International Journal of Prosthodontics and Restorative Dentistry

Register      Login

VOLUME 14 , ISSUE 2 ( April-June, 2024 ) > List of Articles

ORIGINAL RESEARCH

A Case–Control Study to Compare Sleep Quality between Edentulous and Dentulous Elderly Patients

Bhaskar Agarwal, Ajay Kumar, Pooran Chand, Kshitij Arora, Mohit, Sunita Singh

Keywords : Body mass index, Edentulous, Elderly, Pittsburgh sleep quality index, Sleep quality

Citation Information : Agarwal B, Kumar A, Chand P, Arora K, Mohit, Singh S. A Case–Control Study to Compare Sleep Quality between Edentulous and Dentulous Elderly Patients. Int J Prosthodont Restor Dent 2024; 14 (2):94-98.

DOI: 10.5005/jp-journals-10019-1451

License: CC BY-NC 4.0

Published Online: 29-06-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Purpose: To assess the effect of an edentulous state on sleep quality in the elderly. Materials and methods: A case–control study was carried out in which a total of 100 elderly individuals aged over 60 years were enrolled. Of these, 50 were edentulous and comprised the case group, while 50 age-matched dentulous elderly individuals comprised the control group. Body mass index (BMI), medical history, activity level, and personal habit profiles of both groups were noted. Sleep quality assessment was done using the Pittsburgh Sleep Quality Index (PSQI). PSQI scores greater than five were considered indicators of poor sleep quality. Chi-squared and independent samples ”t-tests” were used for univariate analysis. Linear regression was performed for multivariate analysis. Results: The mean age of cases was 68.82 ± 5.20 years (range 61–78). The majority of cases were females (56%). Cases had a significantly higher mean BMI and proportion of those with a sedentary activity profile compared to controls. The maximum number of cases had been in an edentulous state for <6 months (42%). The mean sleep quality scores for PSQI domains, including latency, duration, subjective sleep quality, daytime dysfunction, and habitual, were significantly higher in cases compared to controls. The overall mean total PSQI score was 13.50 ± 2.92 in cases compared to 6.99 ± 2.05 in controls (p < 0.001). The majority of cases had moderate-to-severe sleep disturbance (88%) compared to only 1 (2%) of controls (p < 0.001). On linear regression for PSQI scores, only age and edentulous state emerged as independent significant factors associated with PSQI scores (p < 0.05). Conclusion: Edentulous state contributes to poor sleep quality in elderly patients. Interventions to improve sleep quality in elderly patients with an edentulous state should be done.


PDF Share
  1. Al-Rafee MA. The epidemiology of edentulism and the associated factors: a literature review. J Family Med Prim Care 2020;9(4):1841–1843. DOI: 10.4103/jfmpc.jfmpc_1181_19
  2. Kaushik K, Dhawan P, Tandan P, et al. Oral health-related quality of life among patients after complete denture rehabilitation: a 12-month follow-up study. Int J Appl Basic Med Res 2018;8(3):169–173. DOI: 10.4103/ijabmr.IJABMR_171_18
  3. Shah RJ, Diwan FJ, Diwan MJ, et al. A study of the emotional effects of tooth loss in an edentulous Gujarati population and its association with depression. J Indian Prosthodont Soc 2015;15(3):237–243. DOI: 10.4103/0972-4052
  4. Peltzer K, Hewlett S, Yawson AE, et al. Prevalence of loss of all teeth (edentulism) and associated factors in older adults in China, Ghana, India, Mexico, Russia and South Africa. Int J Environ Res Public Health 2014;11:11308–11324. DOI: 10.3390/ijerph111111308
  5. Pengpid S, Peltzer K. The prevalence of edentulism and their related factors in Indonesia, 2014/15. BMC Oral Health 2018;18(1):118. DOI: 10.1186/s12903-018-0582-7
  6. Emami E, Lavigne G, de Grandmont P, et al. Perceived sleep quality among edentulous elders. Gerodontology 2012;29(2):e128–e134. DOI: 10.1111/j.1741-2358.2010.00426.x
  7. Vago EL, Frange C, DA Paz Oliveira G, et al. The association between sleep disturbances and tooth loss among post-stroke patients. Arq Neuropsiquiatr 2022;80(2):173–179. DOI: 10.1590/0004-282X-ANP-2020-0368
  8. Tripathi A, Gupta A, Rai P, et al. Correlation between duration of edentulism and severity of obstructive sleep apnea in elderly edentulous patients. Sleep Sci 2022;15(Spec 2):300–305. DOI: 10.5935/1984-0063.20210006
  9. Heidsieck DS, de Ruiter MH, de Lange J. Management of obstructive sleep apnea in edentulous patients: an overview of the literature. Sleep Breath 2016;20(1):395–404. DOI: 10.1007/s11325-015-1285-9
  10. Sanders AE, Akinkugbe AA, Slade GD, et al. Tooth loss and obstructive sleep apnea signs and symptoms in the US population. Sleep Breath 2016;20(3):1095–1102. DOI: 10.1007/s11325-015-1310-z
  11. Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193–213. DOI: 10.1016/0165-1781(89)90047-4
  12. Weir CB, Jan A. BMI Classification Percentile and Cut Off Points. Treasure Island (Florida): StatPearls Publishing; 2024.
  13. Lee J, Kim J, Chow A, et al. Different levels of physical activity, physical health, happiness, and depression among older adults with diabetes. Gerontol Geriatr Med 2021;7:2333721421995623. DOI: 10.1177/2333721421995623
  14. Patel MM. A comparison of the edentulous and dentate prosthodontic patient for the occurrence of obstructive sleep apnea. Graduate Theses, Dissertations, and Problem Reports. 2004;10808. Available online at: https://researchrepository.wvu.edu/cgi/viewcontent.cgi?article=11910&context=etd last accessed 10th October, 2023.
  15. Al-Zahrani MS, Alhassani AA, Zawawi KH. Tooth loss as a potential risk factor for deficient sleep: an analysis of a nationally representative sample of adults in the USA. Sleep Breath 2021;25(2):1101–1107. DOI: 10.1007/s11325-020-02131-z
  16. Cardoso PC, Mecenas P, Normando D. The impact of the loss of first permanent molars on the duration of treatment in patients treated with orthodontic space closure and without skeletal anchorage. Prog Orthod 2022;23(1):32. DOI: 10.1186/s40510-022-00427-2
  17. Triplett WW, Lund BA, Westbrook PR, et al. Obstructive sleep apnea syndrome in patients with class II malocclusion. Mayo Clin Proc 1989;64(6):644–652. DOI: 10.1016/s0025-6196(12)65342-7
  18. Buysse DJ, Reynolds CF 3rd, Monk TH, et al. Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh sleep quality index (PSQI). Sleep 1991;14(4):331–338. DOI: 10.1093/sleep/14.4.331
  19. Bucca C, Cicolin A, Brussino L, et al. Tooth loss and obstructive sleep apnoea. Respir Res 2006;7(1):8. DOI: 10.1186/1465-9921-7-8
  20. Ohayon MM, Vecchierini MF. Normative sleep data, cognitive function and daily living activities in older adults in the community. Sleep 2005;28(8):981–989. DOI: 10.1093/sleep/28.8.981
  21. Ancoli-Israel S. Sleep and its disorders in aging populations. Sleep Med 2009;10(Suppl 1):S7–S11. DOI: 10.1016/j.sleep.2009.07.004
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.