Periodontitis and Sleep Disordered Breathing in the Hispanic Community Health Study/Study of Latinos

• Published in: Sleep (New York, N.Y.) N.Y.), 2015-08, Vol.38 (8), p.1195-1203
• Main Authors: Sanders, Anne E, Essick, Greg K, Beck, James D, Cai, Jianwen, Beaver, Shirley, Finlayson, Tracy L, Zee, Phyllis C, Loredo, Jose S, Ramos, Alberto R, Singer, Richard H, Jimenez, Monik C, Barnhart, Janice M, Redline, Susan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; C-Reactive Protein - analysis; Cross-Sectional Studies; Female; Health Surveys; Hispanic Americans - statistics & numerical data; Humans; Logistic Models; Male; Middle Aged; Odds Ratio; Periodontitis - complications; Periodontitis - diagnosis; Periodontitis - metabolism; Periodontitis and SDB in the Hispanic Community Health Study/Study of Latinos; Regression Analysis; Residence Characteristics; Risk Factors; Sleep; Sleep Apnea Syndromes - complications; Sleep Apnea Syndromes - diagnosis; Sleep Apnea Syndromes - metabolism; Sleep Apnea Syndromes - physiopathology; United States; Young Adult
• ISSN: 0161-8105; 1550-9109
• DOI: 10.5665/sleep.4890

To investigate the association between sleep disordered breathing (SDB) and severe chronic periodontitis. Cross-sectional data analysis from the Hispanic Community Health Study/Study of Latinos. Community-based setting with probability sampling from four urban US communities. 12,469 adults aged 18-74 y. None. Severe chronic periodontitis was defined using the Centers for Disease Control and Prevention/American Academy of Periodontology case classification based on full-mouth periodontal assessments performed by calibrated dentists. SDB was evaluated in standardized home sleep tests, and defined as the number of apnea plus hypopnea events associated with ≥ 3% desaturation, per hour of estimated sleep. SDB was quantified using categories of the apnea-hypopnea index (AHI): 0.0 events (nonapneic); 0.1-4.9 (subclinical); 5.0-14.9 (mild); and ≥ 15 (moderate/severe). Covariates were demographic characteristics and established periodontitis risk factors. C-reactive protein was a potential explanatory variable. Using survey estimation, multivariable binary logistic regression estimated odds ratios (OR) and 95% confidence limits (CL). Following adjustment for confounding, the SDB and periodontitis relationship remained statistically significant, but was attenuated in strength and no longer dose-response. Compared with the nonapneic referent, adjusted odds of severe periodontitis were 40% higher with subclinical SDB (OR = 1.4, 95% CL: 1.0, 1.9), 60% higher with mild SDB (OR = 1.6, 95% CL: 1.1, 2.2) and 50% higher with moderate/severe SDB (OR = 1.5, 95% CL: 1.0, 2.3) demonstrating an independent association between SDB and severe periodontitis. This study identifies a novel association between mild sleep disordered breathing and periodontitis that was most pronounced in young adults.