Periodontitis and sleep disordered breathing in the Hispanic Community Health Study/Study of Latinos

Anne E. Sanders*, Greg K. Essick, James D. Beck, Jianwen Cai, Shirley Beaver, Tracy L. Finlayson, Phyllis C. Zee, Jose S. Loredo, Alberto R. Ramos, Richard H. Singer, Monik C. Jimenez, Janice M. Barnhart, Susan Redline

*Corresponding author for this work

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Study Objectives: To investigate the association between sleep disordered breathing (SDB) and severe chronic periodontitis. Design: Cross-sectional data analysis from the Hispanic Community Health Study/Study of Latinos. Setting: Community-based setting with probability sampling from four urban US communities. Participants: 12,469 adults aged 18-74 y. Interventions: None. Measurements and Results: Severe chronic periodontitis was defined using the Centers for Disease Control and Prevention/American Academy of Periodontology case classification based on full-mouth periodontal assessments performed by calibrated dentists. SDB was evaluated in standardized home sleep tests, and defined as the number of apnea plus hypopnea events associated with ≥ 3% desaturation, per hour of estimated sleep. SDB was quantified using categories of the apnea-hypopnea index (AHI): 0.0 events (nonapneic); 0.1-4.9 (subclinical); 5.0-14.9 (mild); and ≥ 15 (moderate/severe). Covariates were demographic characteristics and established periodontitis risk factors. C-reactive protein was a potential explanatory variable. Using survey estimation, multivariable binary logistic regression estimated odds ratios (OR) and 95% confidence limits (CL). Following adjustment for confounding, the SDB and periodontitis relationship remained statistically significant, but was attenuated in strength and no longer dose-response. Compared with the nonapneic referent, adjusted odds of severe periodontitis were 40% higher with subclinical SDB (OR = 1.4, 95% CL: 1.0, 1.9), 60% higher with mild SDB (OR = 1.6, 95% CL: 1.1, 2.2) and 50% higher with moderate/severe SDB (OR = 1.5, 95% CL: 1.0, 2.3) demonstrating an independent association between SDB and severe periodontitis. Conclusions: This study identifies a novel association between mild sleep disordered breathing and periodontitis that was most pronounced in young adults.

Original languageEnglish (US)
Pages (from-to)1195-1203
Number of pages9
JournalSleep
Volume38
Issue number8
DOIs
StatePublished - Aug 1 2015

Keywords

  • Apnea-hypopnea index
  • Epidemiology
  • Hispanic
  • Periodontal disease
  • Survey

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology (medical)

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    Sanders, A. E., Essick, G. K., Beck, J. D., Cai, J., Beaver, S., Finlayson, T. L., Zee, P. C., Loredo, J. S., Ramos, A. R., Singer, R. H., Jimenez, M. C., Barnhart, J. M., & Redline, S. (2015). Periodontitis and sleep disordered breathing in the Hispanic Community Health Study/Study of Latinos. Sleep, 38(8), 1195-1203. https://doi.org/10.5665/sleep.4890