Oral sleep apnea : A prosthodontic overview

Obstructive sleep apnoea (OSA) is a sleep disordered breathing disease involving repeated obstruction of the upper airway during sleep. The occlusion of the upper airway is caused by sleep-induced physiologic change in muscle activity superimposed with various structural defects of upper airway, sleeping in supine position, upper airway oedema caused by smoking, hypothyroidism, acromegaly and nasal obstruction. Symptoms include daytime sleepiness, poor sleep quality, headache, and restless legs. Almost every branch in dentistry needs to be aware of sleep disorders and their potential impact. Diagnosis of OSA can be made on history, examination, polysomnography, limited channel testing, split-night testing, and oximetry. Comprehensive evaluation is essential for selecting and planning obstructive sleep apnoea (OSA) treatments. Methods: A comprehensive literature search was conducted across several databases to identify studies examining the treatment of OSA. The review included observational studies, clinical trials, and systematic reviews published in English up to January 2024. Conclusions: OSA treatment requires a multi-disciplinary approach. Studies show that Mandibular Advancement Devices (MADs)are most effective among all the oral appliances. MADs are indicated in the treatment of patients with mild to moderate OSA and in patients who do not tolerate CPAP. MADs reduce sleep apnea and daytime sleepiness and improve quality of life. While in severe cases, CPAP therapy or Surgical intervention is the only viable treatment option.