{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T15:20:01Z","timestamp":1778858401921,"version":"3.51.4"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T00:00:00Z","timestamp":1768608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sleep Breath"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1007\/s11325-025-03549-z","type":"journal-article","created":{"date-parts":[[2026,1,17]],"date-time":"2026-01-17T13:25:21Z","timestamp":1768656321000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sex-difference in chewing difficulty and the risk of obstructive sleep apnea among middle-aged and older adults"],"prefix":"10.1007","volume":"30","author":[{"given":"Jae Hyeok","family":"Lim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan Bi","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun Seo","family":"Jang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun-Cheol","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2955-6382","authenticated-orcid":false,"given":"Jaeyong","family":"Shin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,17]]},"reference":[{"issue":"14","key":"3549_CR1","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1001\/jama.2020.3514","volume":"323","author":"DJ Gottlieb","year":"2020","unstructured":"Gottlieb DJ, Punjabi NM (2020) Diagnosis and management of obstructive sleep apnea: a review. JAMA 323(14):1389\u20131400. https:\/\/doi.org\/10.1001\/jama.2020.3514","journal-title":"JAMA"},{"issue":"8","key":"3549_CR2","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.3978\/j.issn.2072-1439.2015.06.11","volume":"7","author":"KA Franklin","year":"2015","unstructured":"Franklin KA, Lindberg E (2015) Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea. J Thorac Dis 7(8):1311\u20131322. https:\/\/doi.org\/10.3978\/j.issn.2072-1439.2015.06.11","journal-title":"J Thorac Dis"},{"issue":"6","key":"3549_CR3","doi-asserted-by":"publisher","first-page":"2083","DOI":"10.1007\/s11325-023-02810-7","volume":"27","author":"AB de Araujo Dantas","year":"2023","unstructured":"de Araujo Dantas AB, Gon\u00e7alves FM, Martins AA, Alves G, Stechman-Neto J, Corr\u00eaa CC et al (2023) Worldwide prevalence and associated risk factors of obstructive sleep apnea: a meta-analysis and meta-regression. Sleep Breath 27(6):2083\u20132109. https:\/\/doi.org\/10.1007\/s11325-023-02810-7","journal-title":"Sleep Breath"},{"key":"3549_CR4","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00053-2023","author":"P Balagny","year":"2023","unstructured":"Balagny P, Vidal-Petiot E, Renuy A, Matta J, Frija-Masson J, Steg PG et al (2023) Prevalence, treatment and determinants of obstructive sleep apnoea and its symptoms in a population-based French cohort. ERJ Open Res. https:\/\/doi.org\/10.1183\/23120541.00053-2023","journal-title":"ERJ Open Res"},{"issue":"9","key":"3549_CR5","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1016\/s2213-2600(22)00137-0","volume":"10","author":"M Jew","year":"2022","unstructured":"Jew M, Barnes TR, Malhotra A (2022) Patient experience with obstructive sleep apnoea. Lancet Respir Med 10(9):828\u2013830. https:\/\/doi.org\/10.1016\/s2213-2600(22)00137-0","journal-title":"Lancet Respir Med"},{"issue":"6","key":"3549_CR6","doi-asserted-by":"publisher","first-page":"984","DOI":"10.1016\/j.sleh.2023.08.007","volume":"9","author":"SL Orbell","year":"2023","unstructured":"Orbell SL, Scott PW, Baniak LM, Chasens ER, Godzik C, Jeon B et al (2023) Patient-level factors associated with the self-report of trouble sleeping to healthcare providers in adults at high risk for obstructive sleep apnea. Sleep Health 9(6):984\u2013990. https:\/\/doi.org\/10.1016\/j.sleh.2023.08.007","journal-title":"Sleep Health"},{"key":"3549_CR7","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.sleep.2023.11.1134","volume":"113","author":"MY Guo","year":"2024","unstructured":"Guo MY, Li PJ, Xiao Y, Cao Y, Liang ZA (2024) Effectiveness of mandibular advancement devices in the treatment of obstructive sleep apnea and the impact of different body positions on treatment: a systematic review and meta-analysis. Sleep Med 113:275\u2013283. https:\/\/doi.org\/10.1016\/j.sleep.2023.11.1134","journal-title":"Sleep Med"},{"issue":"3","key":"3549_CR8","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/j.1834-7819.2001.tb00276.x","volume":"46","author":"D