Obstructive Sleep Apnoea: a dental perspective

Abstract

Obstructive sleep apnoea (OSA) is regarded as a potentially life threatening breathing disorder characterised by periodic cessation of air intake during sleep. Treatment modalities include conservative measures such as weight loss, change in sleep position and avoidance of alcohol: these may suffice in reducing airway obstruction. Pharmacotherapy has also been used with various grades of success. Nasal continuous positive airway pressure (nCPAP) helps maintain airway patency during sleep by a continuous stream of air under light pressure. Tracheostomy, by its very nature, completely bypasses any pharyngeal obstruction but is associated with a high degree of morbidity. Other surgical procedures such as uvulopalatopharyngoplasty (UPPP), orthognathic surgery, hyoid-myotomy suspension and tongue reduction have also been used. Mandibular advancement splints (MAS) are increasingly being recognised as a suitable management option for those subjects with mild to moderate OSA. A study was undertaken to ascertain the effectiveness of using mandibular advancement splints in the treatment of OSA. Mandibular protrusion using a MAS is frequently, but not invariably, associated with improvement in velo- and oro-pharyngeal airway dimensions in awake subjects.