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Inflammation, Hypoxia, and Periodontal Breakdown: The Association Between Obstructive Sleep Apnea and Periodontitis;
Fariba Esperouz1, Mauro Lorusso1, Giuseppina Raffaella Giannini1
1Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
Clinical and Experimental Dental Research
|July 19, 2026
Summary
Obstructive sleep apnea (OSA) significantly increases the risk of developing periodontitis, more than doubling the likelihood. This systematic review highlights a moderate positive association between OSA and periodontal disease severity, underscoring a link between sleep and oral health.
Area of Science:
- Oral Health and Sleep Medicine
- Systematic Review and Meta-Analysis
Background:
- Obstructive sleep apnea (OSA) is a prevalent condition with systemic health implications.
- Periodontitis is a common inflammatory oral disease with significant public health impact.
Purpose of the Study:
- To systematically review and meta-analyze the association between obstructive sleep apnea and periodontitis.
- To quantify the magnitude of the relationship between OSA and periodontitis.
Main Methods:
- Systematic literature search across major databases (PubMed, Scopus, Web of Science) up to November 2025.
- Inclusion of observational studies on adults, assessing study quality with ROBINS-I.
- Random-effects meta-analysis of odds ratios (ORs) and correlation coefficients (r).
Main Results:
- Twenty-three studies included in qualitative synthesis; 18 in quantitative analysis.
- OSA significantly associated with increased periodontitis risk (OR = 2.22; 95% CI: 1.78-2.77).
- Moderate positive association between OSA and periodontal disease severity (r = 0.39; 95% CI: 0.17-0.58).
Conclusions:
- Evidence supports a significant association between obstructive sleep apnea and periodontitis.
- Patients with OSA have over double the risk of developing periodontal disease.
- Interdisciplinary management is recommended for comprehensive care.
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