1061 Problems During Daytime Due To Poor Sleep Are Associated With Indicators Of Poor Dental Health In A Largely Non-smoking Population

Abstract

Abstract Introduction Growing evidence connects periodontal disease, a major and modifiable cause of local and systemic inflammation, with metabolic and cardiovascular morbidity and mortality, as well as mental illness. Sleep has been previously predictively associated with metabolic and psychiatric morbidity and mortality, and has recently been linked with periodontal disease. We are now evaluating associations between self-reported insomnia measures and surrogate indicators of periodontal disease in a population with a very low prevalence of smoking — a major confounder in previous studies. Methods Dental and sleep questionnaires (Pittsburgh Sleep Quality Index) were obtained from 3881 Old Order Amish from Lancaster county. Difficulty falling or staying asleep, sleep quality, problems during the day due to poor sleep, and sleepiness during daytime were related to self-reported loose teeth, partial dentures, full dentures and any dentures using linear models with adjustment for age and sex. Results Significant associations emerged between problems falling asleep and loose teeth (p<0.05), problems staying asleep and any dentures (p<0.05), sleep quality with loose teeth and partial, as well as complete dentures (p<0.05 for both). Problems during daytime due to poor sleep were associated with loose teeth (p<0.05), any dentures (p<0.003) and full dentures (p<0.0001 — the only associations resisting Bonferroni correction). Sleepiness during daytime, which is the most important marker associated with sleep apnea was not associated with any dental health measures. Conclusion Limitations include not accounting for family aggregation, limited generalizability, not fully differentiating between respiratory versus non-respiratory sleep impairment, and periodontal versus traumatic dental pathology. Yet, the results of our study, which minimizes the strong potential confounding by smoking, confirm associations between sleep-related problems and periodontal disease, and justify future longitudinal and interventional research to dissect causality and identify multi-target treatment modalities. Support This work was supported by the Mid-Atlantic Nutrition Obesity Research Center Preliminary Developmental NORC grant (Postolache, PI), a sub-award of the parent grant P30 DK072488 (Mitchell, PI), and intramural funds from the University of Maryland, Baltimore.