Award Date

5-15-2026

Degree Type

Thesis

Degree Name

Master of Science (MS)

Department

Dental Medicine

First Committee Member

Linh Nguyen

Second Committee Member

Tanya Al-Talib

Third Committee Member

Charles Hill

Fourth Committee Member

Arpita Basu

Number of Pages

54

Abstract

Background

Periodontitis and sleep disorders are chronic inflammatory conditions with significant systemic implications, and emerging evidence suggests a potential bidirectional relationship between them. Despite this connection, sleep disorders, particularly obstructive sleep apnea, remain widely underdiagnosed. Understanding the gap between patient-reported sleep disturbances and clinician-diagnosed sleep disorders may help strengthen screening and referral practices in both dental and medical settings.

Methods

A retrospective cross-sectional analysis was conducted using data from the 2009-2014 National Health and Nutrition Examination Survey (NHANES). Two sleep-related question items identified participants who self-reported sleep trouble and those who reported receiving a clinician-diagnosed sleep disorder. Periodontal status was determined using clinical attachment loss and probing depth measurements. Eight covariates—periodontitis, gender, age, ethnicity, sleep duration, smoking status, education level, and income—were analyzed using the test of proportions, chi-square test of independence, and McNemar’s test. NHANES sample weights were applied to represent the number of individuals in the United States population.

Results

Self-reported sleep disturbances occurred at substantially higher rates than clinician-diagnosed sleep disorders among individuals with periodontitis. Significant differences in symptom reporting were observed across periodontal condition, gender, age group, ethnicity, sleep duration, and education level. Among participants reporting a clinician-diagnosed sleep disorder, significant differences were found based on ethnicity, sleep duration, and education level. A notable diagnostic gap emerged: 22% of participants reported sleep difficulties, whereas only 9% reported receiving a formal diagnosis.

Conclusion

A considerable discrepancy exists between patient-perceived sleep disturbances and cliniciandiagnosed sleep disorders among individuals with periodontitis, indicating under-recognition of sleep-related conditions in this population. Strengthening patient and clinician education, increasing vigilance for sleep-related symptoms, and incorporating demographic and behavioral risk factors into screening practices may help reduce underdiagnosis and support earlier identification of individuals at elevated risk for obstructive sleep apnea.

Keywords

NHANES; obstructive sleep apnea; orthodontics; periodontics; sleep disorders; sleep questionnaire

Disciplines

Dentistry | Medical Sciences | Medicine and Health Sciences | Public Health

File Format

PDF

File Size

1149 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

Available for download on Saturday, May 15, 2027


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