International Journal of Medical Science and Clinical Invention 5(05): 3844-3847, 2018 DOI:10.18535/ijmsci/v5i5.18 ICV 2016: 77.2 e-ISSN:2348-991X, p-ISSN: 2454-9576 © 2018,IJMSCI 3844 International Journal of Medical Science and Clinical Invention, vol. 5, Issue 05, May, 2018 Research Article Management of Obstructive Sleep Apnoea- A Review Article Rohit Raghavan 1 ,Shajahan P A 2 , Monisha V S 3 1 Professor & HOD ,Dept of Prosthodontics and crown and Bridge and Implantology,Royal Dental College,Palakkad, Kerala 2 Professor ,Dept of Prosthodontics and crown and Bridge and Implantology,Royal Dental College,Palakkad, Kerala 3 Post Graduate Student, Dept of Prosthodontics and crown and Bridge and Implantology,Royal Dental College,Palakkad, Kerala Abstract: Sleep disordered breathing is a term which includes simple snoring, upper airway resistance syndrome, and obstructive sleep apnea (OSA). Simple snoring is a common complaint affecting 45% of adults occasionally and 25% of adults habitually and is a sign of upper airway obstruction. The role of dentistry in sleep disorders is becoming more significant, especially in co-managing patients with simple snoring and mild to moderate OSA. The practicing dental professional has the opportunity to assist patients at a variety of levels, starting with the recognition of a sleep-related disorder, referring patients to a physician for evaluation, and assisting in the management of sleep disorders. Diagnosis of OSA is made on the basis of the history and physical examination and investigations such as polysomnography, limited channel testing, split- night testing, and oximetry. The American Academy of Sleep Medicine (AAOSM) has recommended oral appliances for use in patients with primary snoring and mild to moderate OSA. It can also be used in patients with a lesser degree of oxygen saturation, relatively less day time sleepiness, lower frequency of apnea, those who are intolerant to CPAP, or those who refuse surgery. Keywords: Dental implications, obstructive sleep apnea, oral appliances. INTRODUCTION Upper airway sleep disorders (UASDs) are conditions that occur in the upper airway that diminish sleep time and sleep quality, resulting in patient exhibiting symptom that include day time sleepiness, tiredness and lack of concentration. American Academy of Sleep Medicine 2009“defined by the occurrence of daytime sleepiness, loud snoring, witnessed breathing interruptions, or awakening due to gasping or choking in the presence of at least 5 obstructive respiratory events(apneas, hypopneas or respiratory effort related arousals) per hour of sleep.” PATHO-PHYSIOLOGIC ASPECT OF OBSTRUCTIVE SLEEP APNEA It is characterized by cessation of airflow because of upper airway obstruction despite simultaneous respiratory effort . The respiratory effort continues despite obstruction until the individual is aroused from sleep. 1 During sleeping genioglossus, tensor veli palatini and other muscles which hold the airway patent gets relaxed, mandible move posteriorly as does the tongue which decreases upper airway volume. This causes decrease in the oxygen blood level by Central reflex stimulation which increases respiratory muscle contraction. Air gets sucked in at increased velocity causing vibration of soft palate and uvula resulting in snoring . 2 CLASSIFICATION OF SLEEP APNEAS The American Academy Of Sleep Medicine (AASM) classify sleep apneas (A) According to Severity :Described by MCNAMARA ET AL • NORMAL : AHI/RDI < 5 Episodes/hr • MILD : AHI/RDI = 5-20 • MODERATE : AHI/RDI = 20-40 • SEVERE : AHI/RDI > 40 Episodes can last from 10-120 seconds ACCORDING TO ORIGIN: OBSTRUCTIVE SLEEP APNEA: Cessation of airflow due to total airway collapse despite persistent effort to breathe. OSA is the most common type of sleep apnea. CENTRAL SLEEP APNEA: Much less common than OSA occur due to lack of CNS stimulation to respiratory muscles. Airway remains open, the chest wall muscles make no effort to create airflow. Etiology is encephalitis, brain