obstructive sleep apnea
a clinical review
Keywords:
OSA, SDB, Hypopnea, REM, pharyngeal critical closing pressure
Abstract
The aim of this article is to provide a detailed description for obstructive sleep apnea regarding its signs and symptoms, the way it is diagnosed, the risk factors, management, the role of dentists and oral appliances in treatment. Obstructive sleep apnea (OSA) is a potentially life-threatening disorder characterized by repeated collapse of the upper airway during sleep, with periodic cessation of breathing for more than ten seconds.
Dental professionals have a unique doctor patient relationship that can help them in recognizing the sleep disorder and co-managing the patients along with a physician or a sleep specialist. Oral appliance therapy is an important treatment modality for sleep apnea patients
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References
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2. Meenakshi S, Raghunath N. Sleep Apnea: More than Just a Noise. J Orofac Res 2012; 2(2):76-81.
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4. Waller P C, Bhopal RS. Is snoring a cause of vascular disease: An epidemiological review. Lancet 1989;1:143-146.
5. Shamsuzzan AS, Gesh BJ Somers VK. Obstructive sleep apnea: Implications for Cardiac and vascular diseases. JAMA- 2003;1906-1914.
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7. Grace KP, Hughes SW, Horner RL. Identification of the Mechanism Mediating Genioglossus Muscle Suppression in REM Sleep. Am J Respir Crit Care Med 2013;187:311-319.
8. McSharry DG, Saboisky JP, Deyoung P, Jordan AS, Trinder J, Smales E et al. Physiological Mechanisms of Upper Airway Hypotonia During REM Sleep. Sleep 2014;37:561-569.
9. Aurora RN, Crainiceanu C, Gottlieb DJ, Kim JS, Punjabi NM. Obstructive Sleep Apnea during REM Sleep and Cardiovascular Disease. Am J Respir Crit Care Med. 2018;197(5):653-660.
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11. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing in middle-aged adults. N Engl J Med 1993; 328(17):1230-5.
12. Goodday RH. Nasal respiration, nasal airway resistance, and obstructive sleep apnea syndrome. Oral Maxillofac Surg Clin North Am 1997; 9(2):167-77.
13. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-43.
14. Guilleminault C, Hill MW, Simmons FB, Dewent WC. Obstructive sleep apnea: electromyographic and fiberoptic studies. Exp Neurol 1978; 62(1):48-67.
15. Remmers JE, DeGroot WJ, Sauerland EK, Anch AM. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol 1978; 44(8):931-8.
16. Lowe AA, Santamaria JD, Fleetham JA, Price C. Facial morphology and obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1986; 90(6):484-91.
17. Eckert DJ, Malhotra A. Pathophysiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5:144-53.
18. Young T, Skatrud J. Peppard PE. Riskfactors for obstructive sleep apnea in adults. JAMA 2004; 291:2013 6.
19. Eikermann M, Jordan AS, Chamberlin NL, gautam S, Wellman A, Lo YL, et al. The influence of aging on pharyngeal collapsibility during sleep. Chest. 2007; 131:1702-9.
20. Jordan AS, McEvoy RD. gender differences in sleep apnea: epidemiology, clinical presentation and pathogenic mechanisms. Sleep Med Rev 2003; 7 : 377-89.
21. Schwart AR, Patil SP, Laffan AM, Polotsky V, Schneider H, Smith PL. Obesity and obstructive sleep apnea– pathogenic mechanism and therapeutic approaches. Proc Am Thorac Soc2008; 5:185-92.
22. RedlineS, Tishler PV. The genetics of sleep apnea. Sleep Med Rev 2000; 4 :583-602.
23. Schwab RJ. Genetic determinants of upper airway structures that predispose to obstructive sleep apnea. Respir Physiol Neurobiol 2005; 147: 289-98.
24. Khoo SM, Tan WC, Ng TP, Ho CH. Risk factors associated with habitual snoring and sleep-disordered breathing in a multi-ethnic Asian population: a population-based study. Resp Med 2004; 98:557-66.
25. Ekici M, Ekici A, Keles H, Akin A,Karlidag A, Tunckol M, et al. Risk factors and correlates of snoring and observed apnea. Sleep Med 2008; 9:290-6.
26. Balachandran JS, Patel SR. In the clinic. Obstructive sleep apnea. Ann Intern Med ;161(9):1-15
27. Polysomnography Task Force, American sleep Disorders Associaion Standarda of Practice Committee, Practice parameters for the indications for polysomnographu and related procedure. Sleep 1997:20:406-22.