Sherring","year":"2001","unstructured":"Sherring D, Vowles N, Antic R, Krishnan S, Goss AN (2001) Obstructive sleep apnoea: a review of the orofacial implications. Aust Dent J 46(3):154\u2013165. https:\/\/doi.org\/10.1111\/j.1834-7819.2001.tb00276.x","journal-title":"Aust Dent J"},{"key":"3549_CR9","doi-asserted-by":"publisher","first-page":"8196410","DOI":"10.1155\/2019\/8196410","volume":"2019","author":"T Azuma","year":"2019","unstructured":"Azuma T, Irie K, Watanabe K, Deguchi F, Kojima T, Obora A et al (2019) Association between chewing problems and sleep among Japanese adults. Int J Dent 2019:8196410. https:\/\/doi.org\/10.1155\/2019\/8196410","journal-title":"Int J Dent"},{"issue":"3","key":"3549_CR10","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1007\/s11325-015-1310-z","volume":"20","author":"AE Sanders","year":"2016","unstructured":"Sanders AE, Akinkugbe AA, Slade GD, Essick GK (2016) Tooth loss and obstructive sleep apnea signs and symptoms in the US population. Sleep Breath 20(3):1095\u20131102. https:\/\/doi.org\/10.1007\/s11325-015-1310-z","journal-title":"Sleep Breath"},{"issue":"1","key":"3549_CR11","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1111\/odi.13734","volume":"28","author":"F de Bof Andra","year":"2022","unstructured":"de Bof Andra F, Watt RG, Lima-Costa MF, de Oliveira C (2022) Poor sleep quality and oral health among older Brazilian adults. Oral Dis 28(1):227\u201332. https:\/\/doi.org\/10.1111\/odi.13734","journal-title":"Oral Dis"},{"issue":"4","key":"3549_CR12","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1007\/s00784-016-1851-y","volume":"21","author":"MC Carra","year":"2017","unstructured":"Carra MC, Schmitt A, Thomas F, Danchin N, Pannier B, Bouchard P (2017) Sleep disorders and oral health: a cross-sectional study. Clin Oral Investig 21(4):975\u2013983. https:\/\/doi.org\/10.1007\/s00784-016-1851-y","journal-title":"Clin Oral Investig"},{"issue":"4","key":"3549_CR13","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1007\/s11325-015-1160-8","volume":"19","author":"TS Al-Jewair","year":"2015","unstructured":"Al-Jewair TS, Al-Jasser R, Almas K (2015) Periodontitis and obstructive sleep apnea\u2019s bidirectional relationship: a systematic review and meta-analysis. Sleep Breath 19(4):1111\u20131120. https:\/\/doi.org\/10.1007\/s11325-015-1160-8","journal-title":"Sleep Breath"},{"issue":"3","key":"3549_CR14","doi-asserted-by":"publisher","first-page":"e211009","DOI":"10.1001\/jamanetworkopen.2021.1009","volume":"4","author":"B Pivetta","year":"2021","unstructured":"Pivetta B, Chen L, Nagappa M, Saripella A, Waseem R, Englesakis M et al (2021) Use and performance of the STOP-Bang questionnaire for obstructive sleep apnea screening across geographic regions: a systematic review and meta-analysis. JAMA Netw Open 4(3):e211009\u2013e","journal-title":"JAMA Netw Open"},{"key":"3549_CR15","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.sleep.2024.05.047","volume":"119","author":"F Zhang","year":"2024","unstructured":"Zhang F, Huang X, Wang H, Bai Y, Huang L, Li Y et al (2024) Prevalence of obstructive sleep apnea in whole spectrum chronic kidney disease patients: a systematic review and meta-analysis. Sleep Med 119:526\u201334. https:\/\/doi.org\/10.1016\/j.sleep.2024.05.047","journal-title":"Sleep Med"},{"issue":"2","key":"3549_CR16","doi-asserted-by":"publisher","first-page":"e0193549","DOI":"10.1371\/journal.pone.0193549","volume":"13","author":"JS Sunwoo","year":"2018","unstructured":"Sunwoo JS, Hwangbo Y, Kim WJ, Chu MK, Yun CH, Yang KI (2018) Prevalence, sleep characteristics, and comorbidities in a population at high risk for obstructive sleep apnea: a nationwide questionnaire study in South Korea. PLoS One 13(2):e0193549. https:\/\/doi.org\/10.1371\/journal.pone.0193549","journal-title":"PLoS One"},{"key":"3549_CR17","doi-asserted-by":"publisher","first-page":"103787","DOI":"10.1016\/j.jdent.2021.103787","volume":"113","author":"H-E Kim","year":"2021","unstructured":"Kim H-E, Lee H (2021) Factors affecting subjective and objective masticatory function in older adults: importance of an integrated approach. J Dent 113:103787","journal-title":"J Dent"},{"issue":"1","key":"3549_CR18","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1111\/ggi.14783","volume":"24","author":"E Seto","year":"2024","unstructured":"Seto E, Kosaka