Duration and quality of sleep in patients with periodontal health and with periodontitis

Abstract : Sleep is a key factor in human health. Lack of sleep is associated with many chronic diseases, including periodontal problems. Studies show that sleep disorders can worsen periodontal health and increase the risk of diseases such as gingivitis and periodontitis. The study aims to investigate the importance of sleep for periodontal health among patients aged 18 and older in the Republic of Bulgaria. Methods : In 2025, 504 patients were included in the current study. A detailed periodontal diagnosis and a survey with original questions and validated international instruments (Pittsburgh Sleep Quality Index) were performed. Results : The duration of sleep per day in the studied individuals varies substantially, from 3 to 12 hours. Most often, the night sleep lasted between 6 and 7 hours, in 59.4% of respondents. The examined women slept longer, about a quarter of an hour longer (p = 0.02). The study found approximately the same proportion of people without periodontitis (50.4%) and those with periodontitis at different clinical stages (49.6%). No significant differences were found in the average sleep duration in people without and those with periodontitis, as well as the time for falling asleep (p > 0.05). The entire score index for sleep quali­ty (PSQI) showed significantly lower values among patients with periodontitis (p = 0.049), indicating better sleep quality. Furthermore, patients with periodontitis were more prevalent in the group of PSQI < 5 (46.6% compared to 35.6% in the other group, p = 0.012). We further examined the differences in the questionnaire and found that patients with periodontitis had stayed awake less often. In addition, patients with periodontitis reported fewer sleep disturbance episodes. Conclusion : Periodontal diseases are common conditions and have socially significant potential due to the possibility of loss of dentition and changes in facial aesthetics. At the same time, there is a bidirectional relationship between sleep problems and the systemic response to untreated periodontal disease. Future studies are needed to establish the effect of insufficient sleep on the development and progression of periodontitis.