be a precipitant of this condition. Sleep loss is known to activate inflammatory pathways, which can contribute to oral disease. Although several studies have identified a link between periodontitis and sleep loss, little research has been done to investigate the link between sleep duration and the development and progression of periodontitis. Therefore, the present study aimed to assess the association between sleep duration and periodontitis and investigate the factors affecting this relationship.
This cross-sectional study included 35,636 participants who completed the National Health and Nutrition Examination Surveys (NHANES) between 2005 and 2020. Participants were excluded from the analysis if they were under 30 years old, or if they had missing data regarding sleep duration, periodontal examinations, or relevant covariates. Data on sleep duration was determined from the NHANES and participants were classified into one of four groups: insufficient sleep (2-6 hours), adequate sleep (7-8 hours), excessive (9-12 hours), and continuous. Information on periodontitis was also obtained from the NHANES and participants were classified as having none, mild, moderate, or severe periodontitis based on the American Periodontal Association criteria. The primary outcomes were periodontitis and tooth loss.
The results demonstrated that there was a significant association between insufficient sleep duration and the presence of both moderate to severe periodontitis and tooth loss. There was a U-shaped pattern between sleep duration and periodontitis—periodontitis was most prevalent in those with inadequate or excessive sleep and lowest in those with adequate sleep. In looking at mediating factors, it was found that blood pressure explained approximately 7% of the relationship between sleep duration and tooth loss. However, the study was limited by the use of self-reported measures for sleep duration, which may have introduced bias. Nonetheless, the present study demonstrated that sleep duration is closely associated with periodontitis and tooth loss.
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