T, Hatta K, Mameno T, Mihara Y, Fushida S et al (2024) Factors related to subjective evaluation of difficulty in chewing among community-dwelling older adults. Geriatr Gerontol Int 24(1):327\u201333. https:\/\/doi.org\/10.1111\/ggi.14783","journal-title":"Geriatr Gerontol Int"},{"issue":"5","key":"3549_CR19","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1513\/AnnalsATS.202006-696FR","volume":"18","author":"C Lal","year":"2021","unstructured":"Lal C, Weaver TE, Bae CJ, Strohl KP (2021) Excessive daytime sleepiness in obstructive sleep Apnea. Mechanisms and clinical management. Ann Am Thorac Soc 18(5):757\u2013768. https:\/\/doi.org\/10.1513\/AnnalsATS.202006-696FR","journal-title":"Ann Am Thorac Soc"},{"issue":"8","key":"3549_CR20","first-page":"1079","volume":"31","author":"NS Marshall","year":"2008","unstructured":"Marshall NS, Wong KK, Liu PY, Cullen SR, Knuiman MW, Grunstein RR (2008) Sleep apnea as an independent risk factor for all-cause mortality: the Busselton health study. Sleep 31(8):1079\u20131085","journal-title":"Sleep"},{"key":"3549_CR21","unstructured":"Jehan S, Zizi F, Pandi-Perumal SR, Wall S, Auguste E, Myers AK et al (2017) Obstructive sleep apnea and obesity: implications for public health. Sleep Med Disorders: Int J 1(4):00019"},{"key":"3549_CR22","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.sleep.2021.05.010","volume":"84","author":"P Jennum","year":"2021","unstructured":"Jennum P, Coaquira Castro J, Mettam S, Kharkevitch T, Cambron-Mellott MJ (2021) Socioeconomic and humanistic burden of illness of excessive daytime sleepiness severity associated with obstructive sleep Apnoea in the European union 5. Sleep Med 84:46\u201355. https:\/\/doi.org\/10.1016\/j.sleep.2021.05.010","journal-title":"Sleep Med"},{"key":"3549_CR23","doi-asserted-by":"publisher","first-page":"105651","DOI":"10.1016\/j.aap.2020.105651","volume":"144","author":"DW Lee","year":"2020","unstructured":"Lee DW, Kim K, Baek J, Oh SS, Jang SI, Park EC (2020) Association of habitual alcohol use on risk-taking behaviors while using a car: the Korean National Health and Nutrition Examination Survey 2009\u20132013. Accid Anal Prev 144:105651. https:\/\/doi.org\/10.1016\/j.aap.2020.105651","journal-title":"Accid Anal Prev"},{"issue":"3","key":"3549_CR24","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1378\/chest.15-0903","volume":"149","author":"F Chung","year":"2016","unstructured":"Chung F, Abdullah HR, Liao P (2016) STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea. Chest 149(3):631\u20138. https:\/\/doi.org\/10.1378\/chest.15-0903","journal-title":"Chest"},{"issue":"3","key":"3549_CR25","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1097\/ACO.0b013e32832a96e2","volume":"22","author":"F Chung","year":"2009","unstructured":"Chung F, Elsaid H (2009) Screening for obstructive sleep apnea before surgery: why is it important? Curr Opin Anaesthesiol 22(3):405\u2013411. https:\/\/doi.org\/10.1097\/ACO.0b013e32832a96e2","journal-title":"Curr Opin Anaesthesiol"},{"issue":"1","key":"3549_CR26","doi-asserted-by":"publisher","first-page":"12768","DOI":"10.1038\/s41598-023-40055-2","volume":"13","author":"J-H Lee","year":"2023","unstructured":"Lee J-H, Han K, Lee SY (2023) Associations between obstructive sleep apnea and dental pain and chewing discomfort in Korean adults: a nationwide cross-sectional study. Sci Rep 13(1):12768","journal-title":"Sci Rep"},{"key":"3549_CR27","first-page":"1323","volume-title":"The association between obstructive sleep apnea and oral function, using the Korea National health and nutrition examination survey data","author":"K Woo","year":"2025","unstructured":"Woo K, Lee J, Jung C-E, Park J, Choy Y (2025) The association between obstructive sleep apnea and oral function, using the Korea National health and nutrition examination survey data. MDPI, Healthcare, p 1323"},{"key":"3549_CR28","unstructured":"Gordis L (2013) Epidemiology e-book. Elsevier Health Sciences"},{"issue":"7","key":"3549_CR29","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.3390\/biomedicines12071382","volume":"12","author":"A Maniaci","year":"2024","unstructured":"Maniaci A, Lavalle S, Anzalone R, Lo Giudice A, Cocuzza S, Parisi FM et al (2024) Oral health implications of obstructive sleep apnea: a literature review. Biomedicines 