Association between severe periodontitis and sleep quality: Results from the NHANES, 2009–2014

Periodontitis has a high global prevalence, and sleep may impact both the occurrence and the severity of the condition. With an emphasis on sex disparities, this study examined the association between sleep and severe periodontitis in a population sample that was representative of the United States. This study used a sample of 5495 people from the National Health and Nutrition Examination Survey (NHANES) and conducted univariate and multivariate logistic regression analyses before and after adjusting for age, sex, ethnicity, poverty-income ratio (PIR), body mass index (BMI), smoking status, and diabetes mellitus (DM) status. Furthermore, this study included a stratified sex-based analysis to investigate potential sex differences between severe periodontitis and sleep. The results are presented with odds ratios (ORs) and 95% confidence intervals (95% CIs). The results of multivariate logistic regression revealed a significant association between the recommended sleep duration each night (seven to nine hours) and the prevalence of severe periodontitis in women (OR_ad = 0.68, p = 0.003). Furthermore, in women, urinating twice or three times per night was significantly associated with severe periodontitis (OR_ad = 1.44, p = 0.011), whereas the association was more significant in women who urinated at least four times per night (OR_ad = 1.68, p = 0.035). In men, these associations were not observed. There was no significant association between poor sleep quality and severe periodontitis, but the association differed by sex. Severe periodontitis in women was found to be significantly associated with poor sleep quality, but not in men.