Examination of Oral Functions Related to Excessive Daytime Sleepiness - Original Article - Multivariate logistic regression

Sep 28, 2026

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Excessive daytime sleepiness (EDS) poses a major occupational health risk by impairing worker safety, productivity, and health. Prior reports suggest links between oral function and EDS. This cross-sectional study evaluated relationships among lip-seal force, tongue pressure, and questionnaire-based oral function measures with EDS in 392 Japanese male workers. EDS was assessed using the Epworth Sleepiness Scale, and swallowing function via EAT-10. Severe EDS showed associations with EAT-10 and snoring, while moderate-to-severe EDS additionally related to lip-seal strength, but not tongue pressure or BMI.

LanguageEnglish

CategoryHealthcare

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Pages10

Reading Time25 min

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Abstract

Introduction

Materials and Methods

Review began 10/22/2025 Review ended 11/13/2025 Published 12/02/2025 © Copyright 2025 Sunakawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98283 Open Access Original Article Examination of Oral Functions Related to Excessive Daytime Sleepiness Atsumi Sunakawa 1, Yoshiaki Ihara 2, Hirotaka Kato 2, Akira Minoura 3, Kojiro Hirano 4 , Kouzou Murakami 5, Yoshio Watanabe 6, Yoshinori Ito 7, Akatsuki Kokaze 6 1. Department of Oral Functional Rehabilitation Medicine, Showa Medical University Graduate School of Dentistry, Tokyo, JPN 2. Department of Oral Health Management, Division of Oral Functional Rehabilitation Medicine, Showa Medical University, Tokyo, JPN 3. Department of Hygiene, Public Health and Preventive Medicine, Showa Medical University School of Medicine, Tokyo, JPN 4. Department of Otorhinolaryngology Head and Neck Surgery, Showa Medical University School of Medicine, Tokyo, JPN 5. Department of Radiology, Division of Radiology, Showa Medical University School of Medicine, Tokyo, JPN 6. Department of Medicine, Division of Respirology and Allergology, Showa Medical University School of Medicine, Tokyo, JPN 7. Department of Radiology, Division of Radiation Oncology, Showa Medical University School of Medicine, Tokyo, JPN Corresponding author: Yoshiaki Ihara, [ikkun@dent.showa-u.ac.jp](ikkun@dent.showa-u.ac.jp) Abstract Excessive daytime sleepiness (EDS) is a major occupational health concern that negatively affects worker safety, productivity, and overall health. Possible associations between oral function and EDS have been reported. This study aimed to investigate the relationships between lip-seal force, tongue pressure, and questionnaire-based assessments of oral function and EDS in a working-age population. A cross-sectional study was conducted with 392 Japanese male workers. Daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS), and swallowing function was evaluated using the Eating Assessment Tool-10 (EAT- 10) . Participants were classified into two categories based on ESS scores: a severe EDS group (ESS ≥11) and a moderate-to-severe EDS group (ESS ≥5) . Additional variables included body mass index (BMI), self-reported snoring, tongue pressure, and lip-seal strength. To identify factors independently associated with higher ESS scores, we performed multivariate logistic regression analyses. Participants with ESS scores ≥11 were classified as having severe EDS, while those with scores ≥5 were categorized as having moderate or severe EDS. In the severe EDS group, EAT-10 scores and snoring were significantly associated with ESS. In the moderate or severe EDS group, significant associations were found between ESS scores and EAT-10, snoring, and lip-seal strength. No significant associations were observed between ESS scores and tongue pressure or BMI. The findings show that dysphagia and reduced lip-seal strength are significantly associated with EDS among working-age Japanese men. Oral function assessments may be a useful tool for early detection and prevention of sleep-related disorders in occupational health settings. Categories: Occupational Health, Dentistry Keywords: eating assessment tool-10, excessive daytime sleepiness, lip-seal strength, oral function, tongue pressure Introduction Excessive daytime sleepiness (EDS) is a major occupational health issue, impacting work performance and increasing accident risk [1] . EDS not only reflects symptoms of insomnia but also negatively affects workers 'job productivity. Moreover, it is a major occupational health issue that increases the risk of traffic accidents, and measures are needed to address it. Obstructive sleep apnea (OSA), which is often underdiagnosed because of its subtle symptoms

FAQs

What was the main objective of the study?

To investigate whether oral function measures—lip-seal force, tongue pressure, and questionnaire-based assessments—are related to excessive daytime sleepiness (EDS) in working-age men.

How was EDS measured and how were participants grouped?

EDS was assessed using the Epworth Sleepiness Scale (ESS) and participants were classified into severe EDS (ESS ≥11) and moderate-to-severe EDS (ESS ≥5).

Which oral function factors showed significant associations with ESS?

In the severe EDS group, EAT-10 scores and snoring were significantly associated with ESS. In the moderate-to-severe group, ESS was associated with EAT-10, snoring, and lip-seal strength, while tongue pressure and BMI showed no significant associations.

Sep 28, 2026

Uploaded by Franzy