Journal of the Canadian Dental Association 652 December 2001, Vol. 67, No. 11 C L I N I C A L P R A C T I C E A n increasing number of people are realizing that changes in their sleeping habits and daytime behav- iour may be attributable to obstructive sleep apnea syndrome (OSAS). This new awareness has led many patients to seek both information and definitive treatment. Because the jaws and related structures influence the devel- opment of this syndrome, dentists play an important role in both identifying patients who should be assessed by sleep specialists and instituting treatment in selected cases. The purpose of this article is to provide information to dentists that will enable them to identify patients who may have OSAS and to assist these patients in making informed decisions regarding treatment options. Prevalence OSAS is characterized by repetitive episodes of upper airway obstruction that occur during sleep usually in asso- ciation with a reduction in blood oxygen saturation. 1 The prevalence of OSAS in the middle-aged population (30 to 60 years) is 4% in men and 2% in women. 2 However, prevalence rises dramatically with age, to an estimated 28% to 67% for elderly men and 20% to 54% for elderly women. 3 Clinical Manifestations The clinical manifestations of OSAS are related to obstruction of the upper airway, fragmented sleep, and the respiratory and cardiovascular consequences of disordered breathing. Excessive daytime somnolence is a key feature of OSAS resulting from disrupted sleep. Patients may report that they frequently fall asleep during the day while driving, working, reading and watching television. 4 Thus, perform- ing activities related to transportation or the use of machin- ery and heavy equipment can put both the patient and others at significant risk of injury. 5,6 Chronic daytime sleepiness also leads to poor work performance and decreased productivity. Snoring, ranging in severity from mild to extremely loud, is invariably present. The partners of people with OSAS may witness gasping, choking or periods of apnea, with repeated arousals through the night. In many cases these symptoms are significant enough that the partner sleeps in another room. When questioned in the morning the patient is usually unaware of the frequency of arousals. Other complaints include a feeling of not being rested despite a full night of sleep, dry mouth, morning headaches, absence of dreams, fatigue, decreased libido and symptoms of depression. Obstructive Sleep Apnea Syndrome: Diagnosis and Management • Reginald H.B. Goodday, DDS, MSc, FRCD(C) • • David S. Precious, DDS, MSc, FRCD(C ) • • Archibald D. Morrison, DDS, MSc, FRCD(C) • • Chad G. Robertson, DDS • Abstract Increased awareness that changes in sleeping habits and daytime behaviour may be attributable to obstructive sleep apnea syndrome (OSAS) has led many patients to seek both information and definitive treatment. The purpose of this article is to provide information to dentists that will enable them to identify patients who may have OSAS and to assist these patients in making informed decisions regarding treatment options. In patients who have identifiable anatomic abnormalities of the maxilla and mandible resulting in a narrow pharyngeal airway, orthognathic surgery appears to be an excellent treatment option. MeSH Key Words: sleep apnea, obstructive/diagnosis; sleep apnea, obstructive/surgery © J Can Dent Assoc 2001; 67(11):652-8 This article has been peer reviewed.