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Oral Health Topics

Sleep Apnea (Obstructive)

Key Points

  • Sleep-related breathing disorders comprise a variety of diagnoses, including simple snoring, hypopnea, upper airway resistance syndrome, central sleep apnea, and obstructive sleep apnea (OSA). OSA is the most prevalent form of sleep apnea, accounting for over 80% of sleep-disordered breathing cases in the U.S.
  • OSA is characterized by recurrent narrowing or collapse of the upper airway during sleep, resulting in partial or complete cessation of airflow despite continued respiratory effort. Risk factors associated with OSA include oral or craniofacial abnormalities (e.g., large tongue or tonsils, retrognathia), anthropometric features (e.g., obesity), male gender and advanced age. OSA has numerous health consequences, ranging from sleep fragmentation and excessive daytime sleepiness to chronic hypertension, coronary heart failure, neurocognitive dysfunction and ischemic stroke.
  • OSA is a common sleep disorder and potentially dangerous when left untreated. OSA is also often underdiagnosed, but risk factors and predisposing symptoms of OSA can be identified in various clinical settings, including dental practice.
  • When taking patient health histories and conducting oral clinical examinations, dentists can screen patients for OSA-related risk factors or common presenting features, such as: large tongue or tonsils; mandibular retrognathia or micrognathia; large neck circumference; nocturnal choking or gasping; obesity; loud or irregular snoring; or breathing pauses during sleep (if reported by bed partner). Individuals presenting with these symptoms or features may be referred to a primary care physician or sleep medicine specialist for further evaluation.
  • Various treatment options are available for patients with OSA, including the use of positive airway pressure (PAP) therapy. Oral appliance therapy is also a commonly recommended modality for patients with mild to moderate OSA (or people with severe apnea who cannot tolerate the use of PAP).
  • Dentists working collaboratively with primary care physicians and sleep specialists, as part of a multidisciplinary care team, can assist in providing optimal long-term care for patients with OSA, including periodic dental and periodontal assessment, as well as fabrication and maintenance of properly fitted oral appliances that can be used safely over time.

Sleep Apnea (Obstuctive)

  • Introduction
  • Prevalence
  • Symptoms, Risk Factors and Complications
  • Diagnosis
  • Treatment Options
  • Dental Considerations
  • ADA Policy
  • References
  • ADA Resources
  • Other Resources
Reviewed by: Clinical Excellence Subcommittee, Council on Scientific Affairs, and the Center for Dental Practice

Date posted: March 10, 2020

Prepared by:

Department of Scientific Information, Evidence Synthesis & Translation Research, ADA Science & Research Institute, LLC.


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