Association of Obstructive Sleep Apnea in Periodontitis Patients with and Without Type 2 Diabetes Mellitus: An Observational Study

Abstract Aim: The aim of this study was to evaluate the prevalence of Obstructive Sleep Apnea (OSA) within the general population and investigate its association with periodontitis in patients with and without Type 2 Diabetes Mellitus (T2DM). Materials and Methods: A total of 120 patients were enrolled and divided into three groups: Group A (control), consisting of patients with gingivitis; Group B, consisting of patients with periodontitis; and Group C, consisting of patients with both periodontitis and T2DM. Each group contained 40 participants. A detailed oral history was collected from all participants, including information on diabetes, smoking, and alcohol consumption. The Berlin questionnaire was administered to assess the risk of OSA. Baseline periodontal parameters were recorded for each participant. Results: Among the study groups, 52.5% of patients in Group B (periodontitis) and 82.5% in Group C (periodontitis with T2DM) were identified as having a high risk for OSA. Among smokers, 33% in Group B and 59% in Group C were at high risk for OSA, whereas only 8% of smokers in Group A exhibited a high risk. Additionally, 60% of individuals who consumed alcohol were categorized as high risk for OSA. Multivariate regression analysis showed a significant association between periodontitis and OSA risk, with the highest risk observed in individuals with both periodontitis and T2DM ( P < 0.05). Conclusion: This study indicates that patients with periodontitis are at a significantly higher risk for OSA, with the risk elevated even further in patients with both periodontitis and T2DM. These findings underscore the need for heightened awareness and potential screening for OSA in individuals with periodontitis, particularly those with additional risk factors such as T2DM, smoking, and alcohol consumption. Early detection and referral for sleep studies can help mitigate the potential systemic impacts of untreated OSA, such as cardiovascular disease, hypertension, and metabolic disturbances. Additionally, clinicians should consider integrating screenings for OSA into routine periodontal care, particularly for patients with known risk factors. Longitudinal studies are needed to evaluate whether the treatment of periodontitis can improve OSA outcomes and whether early intervention for OSA can positively affect periodontal health and overall systemic health.