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Association of Sleep Duration with Tooth Loss and Periodontitis: Insights from the National Health and Nutrition Examination Surveys (2005-2020)

  • Dentistry • Original Article
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Abstract

Objective

Sleep disorders such as insomnia, apnea, and restless leg syndrome can negatively affect a person’s overall health and may cause hypertension, heart failure, and coronary heart disease. Likewise, periodontitis, a gum disease, can lead to both physical and psychological health issues, exerting a considerable effect on one's overall well-being—periodontitis stands as a primary cause of tooth loss. Nevertheless, there has been insufficient research on the correlation between the amount of sleep individuals get and the occurrence of periodontitis/tooth loss among Americans. Therefore, this study aimed to assess the influence of sleep length on periodontitis in the American population.

Methods

Periodontitis severity was classified (none, mild, moderate, and severe) using American Periodontal Association criteria. Sleep duration was assessed by self-reported data and categorized into three groups (deficient, adequate, and excessive). Tooth loss was assessed by the oral examination. To establish a connection between the duration of sleep and periodontitis/tooth loss, a weighted multivariable logistic regression analysis was employed. A GAM analysis and smooth curve fitting assessment were conducted to identify non-linear relationships. Subgroup, interaction, and mediation analyses were also performed.

Results

The prevalence of tooth loss was significantly high, affecting 96.4% of the individuals, whereas 46.6% of the study sample experienced moderate to severe periodontitis. The average age of participants was 52.7 years. After adjusting for potential confounding factors, the analysis of weighted multivariable logistic regression revealed a significant association between sleep insufficiency and moderate/severe periodontitis (OR 1.15, 95% CI 1.01–1.30, P = 0.0298), as well as tooth loss (OR 1.16, 95% CI 1.01–1.33, P = 0.0371). Additionally, the research showed a correlation between the length of sleep and periodontitis that followed a U-shaped pattern. In addition, the analysis of mediation revealed that high blood pressure explained 7.0% (95% CI 4.0% to 12.9%; P < 0.0001) of the link between the amount of sleep and the likelihood of losing teeth.

Conclusion

Sleep duration was independently correlated with moderate/severe periodontitis/tooth loss and had a non-linear relationship.

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Data availability

The data supporting the findings of this study are available from the corresponding author upon request.

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Acknowledgements

The authors would like to thank the NHANES and its anonymous participants.

Funding

The works were supported by the Guizhou Provincial Science and Technology Plan Project, Qiankehe Foundation-ZK[2023] General Project 538.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China

    Manyi Liu, Yadong Wu, Jukun Song & Wei He

  2. Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China

    Manyi Liu, Yadong Wu, Jukun Song & Wei He

Authors
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Contributions

J.K.S, W.H, and M.Y.L wrote the main manuscript text. J.K.S and Y.D.W prepared Figs. 1, 2, 3, 4, 5, 6, and 7. J.K.S contributed to data analysis. All authors reviewed the manuscript.

Corresponding authors

Correspondence to Jukun Song or Wei He.

Ethics declarations

Ethics approval and consent to participate

NHANES protocol approved by NCHS Research Ethics Review Board, and obtained informed consent from all participants (https://www.cdc.gov/nchs/nhanes/irba98.htm). And all methods were performed in accordance with the Declaration of Helsinki.

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Not applicable.

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The authors declare that they have no competing interests.

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Liu, M., Wu, Y., Song, J. et al. Association of Sleep Duration with Tooth Loss and Periodontitis: Insights from the National Health and Nutrition Examination Surveys (2005-2020). Sleep Breath 28, 1019–1033 (2024). https://doi.org/10.1007/s11325-023-02966-2

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  • DOI: https://doi.org/10.1007/s11325-023-02966-2

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