Orthodontists may be the first to spot Sleep Apnea and Sleep-Disordered Breathing
The short answer is yes. Although an orthodontist cannot diagnose and treat OSA (obstructive sleep apnea) on her/his own, they may possibly be the first medical professional in line to recognize signs and symptoms in both children and adults.
Your orthodontist is well-positioned to conduct a screening assessment for obstructive sleep apnea and sleep-disordered breathing (SDB) and refer at-risk individuals for a diagnostic evaluation. In the event that it is deemed appropriate by your physician, your orthodontist may closely work with your medical team to support the management of the disease.
What are the causes and symptoms of obstructive sleep apnea?
OSA is the most common form of sleep apnea and arises when the upper airway is not patent or becomes blocked due to the relaxation throat muscles or other airway obstructions such as narrow airway, or obesity.
Children with OSA may show primary snoring, have witnessed pauses in breathing, and gasp or choke during sleep. Sometimes it can be observed that a child sleeps in unusual positions. Often children appear very restless and frequently change their positions while sleeping. Other symptoms in children include sleepiness which can impact routing daily activities and school performance.
Children with OSA or SDB may have difficulty concentrating and fall asleep during schoolwork. In some children, hyperactivity rather than sleepiness may occur. This may be the reason why some children are erroneously diagnosed with ADHD. While obesity can be a contributor in some children, others may be afflicted with failure to thrive.
Adults with OSA often present with snoring, choke and gasp for air, and even pauses in breathing all together can be observed during sleep. Adults may also experience frequent night awakenings, suffer from non-restorative sleep, excessive daytime sleepiness, frequent morning headaches, mood alterations and mood disturbances, difficulty with concentration and attention, and inability to focus on daily tasks. Also, adults with OSA can suffer from difficulty controlling other medical conditions such as hypertension, obesity, and diabetes.
What does sleep apnea treatment look like?
One of the more common treatment modalities is positive airway pressure (PAP) therapy, which is seen as the gold standard treatment for obstructive sleep apnea (OSA) in adult patients. This so-called PAP therapy is delivered through a mask worn at night-time during sleep.
In those cases where a specialist for sleep medicine believes that a patient would best benefit from changing the position of the jaws (orthognathic surgery), an orthodontic specialist is the most qualified professional to provide that treatment. In some cases, if may be useful to use a special appliance for patients to wear during the night that keeps the jaw in a more favorable position.
Some OSA patients can benefit from nasal and/or palatal surgery with or without lower jaw (mandibular) surgery. With the advancement of forward movement of the lower jaw, the tongue inadvertently is moved forward as well, which can help increase the airway and improve breathing. Other soft-tissue surgeries might be indicated that involve the tonsils and adenoids and the tongue.
The takeaway
OSA (obstructive sleep apnea) and SDB (Sleep-disordered breathing) are medical disorders that can have many serious consequences when left unresolved. These conditions can affect individuals of any age and can show up at any point in the lifespan.
Dr. Dina Sanchez is an AAO orthodontist and a Diplomate of the American Board of Orthodontics (ABO). You can work with Dr. Sanchez to achieve a healthy, beautiful smile at any age. If you suspect your child or yourself suffering from sleep-disordered breathing or sleep apnea.
For your complimentary consultation call (410)296-4400