Obstructive Sleep Apnea Syndrome and its Dental Management

Obstructive sleep apnea syndrome (OSAS) has a prevalence of 2 to 4% in the adult population and is associated with a reduced quality of life and increased risk of road traffic accidents due to excessive sleepiness. Continuous positive airway pressure (CPAP) and oral appliance (OA) are effective therapies and are the most widely used modalities in patients with the disease. OSAS is also associated with an increased risk of cardiovascular disease, especially hypertension. In this presentation, I would like to review the relationship between OSAS and cardiovascular diseases and the effectiveness of the CPAP and OA to manage the signs and symptoms of the OSAS and to reduce the risk of the cardiovascular diseases. The mechanisms by which OSAS predisposes a person to cardiovascular disease are not fully understood, but they likely include elevated sympathetic drive secondary to recurrent hypoxias and arousals from sleep, with loss of the resetting of the baroreceptor control, and increased oxidative stress secondary to recurring oxygen desaturation and resaturation. As a dentist, I would also like to review effectiveness of the OA for reduction of their blood pressure and signs and symptoms of the diseases with a real OSAS cases, contrasting to the effectiveness of the CPAP.