title: Periodontitis and Sleep Disordered Breathing in the Hispanic Community Health Study/Study of Latinos.
abstract: OBJECTIVE
  To investigate the association between sleep disordered breathing (SDB) and severe chronic periodontitis.
  
  
  METHODS
  Cross-sectional data analysis from the Hispanic Community Health Study/Study of Latinos.
  
  
  METHODS
  Community-based setting with probability sampling from four urban US communities.
  
  
  METHODS
  12,469 adults aged 18-74 y.
  
  
  METHODS
  None.
  
  
  RESULTS
  Severe chronic periodontitis was defined using the Centers for Disease Control and Prevention/American Academy of Periodontology case classification based on full-mouth periodontal assessments performed by calibrated dentists. SDB was evaluated in standardized home sleep tests, and defined as the number of apnea plus hypopnea events associated with ≥ 3% desaturation, per hour of estimated sleep. SDB was quantified using categories of the apnea-hypopnea index (AHI): 0.0 events (nonapneic); 0.1-4.9 (subclinical); 5.0-14.9 (mild); and ≥ 15 (moderate/severe). Covariates were demographic characteristics and established periodontitis risk factors. C-reactive protein was a potential explanatory variable. Using survey estimation, multivariable binary logistic regression estimated odds ratios (OR) and 95% confidence limits (CL). Following adjustment for confounding, the SDB and periodontitis relationship remained statistically significant, but was attenuated in strength and no longer dose-response. Compared with the nonapneic referent, adjusted odds of severe periodontitis were 40% higher with subclinical SDB (OR = 1.4, 95% CL: 1.0, 1.9), 60% higher with mild SDB (OR = 1.6, 95% CL: 1.1, 2.2) and 50% higher with moderate/severe SDB (OR = 1.5, 95% CL: 1.0, 2.3) demonstrating an independent association between SDB and severe periodontitis.
  
  
  CONCLUSIONS
  This study identifies a novel association between mild sleep disordered breathing and periodontitis that was most pronounced in young adults.
authors: Department of Dental Ecology, University of North Carolina, Chapel Hill, NC.
authors: Anne E
authors: AE
authors: Sanders
authors: Department of Prosthodontics, Center for Pain Research and Innovation, University of North Carolina, Chapel Hill, NC.
authors: Greg K
authors: GK
authors: Essick
authors: Department of Dental Ecology, University of North Carolina, Chapel Hill, NC.
authors: James D
authors: JD
authors: Beck
authors: Department of Biostatistics, University of North Carolina, Chapel Hill, NC.
authors: Jianwen
authors: J
authors: Cai
authors: Sanford-Brown College, Skokie, IL.
authors: Shirley
authors: S
authors: Beaver
authors: Graduate School of Public Health, San Diego State University, San Diego, CA.
authors: Tracy L
authors: TL
authors: Finlayson
authors: Center for Sleep and Circadian Biology, Northwestern University, Chicago, IL.
authors: Phyllis C
authors: PC
authors: Zee
authors: Sleep Medicine Center and VA Pulmonary Sleep Disorders laboratory, University of California San Diego School of Medicine, San Diego, CA.
authors: Jose S
authors: JS
authors: Loredo
authors: Sleep Medicine Center and VA Pulmonary Sleep Disorders laboratory, University of California San Diego School of Medicine, San Diego, CA.
authors: Alberto R
authors: AR
authors: Ramos
authors: Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL.
authors: Richard H
authors: RH
authors: Singer
authors: Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL and Brigham and Women's Hospital Harvard Medical School, Boston, MA.
authors: Monik C
authors: MC
authors: Jimenez
authors: Albert Einstein College of Medicine of Yeshiva University, Bronx, NY.
authors: Janice M
authors: JM
authors: Barnhart
authors: Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
authors: Susan
authors: S
authors: Redline
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010518:Periodontitis / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D012044:Regression Analysis; D012111:Residence Characteristics; D012307:Risk Factors; D012890:Sleep; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D014481:United States; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
keywords: Hispanic; apnea-hypopnea index; epidemiology; periodontal disease; survey