Orthodontists Role in Treatment of Obstructive Sleep Apnea
Posted on 04/10/2019

Orthodontist role in Sleep Disordered Breathing

Adam J. Weiss, D.M.D., Orthodontist 

Sleep plays a very important role in overall body health. Sleep disordered breathing is the disruption of a restful sleep by snoring or gasping.   Poor sleep can lead to multiple health issues including increased risk of heart disease, kidney disease, high blood pressure, diabetes, and stroke.  Children and teens with poor sleep can have issues getting along with others, concentration issues in school, and moodiness.  Sleep deficiency can also increase the risk of obesity.

Allowing for enough hours of sleep is very important, but for some, it is the quality of that sleep that has the greater impact.  For some, quality sleep is negatively affected by snoring or obstructive sleep apnea (OSA).   OSA can be identified by momentary cessation of breathing, followed by gasping for air during sleep. This can occur multiple times throughout the night.  It is very important for children and/or adults who feel tired during the day to discuss with their physician or pediatrician this symptom.  Generally, a sleep study will be conducted to test for OSA and confirm a diagnosis.  The diagnosis must be made by a physician, and preferably one that specializes in sleep medicine.  If diagnosed, treatment with a CPAP device will most likely be recommended.  For those who cannot tolerate the CPAP, or who have mild to moderate obstructive sleep apnea, an oral device may be recommended.  This device is usually provided by a dental professional who provides this service.  Orthodontists, in general, have a lot of experience working with oral appliances for the treatment of OSA.

For pre-teens with sleep disordered breathing, i.e. snoring/OSA, there are therapies that are showing promise to help with this issue.  Arch expansion, typically used to resolve crowding and/or correct crossbites, has been shown in studies to help with airway.  Mandibular advancement appliances used for young patients with deficient mandibles have also been shown to help improve airway.  While the improvement in airway is considered a secondary benefit to the Orthodontic treatment needs, it can often direct the Orthodontist to provide treatment in an otherwise borderline case.   At this time, there are no current studies that demonstrate whether these benefits achieved early will carry into adulthood.  Also, there is no indication that children who have had expansion or mandibular repositioning appliances used during their treatment, are immune from developing OSA in adulthood.  With that being said, the Orthodontist is becoming an integral member of the team involved in improving the quality of sleep.  More information on the treatment of OSA or primary snoring can be found at a website we created at: http://www.oralsleepappliance.com/ .