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29. Gottlieb DJ, Punjabi NM. Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA. 2020;323(14):1389-1400.
30. Johns MW. Anew method measuring daytime sleepiness: The Epworth sleepiness scale. Sleep 2001:14:540-45.
31. Freidman M, Tanyeri H, LaRosa M, Landsberg R, Vaidyanathan K, Pieri S, et al. Clinical predictors of obstructive sleep apnea. Laryngoscope 1999:109:1901-07.
32. Yuko Shigeta, Takumin Ogawa. Oral surgery, Oral medicine, Oral pathology, Oral Radiology 2011` Feb:111(2):239-43.
33. Ramandeep Dugal, M.E.Kothavade, Smita Musani. Role of dentist in management of Obstructive Sleep Apnea-An Overview. IJDA 2010; 2(2) :191-196.
34. Veasey SC, Rosen IM. Obstructive Sleep Apnea in Adults. N Engl J Med. 2019;380(15):1442-1449.
35. Sullivan CE, Issa F G, Berthon Jones M, Eves L. Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the nares. Lancet 1981;1:862-865.
36. Joo MJ, Hendegen JJ. Sleep apnea in an urban public hospital: Assessment of severity and treatment adherence. J Clin Sleep Med. 2007;3:285-288.
37. Lowe AA; Dental appliances for treatment of snoring and sleep apnea. In: Kruyger M, Roth T, Dement W, eds. Principles and Practice of Sleep Medicine. 2nd ed. Philidelphia: WB Saunders Co., 1994; pp722-735.
38. Isono S, Tanaka A, Sho Y, Konn A, Nishino T.Advancement of mandible improves velopharygeal airway patency. J Appl. Physiol 1995;79:2132-2138.
39. Venkat R, Gopichander N Vasantkumar M. Four novel prosthodontics method for managing upper airway resitance syndrome: An investigative analysis revealing the efficacy of the new nasopharyngeal aperture guard appliance, Indina J Dent Res 2010;21:44-8.
40. D. Saee S, S.Sarin P and S Pravin: Obstructive Sleep Apnoea: Dental Implications & Treatment Strategies. Int J Dent Sci. 2009; 7 (1):1-11.
41. Aarnoud Heokema, Frist de Vries, Kees Heydenrijk and Boudewijn Stegenga: Implant-retained oral appliances: a novel treatment for edentulous patients with obstructive sleep apnea-hyponea syndrome. Clin Oral Imp Res 2007; 10-3:383-387.
42. Padma A, Ramakrishnan N, Narayan V; Management of obstructive sleep apnea: A dental perspective Indian J Dent. Res 2007;18:201-209.
43. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. American Sleep Disorders Association 1995;18: 511-513.
44. Jefferey Pancer, Salem Al Faidi, Mohamed Al Fiadi and Victor Hoffstein: Evaluvation of variable mandibular advancement appliances for treatment of snoring and sleep apnea. Chest 1999; 116:1511-1518.
45. Kazya Yoshida DDS PhD. Effect on blood pressure of Oral Appliance Therapy for Sleep Apnea Syndrome Int. J Prosthodont 2006;19:61-66.
46. Kathleen A, Ferguson MD, Rosalind Cartwright, Robert Rogers, Wolfgang Schmidt Nowara. Oral Appliances for snoring and Sleep Apnea: A review Sleep; 2006; 29(2): 244-262.
47. Michael Friedman, Paul Schalch. Palatal stiffening after failed uvulopalatopharyngoplasty with the Pillar implant system. Oper Tech Otolaryngol- Head Neck Surg 2007; 18(1):7-10.
48. Salles C, Mascarenhas Barbosa H. COVID-19 and obstructive sleep apnea. J Clin Sleep Med. 2020;16(9):1647.
49. Nunes JOF, Apostolico JS, Andrade DAG, Ruiz FS, Fernandes ER, Andersen ML et al. Sleep deprivation predisposes allergic mice to neutrophilic lung inflammation. J Allergy Clin Immunol. 2018;141(3):1018-1027
2. Meenakshi S, Raghunath N. Sleep Apnea: More than Just a Noise. J Orofac Res 2012; 2(2):76-81.
3. Muhamad A, Azzaldeen A, Nezar W, Firas K. Asian Pac J Health Sci 2014; 1(4): 528-538
4. Waller P C, Bhopal RS. Is snoring a cause of vascular disease: An epidemiological review. Lancet 1989;1:143-146.
5. Shamsuzzan AS, Gesh BJ Somers VK. Obstructive sleep apnea: Implications for Cardiac and vascular diseases. JAMA- 2003;1906-1914.
