Sleep Quality and Risk of Periodontal Disease: A Systematic Review and Meta‐Analysis
Binbin Nan, Jing Kang, Honghui Wei, Xiaojun Li, Qianming Chen, Zijian ChengABSTRACT
Objective
Sleep regulates immune and inflammatory processes and may influence periodontal health, though evidence remains inconsistent. This meta‐analysis evaluated the association between sleep characteristics, including sleep quality and sleep duration, and periodontal disease (PD).
Methods
Systematic searches up tos May 2025 identified eligible studies. Sleep‐related exposures were assessed using validated questionnaires or sleep duration (< 7 h); periodontal outcomes were defined by clinical examination or self‐report. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a fixed or random effects model, depending on heterogeneity.
Results
Fourteen studies ( n = 126,425) met inclusion criteria, of which nine ( n = 55,524) provided adjusted odds ratios for meta‐analysis. Six assessed questionnaire‐based sleep quality and three assessed sleep duration alone. Across these heterogeneous exposure definitions, adverse sleep characteristics were associated with greater odds of PD (OR = 1.25; 95% CI: 1.11–1.41; p < 0.001, I 2 = 53.8%). Sensitivity analyses showed no substantial change in the pooled estimate, and no statistically significant evidence of publication bias was detected.
Conclusions
Adverse sleep characteristics were associated with greater odds of PD, with a stronger association observed for severe periodontitis in subgroup analysis. However, the certainty of evidence was very low, and prospective studies are warranted to clarify causality