# Association between sleep and periodontal disease in adults—an umbrella review

## TL;DR

This review finds a possible link between poor sleep and periodontal disease, but the evidence is inconsistent and needs more research.

## Contribution

The study provides a comprehensive umbrella review of existing systematic reviews and meta-analyses on sleep and periodontal disease.

## Key findings

- Poor sleep and sleep disorders are associated with a higher likelihood of periodontal disease.
- The evidence is inconsistent and suffers from high heterogeneity and low certainty.
- There is a need for better-designed studies to clarify causal relationships.

## Abstract

Sleep disturbances and periodontal disease are common chronic conditions linked through systemic inflammation; however, their association remains unclear despite the availability of several secondary studies.

An umbrella review was conducted to synthesise evidence from published systematic reviews and meta-analyses that examined the relationship between sleep duration and sleep disorders, including obstructive sleep apnoea, and periodontal disease in adults. Major electronic databases were searched from inception to March 2024 without language restrictions. The methodological quality of the included reviews, overlap of primary studies, and certainty of evidence were systematically assessed.

Thirteen systematic reviews were included, of which seven contained meta-analyses, representing fifty-two unique primary studies. Overall, poor sleep and sleep disorders were associated with a higher likelihood of periodontal disease; however, the magnitude of the effect varied considerably and substantial heterogeneity was observed. There was a high degree of overlap among primary studies, and the certainty of the evidence was low, largely due to observational study designs, risk of bias, and residual confounding.

This umbrella review indicates a positive but inconsistent association between sleep disturbances and periodontal disease. The findings emphasise important limitations in the current evidence base and highlight the need for well-designed prospective studies with standardised assessments to clarify causal pathways and underlying mechanisms.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024511133, PROSPERO CRD42024511133.