6. Kelly R Magliocca, Joseph I Helman. Obstructive sleep apnea. Diagnosis, medical management and dental implications. J Am Dent. Assoc. 136(8): 1121-1129.
7. Grace KP, Hughes SW, Horner RL. Identification of the Mechanism Mediating Genioglossus Muscle Suppression in REM Sleep. Am J Respir Crit Care Med 2013;187:311-319.
8. McSharry DG, Saboisky JP, Deyoung P, Jordan AS, Trinder J, Smales E et al. Physiological Mechanisms of Upper Airway Hypotonia During REM Sleep. Sleep 2014;37:561-569.
9. Aurora RN, Crainiceanu C, Gottlieb DJ, Kim JS, Punjabi NM. Obstructive Sleep Apnea during REM Sleep and Cardiovascular Disease. Am J Respir Crit Care Med. 2018;197(5):653-660.
10. Diagnostic Classifications Steering Committee: The international classification system of sleep disorders diagnostic and coding manual. Rochester, MN: American Sleep Disorders Association, 1990.
11. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing in middle-aged adults. N Engl J Med 1993; 328(17):1230-5.
12. Goodday RH. Nasal respiration, nasal airway resistance, and obstructive sleep apnea syndrome. Oral Maxillofac Surg Clin North Am 1997; 9(2):167-77.
13. Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5: 136-43.
14. Guilleminault C, Hill MW, Simmons FB, Dewent WC. Obstructive sleep apnea: electromyographic and fiberoptic studies. Exp Neurol 1978; 62(1):48-67.
15. Remmers JE, DeGroot WJ, Sauerland EK, Anch AM. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol 1978; 44(8):931-8.
16. Lowe AA, Santamaria JD, Fleetham JA, Price C. Facial morphology and obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1986; 90(6):484-91.
17. Eckert DJ, Malhotra A. Pathophysiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008; 5:144-53.
18. Young T, Skatrud J. Peppard PE. Riskfactors for obstructive sleep apnea in adults. JAMA 2004; 291:2013 6.
19. Eikermann M, Jordan AS, Chamberlin NL, gautam S, Wellman A, Lo YL, et al. The influence of aging on pharyngeal collapsibility during sleep. Chest. 2007; 131:1702-9.
20. Jordan AS, McEvoy RD. gender differences in sleep apnea: epidemiology, clinical presentation and pathogenic mechanisms. Sleep Med Rev 2003; 7 : 377-89.
21. Schwart AR, Patil SP, Laffan AM, Polotsky V, Schneider H, Smith PL. Obesity and obstructive sleep apnea– pathogenic mechanism and therapeutic approaches. Proc Am Thorac Soc2008; 5:185-92.
22. RedlineS, Tishler PV. The genetics of sleep apnea. Sleep Med Rev 2000; 4 :583-602.
23. Schwab RJ. Genetic determinants of upper airway structures that predispose to obstructive sleep apnea. Respir Physiol Neurobiol 2005; 147: 289-98.
24. Khoo SM, Tan WC, Ng TP, Ho CH. Risk factors associated with habitual snoring and sleep-disordered breathing in a multi-ethnic Asian population: a population-based study. Resp Med 2004; 98:557-66.
25. Ekici M, Ekici A, Keles H, Akin A,Karlidag A, Tunckol M, et al. Risk factors and correlates of snoring and observed apnea. Sleep Med 2008; 9:290-6.
26. Balachandran JS, Patel SR. In the clinic. Obstructive sleep apnea. Ann Intern Med ;161(9):1-15
27. Polysomnography Task Force, American sleep Disorders Associaion Standarda of Practice Committee, Practice parameters for the indications for polysomnographu and related procedure. Sleep 1997:20:406-22.
28. Flemons WW, Buysse D, Redline S, et al. Sleep related disorders in adults: Recommendations for syndrome definition and measurement techniques in clinical research – the report ofan American Academy of Sleep Medicine Task Force. Sleep 1997:22:667-89.
