Sanders Anne E, Akinkugbe Aderonke A, Slade Gary D, Essick Greg K
Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, 385 S. Columbia Street, Room 4502, Chapel Hill, NC, 27599-7455, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Sleep Breath. 2016 Sep;20(3):1095-102. doi: 10.1007/s11325-015-1310-z. Epub 2016 Jan 15.
The aim of this study is to investigate the relationship between tooth loss and signs and symptoms of obstructive sleep apnea (OSA) in a representative sample of the general US population.
Data were from 7305 men and women aged ≥25 years participating in the 2005-2008 National Health and Nutrition Examination Survey. Tooth loss, occlusal contacts, and denture use were determined by dental examination. Four cardinal OSA signs and symptoms were evaluated by questions based on American Academy of Sleep Medicine criteria. Adults with ≥2 signs/symptoms of OSA were classified at high-risk of OSA. Prevalence ratios (PR) and 95 % confidence limits (CL) from log binomial regression models estimated the strength of association between tooth loss and high-risk for OSA, adjusting for demographic characteristics, body mass index, dentures, and sleep duration.
Prevalence of high-risk for OSA increased 2 % for each additional lost tooth (PR = 1.02, 95 % CL, 1.01, 1.03) among adults aged 25 to 65 years. When tooth loss was modeled as an ordinal variable with 0-4 lost teeth as the referent category, adjusted prevalence of high-risk for OSA was as follows: 25 % greater in those missing 5-8 teeth (PR = 1.25, 95 % CL, 1.07, 1.46); 36 % greater in those missing 9-31 teeth (PR = 1.36, 95 % CL, 1.06, 1.73); and 61 % greater in the edentulous (PR = 1.61, 95 % CL, 1.11, 2.33).
Tooth loss may be an independent risk factor for OSA.
本研究旨在调查美国普通人群中有代表性的样本中牙齿缺失与阻塞性睡眠呼吸暂停(OSA)体征和症状之间的关系。
数据来自参加2005 - 2008年国家健康与营养检查调查的7305名年龄≥25岁的男性和女性。通过牙科检查确定牙齿缺失、咬合接触和义齿使用情况。根据美国睡眠医学学会标准,通过问卷评估OSA的四个主要体征和症状。有≥2种OSA体征/症状的成年人被归类为OSA高危人群。对数二项回归模型的患病率比(PR)和95%置信区间(CL)估计了牙齿缺失与OSA高危之间的关联强度,并对人口统计学特征、体重指数、义齿和睡眠时间进行了调整。
在25至65岁的成年人中,每多一颗缺失牙,OSA高危患病率增加2%(PR = 1.02,95% CL,1.01,1.03)。当将牙齿缺失建模为一个有序变量,以0 - 4颗缺失牙作为参照类别时,OSA高危的调整患病率如下:缺失5 - 8颗牙的人群中高25%(PR = 1.25,95% CL,1.07,1.46);缺失9 - 31颗牙的人群中高36%(PR = 1.36,95% CL,1.06,1.73);无牙人群中高61%(PR = 1.61,95% CL,1.11,2.33)。
牙齿缺失可能是OSA的一个独立危险因素。