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Published on: January 21, 2020
Sleep Quality and Risk of Periodontal Disease: A Systematic Review and Meta-Analysis
Binbin Nan1, Jing Kang2, Honghui Wei3
1Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, China.
Objective:
Sleep regulates immune and inflammatory processes and may influence periodontal health, though evidence remains inconsistent. This meta-analysis evaluated the association between sleep characteristics, including sleep quality and sleep duration, and periodontal disease (PD).
Methods:
Systematic searches up tos May 2025 identified eligible studies. Sleep-related exposures were assessed using validated questionnaires or sleep duration (< 7 h); periodontal outcomes were defined by clinical examination or self-report. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a fixed or random effects model, depending on heterogeneity.
Results:
Fourteen studies (n = 126,425) met inclusion criteria, of which nine (n = 55,524) provided adjusted odds ratios for meta-analysis. Six assessed questionnaire-based sleep quality and three assessed sleep duration alone. Across these heterogeneous exposure definitions, adverse sleep characteristics were associated with greater odds of PD (OR = 1.25; 95% CI: 1.11-1.41; p < 0.001, I2 = 53.8%). Sensitivity analyses showed no substantial change in the pooled estimate, and no statistically significant evidence of publication bias was detected.
Conclusions:
Adverse sleep characteristics were associated with greater odds of PD, with a stronger association observed for severe periodontitis in subgroup analysis. However, the certainty of evidence was very low, and prospective studies are warranted to clarify causality.
