Obstructive Sleep Apnea -An Orthodontic review
Abstract: Obstructive Sleep Apnea is caused by an interplay between a variety of factors, including sleep related loss of muscle tone in the tissues supplied by the glossopharyngeal nerve,a natomical obstruction of the nasal passages, large tonsils, large tongue, a retrognathic mandible, obesity, alcohol, sedative medication, allergies. The orthodontic approach is intended to provide patients with immediate relief from OSA, as well as changes to the airway that may address an underlying cause. It can be treated using surgery, continuous positive airway pressure and oral appliances therapy. This article review some of the basic aspects of this sleep-related disorder, its diagnosis and treatment modalities.
Keywords: Orthodontics, Obstructive Sleep Apnea, mandibular advancement, Oral appliance, CPAP
Snoring sound is produced by the vibration of the soft palate or other oropharyngeal tissues, it can became a medical concern because it is key symptom of OSA. Disease is characterized by upper airway obstruction, associated with repeated gaps in breathing and interrupted sleep. Cessations of breathing for 10 seconds or longer are termed apneas (from greek- without breath), When 30 or more apneic episodes occur in the course of seven hours of sleep, resulting in excessive sleepiness during the working hours, a person is described as having sleep apnea syndrome. This may begin at any age, but incidence increases with age.
Anatomic factors that can contribute to OSA are maxillary or mandibular retrognathism, increased lower facial height, large tongue elongated soft palate, inferiorly positioned hyoid bone. This points out how critical the role of orthodontist can be in diagnosing and treating OSA. The first description of this disorder in the medical literature was in 1965 effective treatment that modify these health risks have emerged. Although continuous positive airway pressure (CPAP) is the most efficacious treatment. It requires the used of a mask interface, sealed tubing , and a device connected to a power source. This complexity limits its acceptance by patients and leads to suboptimal treatment adherence.
Oral appliances are a simpler alternative to CPAP for the treatment of Obstructive sleep Apnea (OSA). They are often considered by patients to be a more acceptable treatment modality compared to CPAP. As they are quiet, portable, and do not require a power source,. While the role of oral appliances for the treatment of OSA was unclear in the past, this has changed dramatically. There are served modalities of treatment for obstructive sleep apnea. The use of the oral appliances for management of airway obstruction started in 1900 when the French stomatologist Pierre Robin used oral appliances to manage upper airway obstruction of neonates born with Pierre Robin syndromes.
Continuation in the next articles of this series.
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