The Association Between Sleep Status And Periodontitis: A Preliminary Study

To analyze the association between sleep status and periodontitis through comprehensive assessment of general patient characteristics, oral hygiene habits via questionnaire, Pittsburgh Sleep Quality Index (PSQI) screening, periodontal clinical parameters, detection of periodontal pathogens in subgingival plaque, and inflammatory cytokine levels in gingival crevicular fluid (GCF). This study used a cross-sectional design approved by the ethics committee. It enrolled 105 newly-diagnosed periodontitis patients (from January 2023 to October 2024) divided into normal sleep (PSQI≤5, n=51) and sleep disorder (PSQI>5, n=54) groups. Subgingival plaque samples from 34 randomly selected cases underwent 16S DNA sequencing for microbial community analysis. GCF was assayed for RANKL, OPG, IL-1β, and TNF-α concentrations using ELISA. Florida probe measurements recorded probing depth (PD) and clinical attachment loss (CAL). Correlations between sleep status, periodontitis severity, and GCF cytokines were analyzed finally. The sleep disorder group had more severe periodontal tissue destruction (higher PD and CAL), poorer oral hygiene, and higher abundance of Tannerella forsythia and Treponema lecithinolyticum. KEGG pathway analysis showed upregulation of oxidative phosphorylation and arachidonic acid metabolism in this group. The normal sleep group had higher GCF OPG levels but lower RANKL/OPG, IL-1β, and TNF-α concentrations. PSQI was positively correlated with RANKL, IL-1β, RANKL/OPG, periodontitis stage, PD, and CAL. Sleep disorders may drive the progression of periodontitis by changing the ecology of subgingival flora and oral hygiene habits, activating host proinflammatory pathways and bone metabolism imbalance.