12(7):1382","journal-title":"Biomedicines"},{"issue":"4","key":"3549_CR30","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1111\/joor.12478","volume":"44","author":"MA Peyron","year":"2017","unstructured":"Peyron MA, Woda A, Bourdiol P, Hennequin M (2017) Age-related changes in mastication. J Oral Rehabil 44(4):299\u2013312. https:\/\/doi.org\/10.1111\/joor.12478","journal-title":"J Oral Rehabil"},{"issue":"3","key":"3549_CR31","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1378\/chest.14-2953","volume":"148","author":"V Ieto","year":"2015","unstructured":"Ieto V, Kayamori F, Montes MI, Hirata RP, Greg\u00f3rio MG, Alencar AM et al (2015) Effects of oropharyngeal exercises on snoring: a randomized trial. Chest 148(3):683\u2013691","journal-title":"Chest"},{"issue":"4","key":"3549_CR32","first-page":"137","volume":"2","author":"MR Marques","year":"2003","unstructured":"Marques MR, da Silva M, Barros SP (2003) Periodontal disease and osteoporosis association and mechanisms: a review of the literature. Braz J Oral Sci 2(4):137\u201340","journal-title":"Braz J Oral Sci"},{"issue":"7","key":"3549_CR33","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.1902\/jop.2005.76.7.1123","volume":"76","author":"M Tezal","year":"2005","unstructured":"Tezal M, Wactawski-Wende J, Grossi SG, Dmochowski J, Genco RJ (2005) Periodontal disease and the incidence of tooth loss in postmenopausal women. J Periodontol 76(7):1123\u20131128","journal-title":"J Periodontol"},{"issue":"4","key":"3549_CR34","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1111\/idh.12146","volume":"13","author":"YJ Kim","year":"2015","unstructured":"Kim YJ, Kim CB, Ahn YH, Chung WG, Kim NH (2015) Gender differences in chewing discomfort in older South Koreans. Int J Dent Hyg 13(4):273\u2013282. https:\/\/doi.org\/10.1111\/idh.12146","journal-title":"Int J Dent Hyg"},{"issue":"4","key":"3549_CR35","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1111\/inr.12055","volume":"60","author":"Y Ahn","year":"2013","unstructured":"Ahn Y, Kim N, Kim C, Ham O (2013) Factors affecting unmet healthcare needs of older people in Korea. Int Nurs Rev 60(4):510\u2013519","journal-title":"Int Nurs Rev"},{"issue":"1","key":"3549_CR36","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1186\/s12903-021-01575-3","volume":"21","author":"ES Choi","year":"2021","unstructured":"Choi ES, Jeon HS, Mun SJ (2021) Association between sleep habits and symptoms of oral disease in adolescents: the 2017 Korea youth risk behavior web-based survey. BMC Oral Health 21(1):233. https:\/\/doi.org\/10.1186\/s12903-021-01575-3","journal-title":"BMC Oral Health"},{"issue":"3","key":"3549_CR37","first-page":"119","volume":"5","author":"J Lee","year":"2015","unstructured":"Lee J, Kim B (2015) Relationship between the objective oral health status and the subjective oral health awareness of Korean adults. Asia Pac J Multimed Serv Converg Art Humanit Sociol 5(3):119\u2013130","journal-title":"Asia Pac J Multimed Serv Converg Art Humanit Sociol"}],"container-title":["Sleep and Breathing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-025-03549-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11325-025-03549-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11325-025-03549-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T18:14:30Z","timestamp":1774462470000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11325-025-03549-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,17]]},"references-count":37,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["3549"],"URL":"https:\/\/doi.org\/10.1007\/s11325-025-03549-z","relation":{},"ISSN":["1520-9512","1522-1709"],"issn-type":[{"value":"1520-9512","type":"print"},{"value":"1522-1709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,17]]},"assertion":[{"value":"12 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 October 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 November 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 January 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"was exempt since the raw data of KNHANES are publicly available and all participants in KNHANES are investigated anonymously by the Korea Disease Control and Prevention Agency (KDCA).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All authors declare no conflicts of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"20"}}