Investigation of the relationship between sleep disorders and xerostomia

  • Ioulianos Apessos
  • Dimitrios AndreadisEmail author
  • Paschalis Steiropoulos
  • Dimitrios Tortopidis
  • Lefteris Angelis
Original Article



To investigate the relationship between sleep disorders, morning hyposalivation, and subjective feeling of dry mouth.

Materials and methods

A cross-sectional, observational, clinical study was carried out in a homogenous population sample which consists of Greek male soldiers without any medical history. After the application of oral modified Schirmer test, the sample was divided into a study group (n = 63) (MST < 25 mm/3 min) and a control group (n = 110) (MST ≥ 25 mm/3 min). In order to assess daytime sleepiness, risk of obstructive sleep apnea (OSA), sleep quality, sleep bruxism (SB), and subjective feeling of dry mouth, all the participants filled in the following scales in Greek version: Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire (BQ), a SB questionnaire, and Xerostomia Inventory (XI) respectively. In every subgroup that came of ESS, PSQI, BQ, and SB questionnaire scoring, subjective feeling of dry mouth was evaluated, based on XI values.


Statistically significant difference (p < 0.001) through PSQI scores was found between the study and control group. In contrast, a statistically significant difference was not obtained for the scores of ESS (p = 0.293), BQ (p = 0.089), and SB questionnaire (p = 0.730). XI scores introduced statistically significant difference between the subgroups of PSQI (p < 0.001), BQ (p = 0.001), SB questionnaire (p = 0.004)  and statistically weak between the subgroups of ESS (p = 0.049).


This is the first research study so far suggesting that patients with morning hyposalivation exhibit poor sleep quality using an objective method. The present results have, also, shown that subjective feeling of dry mouth is related to excessive daytime sleepiness, poor sleep quality, high risk of obstructive sleep apnea, and sleep bruxism, but larger-scale studies are still needed.

Clinical Relevance

These findings should keep dentists aware of a possible association between xerostomia and sleep disorders and support larger-scale studies.


Sleep disorders Morning hyposalivation Oral modified Schirmer test Bruxism Xerostomia 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures in this research were performed in accordance with the ethical standards of the Sanitary Division of the Army General Staff by order Φ.040/72/955261/Σ.4721/29Νοε17/ΓΕΣ/ΔΥΓ of the Institutional Research standards of Medical School, Democritus University of Thrace, Alexandroupolis, and with 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Ioulianos Apessos
    • 1
  • Dimitrios Andreadis
    • 2
    Email author
  • Paschalis Steiropoulos
    • 3
  • Dimitrios Tortopidis
    • 4
  • Lefteris Angelis
    • 5
  1. 1.212 Military Hospital of XanthiXanthiGreece
  2. 2.Department of Oral Medicine/Pathology, School of DentistryAristotle University of ThessalonikiThessalonikiGreece
  3. 3.Department of Pneumonology, Medical SchoolDemocritus University of ThraceAlexandroupolisGreece
  4. 4.Department of Prosthodontics, School of DentistryAristotle University of ThessalonikiThessalonikiGreece
  5. 5.School of Informatics, Faculty of SciencesAristotle University of ThessalonikiThessalonikiGreece

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