The Association Between Sleep Quality, Fatigue and Periodontal Status: a Pilot Study
DOI:
https://doi.org/10.15517/ijds.2023.54866Keywords:
Fatigue; Gingival healthy; Oral health-related quality of life; Periodontal disease; Stage-grade periodontitis; Sleep quality.Abstract
Reduced sleep duration, poor sleep quality and fatigue are related to reduced immunity and increased inflammatory markers. Due to its potential to influence inflammation, poor sleep quality and fatigue could be factors for periodontitis and quality of life. Ninety-three individuals with untreated periodontitis and thirty-one individuals with healthy gingiva were included in the study. The research involved a clinical examination and a questionnaire. Demographic information, information on oral health, oral hygiene habits, the Pittsburgh Sleep Quality Index, Jenkins Sleep Scale, Multidimensional Assessment of Fatigue Scale, and Oral Health Impact Profile-14 were included in the questionnaire. Patients were diagnosed based on the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. No statistically significant difference was revealed between sleep quality, fatigue, oral health related quality of life, and stage-grade of periodontitis (p<0.05). However, periodontitis group had higher Oral Health Impact Profile-14 scores (p<0.05). A statistically significantly lower sleep duration was observed in stage IV periodontitis group than the other groups (p<0.05). A statistically significant positive correlation was observed between the Pittsburgh Sleep Quality Index and the scores of the other questionnaires (p<0.05). The stage of periodontitis may impact sleep duration.
Downloads
References
Cekici A., Kantarci A., Hasturk H., Van Dyke T.E. Inflammatory and immune pathways in the pathogenesis of periodontal disease. Periodontol 2000. 2014; 64 (1): 57-80. DOI: https://doi.org/10.1111/prd.12002
Genco R.J., Borgnakke W.S. Risk factors for periodontal disease. Periodontol 2000. 2013; 62 (1): 59-94. DOI: https://doi.org/10.1111/j.1600-0757.2012.00457.x
Aldabal L., Bahammam A.S. Metabolic, endocrine, and immune consequences of sleep deprivation. Open Respir Med J. 2011; 5: 31-43. DOI: https://doi.org/10.2174/1874306401105010031
Chattu V.K., Manzar M.D., Kumary S., Burman D., Spence D.W., Pandi-Perumal S.R. The Global Problem of Insufficient Sleep and Its Serious Public Health Implications. Healthcare (Basel). 2018; 7 (1): 1. DOI: https://doi.org/10.3390/healthcare7010001
Grover V., Malhotra R., Kaur H. Exploring association between sleep deprivation and chronic periodontitis: A pilot study. Journal of Indian Society of Periodontology. 2015; 19 (3): 304. DOI: https://doi.org/10.4103/0972-124X.154173
Mullington J.M., Simpson N.S., Meier-Ewert H.K., Haack M. Sleep loss and inflammation. Best practice & research Clinical endocrinology & metabolism. 2010; 24 (5): 775-84. DOI: https://doi.org/10.1016/j.beem.2010.08.014
Milrad S.F., Hall D.L., Jutagir D.R., Lattie E.G., Ironson G.H., Wohlgemuth W., et al. Poor sleep quality is associated with greater circulating pro-inflammatory cytokines and severity and frequency of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) symptoms in women. Journal of neuroimmunology. 2017; 303: 43-50. DOI: https://doi.org/10.1016/j.jneuroim.2016.12.008
van Leeuwen W.M., Lehto M., Karisola P., Lindholm H., Luukkonen R., Sallinen M., et al. Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP. PloS one. 2009; 4 (2): e4589. DOI: https://doi.org/10.1371/journal.pone.0004589
Hossain J.L., Ahmad P., Reinish L.W., Kayumov L., Hossain N.K., Shapiro C.M. Subjective fatigue and subjective sleepiness: two independent consequences of sleep disorders? J Sleep Res. 2005; 14 (3): 245-53. DOI: https://doi.org/10.1111/j.1365-2869.2005.00466.x
Karshikoff B., Sundelin T., Lasselin J. Role of Inflammation in Human Fatigue: Relevance of Multidimensional Assessments and Potential Neuronal Mechanisms. Front Immunol. 2017; 8: 21. DOI: https://doi.org/10.3389/fimmu.2017.00021
Zhou F., Liu Z., Guo Y., Xu H. Association of short sleep with risk of periodontal disease: A meta-analysis and Mendelian randomization study. J Clin Periodontol. 2021; 48 (8): 1076-84. DOI: https://doi.org/10.1111/jcpe.13483
Alhassani A.A., Al-Zahrani M.S. Is inadequate sleep a potential risk factor for periodontitis? Plos one. 2020; 15 (6): e0234487. DOI: https://doi.org/10.1371/journal.pone.0234487
Iwasaki M., Usui M., Ariyoshi W., Nakashima K., Nagai-Yoshioka Y., Inoue M., et al. Sleep duration and severe periodontitis in middle-aged Japanese workers. J Clin Periodontol. 2022; 49 (1): 59-66. DOI: https://doi.org/10.1111/jcpe.13561
Han K., Park Y.-M., Park J.-B. Evaluation of an association between long sleep duration and periodontal disease among men and women using nationally representative data. Gaceta sanitaria. 2018; 32: 143-50. DOI: https://doi.org/10.1016/j.gaceta.2017.01.013