29. Gottlieb DJ, Punjabi NM. Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA. 2020;323(14):1389-1400.
30. Johns MW. Anew method measuring daytime sleepiness: The Epworth sleepiness scale. Sleep 2001:14:540-45.
31. Freidman M, Tanyeri H, LaRosa M, Landsberg R, Vaidyanathan K, Pieri S, et al. Clinical predictors of obstructive sleep apnea. Laryngoscope 1999:109:1901-07.
32. Yuko Shigeta, Takumin Ogawa. Oral surgery, Oral medicine, Oral pathology, Oral Radiology 2011` Feb:111(2):239-43.
33. Ramandeep Dugal, M.E.Kothavade, Smita Musani. Role of dentist in management of Obstructive Sleep Apnea-An Overview. IJDA 2010; 2(2) :191-196.
34. Veasey SC, Rosen IM. Obstructive Sleep Apnea in Adults. N Engl J Med. 2019;380(15):1442-1449.
35. Sullivan CE, Issa F G, Berthon Jones M, Eves L. Reversal of obstructive sleep apnea by continuous positive airway pressure applied through the nares. Lancet 1981;1:862-865.
36. Joo MJ, Hendegen JJ. Sleep apnea in an urban public hospital: Assessment of severity and treatment adherence. J Clin Sleep Med. 2007;3:285-288.
37. Lowe AA; Dental appliances for treatment of snoring and sleep apnea. In: Kruyger M, Roth T, Dement W, eds. Principles and Practice of Sleep Medicine. 2nd ed. Philidelphia: WB Saunders Co., 1994; pp722-735.
38. Isono S, Tanaka A, Sho Y, Konn A, Nishino T.Advancement of mandible improves velopharygeal airway patency. J Appl. Physiol 1995;79:2132-2138.
39. Venkat R, Gopichander N Vasantkumar M. Four novel prosthodontics method for managing upper airway resitance syndrome: An investigative analysis revealing the efficacy of the new nasopharyngeal aperture guard appliance, Indina J Dent Res 2010;21:44-8.
40. D. Saee S, S.Sarin P and S Pravin: Obstructive Sleep Apnoea: Dental Implications & Treatment Strategies. Int J Dent Sci. 2009; 7 (1):1-11.
41. Aarnoud Heokema, Frist de Vries, Kees Heydenrijk and Boudewijn Stegenga: Implant-retained oral appliances: a novel treatment for edentulous patients with obstructive sleep apnea-hyponea syndrome. Clin Oral Imp Res 2007; 10-3:383-387.
42. Padma A, Ramakrishnan N, Narayan V; Management of obstructive sleep apnea: A dental perspective Indian J Dent. Res 2007;18:201-209.
43. Practice parameters for the treatment of snoring and obstructive sleep apnea with oral appliances. American Sleep Disorders Association 1995;18: 511-513.
44. Jefferey Pancer, Salem Al Faidi, Mohamed Al Fiadi and Victor Hoffstein: Evaluvation of variable mandibular advancement appliances for treatment of snoring and sleep apnea. Chest 1999; 116:1511-1518.
45. Kazya Yoshida DDS PhD. Effect on blood pressure of Oral Appliance Therapy for Sleep Apnea Syndrome Int. J Prosthodont 2006;19:61-66.
46. Kathleen A, Ferguson MD, Rosalind Cartwright, Robert Rogers, Wolfgang Schmidt Nowara. Oral Appliances for snoring and Sleep Apnea: A review Sleep; 2006; 29(2): 244-262.
47. Michael Friedman, Paul Schalch. Palatal stiffening after failed uvulopalatopharyngoplasty with the Pillar implant system. Oper Tech Otolaryngol- Head Neck Surg 2007; 18(1):7-10.
48. Salles C, Mascarenhas Barbosa H. COVID-19 and obstructive sleep apnea. J Clin Sleep Med. 2020;16(9):1647.
49. Nunes JOF, Apostolico JS, Andrade DAG, Ruiz FS, Fernandes ER, Andersen ML et al. Sleep deprivation predisposes allergic mice to neutrophilic lung inflammation. J Allergy Clin Immunol. 2018;141(3):1018-1027
How to Cite
1.
kota SP, Lavanya, Bandari G, Ramesh Goud S.V, Chikurmally S. obstructive sleep apnea . Int J Med Res Rev [Internet]. 2023Feb.2 [cited 2024Dec.23];10(6):183-94. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1403
Section
Review Article
Copyright (c) 2023 Author (s). Published by Siddharth Health Research and Social Welfare Society
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