Beyond the Mouth: Oral Health-Related Quality of Life and Emotional Loneliness in Later Life and Their Associations With Sleep Quality and Dream Recall

Background Oral health-related quality of life (OHRQoL) is important in healthy aging, but its associations with emotional loneliness, sleep, and dream recall remain unclear. Objective To examine these associations in community-dwelling older adults. Methods This cross-sectional study included 609 adults aged ≥60 years in Greece. OHRQoL was assessed using the Geriatric Oral Health Assessment Index and emotional loneliness using the three-item Emotional Loneliness subscale of the De Jong Gierveld Loneliness Scale. Sleep quality, sleep sufficiency, daytime napping, and dream recall were assessed using brief self-report items. Pearson correlations and hierarchical regressions adjusted for age and gender were conducted. Results Better OHRQoL was associated with lower emotional loneliness (r=−0.329, p<0.001) and with a more favorable subjective sleep appraisal, as reflected by the nearly indistinguishable sleep sufficiency (r=0.146, p<0.001) and sleep quality items (r=0.135, p<0.001; inter-item r=0.989). Better OHRQoL was also associated with less frequent daytime napping (r=−0.105, p<0.01) and more frequent dream recall (r=0.104, p<0.05). Emotional loneliness was associated with lower sleep sufficiency and poorer sleep quality, but not with dream recall. In adjusted models, OHRQoL was associated with better sleep quality (β=0.101, p=0.018) and showed a small nominal association with dream recall (β=0.091, unadjusted p=0.032). Emotional loneliness was associated with poorer sleep quality (β=−0.182, p<0.001). Gender was associated with both outcomes, with women reporting poorer sleep quality but more frequent dream recall. No correction for multiple comparisons was applied; therefore, the dream recall finding should be regarded as exploratory and susceptible to Type I error. Conclusion The clearest finding was the association between better OHRQoL and lower emotional loneliness. The association with sleep quality was smaller, whereas the dream recall finding was very weak, based on a single nonvalidated item, and may reflect measurement error or Type I error. These cross-sectional findings support a cautious biopsychosocial view of OHRQoL but do not permit causal or clinical conclusions. Replication using validated measures, prespecified analyses, and multiple-testing correction is required.