title: Sleep quality in patients with dental anxiety.
abstract: BACKGROUND
  Psychological distress is associated with sleep disturbances; however there is little research on sleep quality in dental anxiety (DA) patients.
  
  
  OBJECTIVE
  To measure the sleep quality in patients with DA compared to patients with an exacerbated gag reflex (GAG) and controls and to analyze its association with various demographic and behavioral parameters.
  
  
  METHODS
  67 DA patients, 54 GAG patients and 100 controls with no history of DA or GAG participated in the study. Data regarding: demographic details, smoking habits, the Pittsburgh Sleep Quality Index (PSQI), Numeric Rating Scale (NRS) for pain assessment, Corah's dental anxiety scale (DAS) and Oral Health Impact Profile-14 (OHIP-14), plaque index (PI) and Decay, Missing and Filled Teeth (DMFT) scores were collected.
  
  
  RESULTS
  49.3% of the DA group and 38.9% of the GAG group were poor sleepers (mean PSQI score > 5), compared to 29.0% of the controls (PSQI mean scores: 5.8 ± 3.4, DA group; 5.2 ± 3.6 GAG group vs. 4.5 ± 2.7, control group; p = 0.029). Compared to controls, DA and GAG patients exhibited poorer scores in the sleep disturbances PSQI component (p = 0.001). DA patients exhibited poorer scores in the sleep duration PSQI component compared to the control (p = 0.002) and GAG groups (p = 0.033). Female gender (p = 0.039), higher current (p = 0.046) and maximal NRS (p = 0.019), higher DAS (p < 0.001) and OHIP-14 (p < 0.001) scores and more missing teeth (p = 0.003) were positively associated with higher PSQI scores.
  
  
  CONCLUSIONS
  DA patients suffered more from impaired sleep than controls and GAGs. Impaired sleep in DA patients is multidimensional phenomenon influenced by the specific diagnosis, gender, pain, dental anxiety levels, dental experience and oral health related quality of life.
authors.affiliation: Department of Oral Medicine, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel; Department of Oral Medicine, Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel. Electronic address: galit@almoznino.com.
authors.forename: Galit
authors.initials: G
authors.lastname: Almoznino
authors.affiliation: Department of Community Dentistry, Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel.
authors.forename: Avraham
authors.initials: A
authors.lastname: Zini
authors.affiliation: Department of Oral Medicine, Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel.
authors.forename: Yair
authors.initials: Y
authors.lastname: Sharav
authors.affiliation: Department of Oral Medicine, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel; In partial fulfillment of DMD Degree, Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel.
authors.forename: Adi
authors.initials: A
authors.lastname: Shahar
authors.affiliation: Department of Oral Medicine, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel.
authors.forename: Hulio
authors.initials: H
authors.lastname: Zlutzky
authors.affiliation: Department of Oral Medicine, Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Haviv
authors.affiliation: Department of Oral Medicine, Oral and Maxillofacial Center, Medical Corps, Israel Defense Forces, Tel-Hashomer, Israel.
authors.forename: Alex
authors.initials: A
authors.lastname: Lvovsky
authors.affiliation: Department of Oral Medicine, Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel.
authors.forename: Doron J
authors.initials: DJ
authors.lastname: Aframian
mesh_terms: D000293:Adolescent; D000328:Adult; D016854:Dental Anxiety / Q000150:complications / Q000523:psychology*; D003773:Dental Plaque; D005260:Female; D005683:Gagging / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D009910:Oral Hygiene; D010147:Pain Measurement / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Dental anxiety; Dental fear; Exacerbated gag reflex; Pain; Sleep