ETIOLOGY/OTHER
ARTICLE ANALYSIS & EVALUATION ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Non-apnea sleep disorder increases the risk of periodontal disease: a retrospective population-based cohort study. Lee CF, Lin MC, Lin CL, Yen CM, Lin KY, Chang YJ, Kao CH. J Periodontol 2014;85(4):e65-71.
REVIEWER Ayse Basak Cinar, DDS, MBA, PhD
PURPOSE/QUESTION The authors attempt to investigate whether non-apnea sleep disorder (NA-SD) (excluding apnea sleep disorder or named obstructive sleep apnea disorder) increases the risk of periodontal disease.
SOURCE OF FUNDING The study was supported in part by the study projects (DMR-102-014 and DMR-102-023) in China Medical University Hospital, Taiwan; Taiwan Ministry of Health and Welfare Clinical Trial Research Center for Excellence (DOH102-TD-B-111-004); Taiwan Ministry of Health and Welfare Cancer Research Center for Excellence (MOHW103-TD-B-111-03); and International Research-Intensive Centers of Excellence (NSC101-2911I-00 2-303), Taiwan
Patients With Non-Apnea Sleep Disorder Have an Increased Risk of Periodontal Diseases SUMMARY Subjects Patients newly diagnosed with NA-SDs in 1997 to 2010 were identified as the study cohort from the Taiwan National Health Insurance database. The date of diagnosis of a non-apnea sleep disorder (NA-SD) was defined as the patient’s index date and was used to initiate the person-years measurement during follow-up and to select comparisons. In total, 127,569 patients were included in this study (46,227 men [aged 18–95 years; mean age 53.7 years] and 81,342 women [age 18–95 years; mean age 50.7 years]). For each patient with NA-SD, two comparisons were randomly selected from the pool of participants without sleep disorders or periodontal disease at baseline, frequency matched by the year of index date, age (5-year spans), and sex. The index year for the comparison sample was defined according to the index year of the matched case, and the index month and date were also identified. Patients who had sleep apnea syndrome and patients with a history of periodontal disease before the index date were excluded from the study.
Key Risk/Study Factor NA-SD and related comorbidity including coronary artery disease, congestive heart failure, chronic kidney disease, diabetes, hypertension, and hyperlipidemia.
Main Outcome Measure The primary disease thought to be related to NA-SD is periodontal diseases. Patients with a diagnosis of periodontal diseases (ICD- 9-CM codes 523.4 and 523.5) for up to five times during the follow-up period ending in December 2010 were considered to have severe periodontal disease.
TYPE OF STUDY/DESIGN
Main Results
Retrospective cohort study
No statistical differences were found in age and sex distribution between the NA-SD and the comparison cohort (p $ 0.05). Comorbidities were more prevalent in the patients with NA-SD than in the comparison cohort, particularly coronary artery disease (20.6% versus 10.2%), hypertension (37.9% versus 24.2%), and hyperlipidemia (19.6% versus 10.4%) (p < 0.05). The overall incidence rate ratio of severe periodontal diseases was 39% higher in the NA-SD cohort than in the comparison cohort (7.93 versus 5.69 per 1000 person-years), with an adjusted hazard ratio (HR) of 1.36 (95% confidence interval [CI]: 1.30 to 1.43) (p < 0.001). The effect of NA-SD on the risk of severe periodontal diseases was higher in young and middle-aged patients compared with patients aged 65 years and over (
ARTICLE ANALYSIS & EVALUATION ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Non-apnea sleep disorder increases the risk of periodontal disease: a retrospective population-based cohort study. Lee CF, Lin MC, Lin CL, Yen CM, Lin KY, Chang YJ, Kao CH. J Periodontol 2014;85(4):e65-71.
REVIEWER Ayse Basak Cinar, DDS, MBA, PhD
PURPOSE/QUESTION The authors attempt to investigate whether non-apnea sleep disorder (NA-SD) (excluding apnea sleep disorder or named obstructive sleep apnea disorder) increases the risk of periodontal disease.
SOURCE OF FUNDING The study was supported in part by the study projects (DMR-102-014 and DMR-102-023) in China Medical University Hospital, Taiwan; Taiwan Ministry of Health and Welfare Clinical Trial Research Center for Excellence (DOH102-TD-B-111-004); Taiwan Ministry of Health and Welfare Cancer Research Center for Excellence (MOHW103-TD-B-111-03); and International Research-Intensive Centers of Excellence (NSC101-2911I-00 2-303), Taiwan
Patients With Non-Apnea Sleep Disorder Have an Increased Risk of Periodontal Diseases SUMMARY Subjects Patients newly diagnosed with NA-SDs in 1997 to 2010 were identified as the study cohort from the Taiwan National Health Insurance database. The date of diagnosis of a non-apnea sleep disorder (NA-SD) was defined as the patient’s index date and was used to initiate the person-years measurement during follow-up and to select comparisons. In total, 127,569 patients were included in this study (46,227 men [aged 18–95 years; mean age 53.7 years] and 81,342 women [age 18–95 years; mean age 50.7 years]). For each patient with NA-SD, two comparisons were randomly selected from the pool of participants without sleep disorders or periodontal disease at baseline, frequency matched by the year of index date, age (5-year spans), and sex. The index year for the comparison sample was defined according to the index year of the matched case, and the index month and date were also identified. Patients who had sleep apnea syndrome and patients with a history of periodontal disease before the index date were excluded from the study.
Key Risk/Study Factor NA-SD and related comorbidity including coronary artery disease, congestive heart failure, chronic kidney disease, diabetes, hypertension, and hyperlipidemia.
Main Outcome Measure The primary disease thought to be related to NA-SD is periodontal diseases. Patients with a diagnosis of periodontal diseases (ICD- 9-CM codes 523.4 and 523.5) for up to five times during the follow-up period ending in December 2010 were considered to have severe periodontal disease.
TYPE OF STUDY/DESIGN
Main Results
Retrospective cohort study
No statistical differences were found in age and sex distribution between the NA-SD and the comparison cohort (p $ 0.05). Comorbidities were more prevalent in the patients with NA-SD than in the comparison cohort, particularly coronary artery disease (20.6% versus 10.2%), hypertension (37.9% versus 24.2%), and hyperlipidemia (19.6% versus 10.4%) (p < 0.05). The overall incidence rate ratio of severe periodontal diseases was 39% higher in the NA-SD cohort than in the comparison cohort (7.93 versus 5.69 per 1000 person-years), with an adjusted hazard ratio (HR) of 1.36 (95% confidence interval [CI]: 1.30 to 1.43) (p < 0.001). The effect of NA-SD on the risk of severe periodontal diseases was higher in young and middle-aged patients compared with patients aged 65 years and over (
