The oral–sleep interface: Associations between oral health status and sleep outcomes in Canadian adults

Background: Sleep disturbances and oral health problems are both prevalent public health concerns with substantial impacts on quality of life and systemic health. However, population-based evidence examining the independent associations between multiple dimensions of oral health and multiple sleep outcomes remains limited. This study investigated the associations between oral health indicators and sleep disturbances among Canadian adults using nationally representative survey data. Methods: We utilized data from adults aged 18 years and older who completed the 2017–2018 Canadian Community Health Survey (CCHS). Four oral health indicators were assessed: self-reported oral health, oral pain, bleeding gums, and dry mouth. Four sleep outcomes were examined: short sleep duration, insomnia symptoms, unrefreshing sleep, and difficulty staying awake. Multivariable logistic regression models were used, with progressive adjustment for sociodemographic factors, health status, and health behaviors. Results: All four oral health indicators were significantly associated with most sleep outcomes in the full adjusted model. For short sleep duration, the strongest association was observed for poor oral health (AOR: 1.623). For insomnia symptoms, dry mouth (AOR: 1.904) and oral pain (AOR: 1.826) exhibited the strongest associations. For unrefreshing sleep, oral pain (AOR: 1.937) and dry mouth (AOR: 1.808) were associated with higher odds of reporting unrefreshing sleep. For difficulty staying awake, dry mouth (AOR: 1.720) and oral pain (AOR: 1.701) showed the strongest associations. Conclusion: Oral health problems are associated with multiple dimensions of sleep disturbance. These findings highlight the need for integrated care and complementary screening between dental and sleep medicine.