Association between obstructive sleep apnea and periodontitis in Chinese male adults: A cross-sectional study

Abstract

STATEMENT OF PROBLEM: An association between obstructive sleep apnea and periodontitis has been suggested, but supporting data are lacking. PURPOSE: The purpose of this cross-sectional study was to investigate any association between obstructive sleep apnea and periodontitis in Chinese male adults. MATERIAL AND METHODS: Ninety-three male adults (aged between 24 and 35 years) were recruited and examined between June and September 2019. Obstructive sleep apnea was diagnosed by using portable, overnight polysomnography, and all participants were classified into study and control groups based on the apnea-hypopnea index. Periodontal examinations were conducted before polysomnography measuring probing depth, clinical attachment level, and bleeding on probing. An objective nasal airway resistance assessment was also performed before polysomnography to quantify mouth breathing during sleep. RESULTS: Overall, 40 (43.0%) participants had periodontitis, and 19 (20.4%) had obstructive sleep apnea; in those diagnosed with periodontitis, 13 of 40 (32.5%) also had obstructive sleep apnea. Obstructive sleep apnea was positively associated with periodontitis (odds ratio =3.719, 95% CI=1.234 to 11.209, P=.020). The obstructive sleep apnea group showed significantly higher bleeding on probing (P=.034) and clinical attachment level (P=.046). Correlation analysis showed a weak but positive correlation between the severity of obstructive sleep apnea and that of periodontitis. The regression analysis identified the lowest oxygen saturation (odds ratio=0.894, 95% CI=0.842 to 0.949, P=.002) to be significantly associated with the prevalence of periodontitis. CONCLUSIONS: A significant association was observed between obstructive sleep apnea and periodontitis. Low oxygen saturation might be a predictive index for periodontitis, suggesting that hypoxia caused by obstructive sleep apnea might be related to the symptoms of periodontitis.