Objectives: To explore the relationship between edentulism and OSA in a representative sample of the U.S. adult population.
Methods: Data were derived from 11,076 adults aged 16 and older who had sleep related data and were examined during the 2005-2008 National Health and Nutrition Examination Survey (NHANES). High risk for OSA was defined as the presence of three or more cardinal OSA signs/symptoms: loud snoring; daytime tiredness; observed apnea; self-reported hypertension OR a doctor’s diagnosis of sleep apnea. Edentulism, defined as loss of ≥28 teeth, was determined by oral examination. Multivariable unconditional logistic regression estimated prevalence odds ratios (POR) and 95% confidence intervals (C.I.) for the relationship between edentulism and OSA accounting for the complex survey design of NHANES.
Results: The overall prevalence of OSA and edentulism were 7.7% and 6.7% respectively. In unadjusted analysis, odds of OSA were 76% greater in edentulous adults compared with the dentate (POR=1.76, 95% CI: 1.32, 2.35). Prevalence odds of OSA increased 29% for each successive decade of age (POR=1.29, CI: 1.23, 1.36). Obese individuals (BMI ≥30) were three times as likely as the non-obese to be at high risk for OSA (POR= 3.11, 95% CI: 2.53, 3.82), while high risk for OSA was less common among women than men (POR = 0.85, 95% CI: 0.68, 1.06). Having adjusted for age, gender and obesity, the relationship was no longer significant (POR= 1.06 95% CI: 0.76, 1.46).
Conclusion: Complete tooth loss was not an independent cause of OSA after accounting for other factors that commonly coexist with edentulism such as older age and weight gain.