Romandini M., Gioco G., Perfetti G., Deli G., Staderini E., Laforì A. The association between periodontitis and sleep duration. Journal of clinical periodontology. 2017; 44 (5): 490-501. DOI: https://doi.org/10.1111/jcpe.12713
Islam M.M., Ekuni D., Toyama N., Taniguchi-Tabata A., Kataoka K., Uchida-Fukuhara Y., et al. Association between sleep quality and duration and periodontal disease among university students: a cross-sectional study. International journal of environmental research and public health. 2020; 17 (9): 3034. DOI: https://doi.org/10.3390/ijerph17093034
Beydoun H.A., Hossain S., Beydoun M.A., Weiss J., Zonderman A.B., Eid S.M. Periodontal disease, sleep duration, and white blood cell markers in the 2009 to 2014 National Health and Nutrition Examination Surveys. J Periodontol. 2020; 91 (5): 582-95. DOI: https://doi.org/10.1002/JPER.19-0055
Wiener R.C. Relationship of routine inadequate sleep duration and periodontitis in a nationally representative sample. Sleep disorders. 2016; 2016: 9158195. DOI: https://doi.org/10.1155/2016/9158195
Karaaslan F., Dikilitaş A. The association between stage-grade of periodontitis and sleep quality and oral health-related quality of life. Journal of periodontology. 2019; 90 (10): 1133-41. DOI: https://doi.org/10.1002/JPER.19-0034
Tawfig A., Alamoudi T.A., Alqassab G.A., Aljabbary R.S., Aldosari M.A., Alamoudi M.A. Association between Sleep Quality and Severity of Periodontitis. Tobacco Regulatory Science. 2021; 7 (6): 7592-9.
Kadim N.M., LaftaAbdulla W., Abd S.T. Is there Any Correlation between Periodontal Diseases and Sleeping. Indian Journal of Forensic Medicine & Toxicology. 2020; 14 (1): 574-80.
Stepnowsky C.J., Palau J.J., Zamora T., Ancoli-Israel S, Loredo JS. Fatigue in sleep apnea: the role of depressive symptoms and self-reported sleep quality. Sleep Med. 2011; 12 (9): 832-7. DOI: https://doi.org/10.1016/j.sleep.2011.07.004
Mills P.J., Kim J.H., Bardwell W., Hong S., Dimsdale J.E. Predictors of fatigue in obstructive sleep apnea. Sleep Breath. 2008; 12 (4): 397-9. DOI: https://doi.org/10.1007/s11325-008-0192-8
Nakada T., Kato T., Numabe Y. Effects of fatigue from sleep deprivation on experimental periodontitis in rats. Journal of periodontal research. 2015; 50 (1): 131-7. DOI: https://doi.org/10.1111/jre.12189
Jo J.-Y., Jeong J.-H., Lee S.-Y., Kwun H.-S., Park K.-L., Urm S.-H., et al. Influences of stress and fatigue on periodontal health indicators in patients with periodontal disease. Journal of Korean Society of Dental Hygiene. 2016; 16 (2): 225-31. DOI: https://doi.org/10.13065/jksdh.2016.16.02.225
Baiju R., Peter E., Varghese N., Sivaram R. Oral health and quality of life: current concepts. Journal of clinical and diagnostic research: JCDR. 2017; 11 (6): ZE21. DOI: https://doi.org/10.7860/JCDR/2017/25866.10110
Petersen P.E. The World Oral Health Report 2003: continuous improvement of oral health in the 21st century-the approach of the WHO Global Oral Health Programme. Community Dentistry and oral epidemiology. 2003; 31: 3-24. DOI: https://doi.org/10.1046/j..2003.com122.x
Durham J., Fraser H.M., McCracken G.I., Stone K.M., John M.T., Preshaw P.M. Impact of periodontitis on oral health-related quality of life. Journal of dentistry. 2013; 41 (4): 370-6. DOI: https://doi.org/10.1016/j.jdent.2013.01.008
Papapanou P.N., Sanz M., Buduneli N., Dietrich T, Feres M, Fine DH, et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of periodontology. 2018; 89: S173-S82. DOI: https://doi.org/10.1002/JPER.17-0721
Silness J., Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontológica Scandinavica.1964; 22 (1): 121-35. DOI: https://doi.org/10.3109/00016356408993968
Löe H., Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontológica Scandinavica. 1963; 21 (6): 533-51. DOI: https://doi.org/10.3109/00016356309011240
Tonetti M.S., Greenwell H., Kornman K.S. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Periodontology.2018; 89: S159-S72. DOI: https://doi.org/10.1002/JPER.18-0006
Chapple I.L., Mealey B.L., Van Dyke T.E., Bartold P.M., Dommisch H., Eickholz P., et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Periodontology. 2018; 89: S74-S84. DOI: https://doi.org/10.1002/JPER.17-0719
Chien K.-L., Chen P.-C., Hsu H.-C., Su T.-C., Sung F.-C., Chen M.-F., et al. Habitual sleep duration and insomnia and the risk of cardiovascular events and all-cause death: report from a community-based cohort. Sleep. 2010; 33 (2): 177-84. DOI: https://doi.org/10.1093/sleep/33.2.177
Kim H., Joo E., Suh S., Kim J.H., Kim S.T., Hong S.B. Effects of long-term treatment on brain volume in patients with obstructive sleep apnea syndrome. Human brain mapping. 2016; 37 (1): 395-409. DOI: https://doi.org/10.1002/hbm.23038
Unal-Ulutatar C., Ozsoy-Unubol T. Psychometric properties of Turkish version of Jenkins sleep scale in fibromyalgia syndrome. Adv Rheumatol. 2020; 60 (1): 22. DOI: https://doi.org/10.1186/s42358-020-0123-3
Belza B.L. Comparison of self-reported fatigue in rheumatoid arthritis and controls. J Rheumatol. 1995; 22 (4): 639-43.
