Periodontitis, Sleep Quality and Fatigue
Condition: Periodontal Diseases; Sleep; Fatigue; Quality of Life; Healthy
MeSH terms: Periodontitis; Periodontal Diseases; Fatigue
Study type: Observational

Summary: 
      The goal of this observational study is to investigate the association of stage-grade of
      periodontitis with sleep quality and fatigue and the effect of periodontitis on QoL (Quality
      of life) in individuals with periodontitis and gingivally healthy individuals.

      The main questions it aims to answer are:

        1. Have poor sleep quality, inadequate sleep and fatigue got an effect on periodontal
           status?

        2. Has periodontal status got an effect on sleep quality and fatigue?

        3. What is the effect of periodontal status on quality of life?

      Routine clinical and radiographic periodontal examinations of the participants were
      performed. Groups were designed according to periodontal status and periodontitis-stages of
      participants. Group 1- Healthy; Group 2- Stage I periodontitis; Group 3- Stage II
      periodontitis; Group 4- Stage III periodontitis; Group 5- Stage IV periodontitis. The
      participants were only asked to fill out the questionnaires (socio-demographic survey, tooth
      cleaning habit survey, The Pittsburgh Sleep Quality Index(PSQI), The Jenkins Sleep
      Scale(JSS), Multidimensional Assessment of Fatigue scale (MAF) and Oral Health Impact
      Profile-14 (OHIP-14)) included in the study and were informed about them. Then, if necessary,
      the participants' routine periodontal treatments were performed.

      In line with the findings of the study;

      1. Sleep quality was found higher in gingival healthy individuals. 3. The severity of
      periodontitis increases, the sleep duration becomes shorter, 4. It has been observed that the
      sleep quality in terms of gender is lower in female individuals compared to male individuals.
    

Detailed description: 
      This was a prospective survey study reporting on a convenience sample of 124 healthy subjects
      or patients with periodontitis reporting for care at the Periodontology Clinic, Necmettin
      Erbakan University. This study was approved by the Faculty of Dentistry Non-Pharmaceutical
      and Non-Medical Device Research Ethics Committee of Necmettin Erbakan University and was
      conducted in accordance with the Helsinki Declaration of 1975, as revised in 2013. The study
      participants provided a written informed consent and comprehended the assessment details
      fully. The investigators excluded the participants who did not comprehend the questionnaire.

      Before the study, the number of patients required for each group was determined by
      calculating the power (G * Power 3.1 software; Heinrich Heine University, Düsseldorf,
      Germany). According to the power analysis results for one-way ANOVA test, the study performed
      on 5 groups provides 90% power and 0.37 effect size for a total of 115 samples. However,
      considering that there may be patients who could not continue the study, it was decided to
      include 124 people in the study.

      Clinical measurements and stage diagnosis for all cases were performed by a single trained
      and calibrated investigator (KD) using Williams periodontal probes. Calibration exercise was
      performed in 10 non-study periodontitis patients. First, PD(probing pocket depth) and
      AL(attachment loss) were measured and the same protocol was repeated 1 hour later.
      Intra-examiner variabilities for PD and AL measurements were assessed after the completion of
      all measurements.

      Statistical analyzes were performed with the SPSS (Statistical Package for the Social
      Sciences) 26.0 package program. The normality of the distribution was checked with the
      Kolmogorov Smirnov test. In the study, one-way anova test and Bonferroni test were used as
      post hoc test for comparison according to stage, grade, age and educational status, while
      independent sample t test was used for comparison according to gender. Pearson correlation
      analysis was applied to test the relationship between the scales. Chi-square analysis was
      used to evaluate the classification made according to sleep quality and the relationship
      between stage and grade. Chi-square analysis was used to evaluate the relationship between
      demographic characteristics and stage and grade. Statistical significance was assessed when p
      < 0.05.
    

Observational model: Case-Control
Time perspective: Other
Sampling method: Probability Sample
Study population: 
        This was a survey study reporting on a convenience sample of 124 healty subjects or
        patients with periodontitis reporting for care at the Periodontology Clinic, Necmettin
        Erbakan University. Konya.
      
Keywords: periodontal diseases; gingival health; sleep; fatigue; oral related quality of life