Sleep disorders in individuals with dentofacial deformities: a preliminary study on the relationship with sex and serotonin levels

Oral Maxillofac Surg. 2025 Jan 10;29(1):28. doi: 10.1007/s10006-025-01333-7.

Abstract

Purpose: It has been suggested that dentofacial deformities (DFD) can impair sleep quality. This pilot study aimed at evaluating sleep disorders in individuals with DFD before orthognathic surgery, correlating the clinical findings with salivary biomarker levels.

Methods: This cross-sectional study enrolled ten males and ten females with DFD diagnoses under orthodontic treatment preceding orthognathic surgery. The participants responded to the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Fletcher and Luckett Sleep Questionnaire (FLSQ). Obstructive sleep apnea (OSA) was examined by the Home Sleep Apnea Test (HSAT). The salivary levels of interleukin-1β (IL-1β), glutamate, and serotonin were measured.

Results: 85% of individuals presented PSQI and FLSQ scores indicative of sleep alterations. Females had higher scores in part 2 of the FLSQ instrument, referring to sleepiness-associated complaints. HSAT analysis revealed a low number of symptomatic OSA individuals, with three males demonstrating altered oxygen desaturation rates. There was a significant negative correlation between the salivary levels of serotonin and the FLSQ results.

Conclusions: Individuals with DFD diagnosis showed poorer sleep quality, which is likely independent of sex and OSA diagnosis, and negatively correlated with salivary levels of serotonin.

Keywords: Dentofacial deformities, sleep disorders; Salivary biomarkers; Serotonin; Sleep apnea.

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Cross-Sectional Studies
  • Dentofacial Deformities* / surgery
  • Female
  • Humans
  • Male
  • Pilot Projects
  • Saliva* / chemistry
  • Saliva* / metabolism
  • Serotonin* / analysis
  • Serotonin* / metabolism
  • Sex Factors
  • Sleep Apnea, Obstructive
  • Sleep Wake Disorders* / etiology
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Serotonin
  • Biomarkers