Yildirim Y., Ergin G. A validity and reliability study of the Turkish Multidimensional Assessment of Fatigue (MAF) scale in chronic musculoskeletal physical therapy patients. J Back Musculoskelet Rehabil. 2013; 26 (3): 307-16. DOI: https://doi.org/10.3233/BMR-130385
Slade G.D., Spencer A.J. Development and evaluation of the oral health impact profile. Community Dental Health. 1994; 11 (1): 3-11.
Mumcu G., Inanc N., Ergun T., Ikiz K., Gunes M., Islek U., et al. Oral health related quality of life is affected by disease activity in Behçet's disease. Oral Diseases.2006;12 (2):145-51. DOI: https://doi.org/10.1111/j.1601-0825.2005.01173.x
Duruöz M.T., Erdem D., Gencer K., Ulutatar F., Baklacıoğlu H.Ş. Validity and reliability of the Turkish version of the Jenkins Sleep Scale in psoriatic arthritis. Rheumatology International. 2018; 38 (2): 261-5. DOI: https://doi.org/10.1007/s00296-017-3911-2
Aluckal E., editor Association between sleep deprivation and chronic periodontitis among beedi workers of Mangalore city. Journal of Sleep Research; 2016; 25: 134. WILEY-BLACKWELL 111 RIVER ST, HOBOKEN 07030-5774, NJ USA.
Singh V.P., Gan J.Y., Liew W.L., Soe H.H.K., Nettem S., Nettemu S.K. Association between quality of sleep and chronic periodontitis: A case-control study in Malaysian population. Dental research journal. 2019; 16 (1): 29. DOI: https://doi.org/10.4103/1735-3327.249555
Bower J.E., Ganz P.A., Tao M.L., Hu W., Belin T.R., Sepah S., et al. Inflammatory Biomarkers and Fatigue during Radiation Therapy for Breast and Prostate CancerInflammation and Fatigue during Radiation Therapy. Clinical Cancer Research. 2009;15 (17): 5534-40. DOI: https://doi.org/10.1158/1078-0432.CCR-08-2584
Liu L., Mills P.J., Rissling M., Fiorentino L., Natarajan L., Dimsdale J.E., et al. Fatigue and sleep quality are associated with changes in inflammatory markers in breast cancer patients undergoing chemotherapy. Brain, behavior, and immunity. 2012; 26 (5): 706-13. DOI: https://doi.org/10.1016/j.bbi.2012.02.001
Levkovich I., Cohen M., Alon S., Kuchuk I., Nissenbaum B., Evron E., et al. Symptom cluster of emotional distress, fatigue and cognitive difficulties among young and older breast cancer survivors: The mediating role of subjective stress. J Geriatr Oncol. 2018; 9 (5): 469-75. DOI: https://doi.org/10.1016/j.jgo.2018.05.002
Beşiroğlu E., Lütfioğlu M. Relations between periodontal status, oral health-related quality of life and perceived oral health and oral health consciousness levels in a Turkish population. International journal of dental hygiene. 2020; 18 (3): 251-60. DOI: https://doi.org/10.1111/idh.12443
Grandner M.A., Petrov M.E.R., Rattanaumpawan P., Jackson N., Platt A., Patel N.P. Sleep symptoms, race/ethnicity, and socioeconomic position. Journal of clinical sleep medicine. 2013; 9 (9): 897-905. DOI: https://doi.org/10.5664/jcsm.2990
Published
Issue
Section
License
Copyright (c) 2023 CC-BY-NC-SA 4.0

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
ODOVTOS - Int. J. Dent. Sc. endorses CC BY-NC-SA
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements:
BY: credit must be given to the creator.
NC: Only noncommercial uses of the work are permitted.
SA: Adaptations must be shared under the same terms.



