Orthodontist and Obstructive Sleep Apnea Screening Tools

Main Article Content

Tuangporn Jessadapornchai
Bancha Samruajbenjakun

Abstract

Obstructive sleep apnea (OSA) is a sleep disorder that contributes to disrupted sleep due to a cessation of breathing or a decrease in airflow. OSA is diagnosed by polysomnography (PSG), which is considered to be the gold standard. However, conducting a PSG has limitations that include, time consumption, inconvenience, and cost. Also, all institutions may not have the equipment, technicians, or expert sleep physicians for a definitive diagnosis of OSA. Patients who have subclinical symptoms may go undiagnosed because of its non-specificity and patient unawareness. OSA should be examined in a timely manner. If the disease goes undiagnosed for an extended time, many short- and long-term unsatisfactory outcomes may occur that affect a person’s lifestyle leading to dramatic consequences. Recent literature encourages orthodontists to know how to investigate OSA and the upper airway using questionnaires and radiography as screening tools before undergoing polysomnography.

Article Details

How to Cite
1.
Jessadapornchai T, Samruajbenjakun B. Orthodontist and Obstructive Sleep Apnea Screening Tools. Thai J Orthod [Internet]. 2024 Oct. 11 [cited 2024 Nov. 21];14(2):58-67. Available from: https://he01.tci-thaijo.org/index.php/THAIORTHO/article/view/266891
Section
Review Article

References

Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American academy of sleep medicine clinical practice guideline. J Clin Sleep Med 2017;13(3):479-504.

Eckert DJ, Malhotra A. Pathophysiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008;5(2):144-53.

Chen H, Aarab G, de Ruiter MHT, de Lange J, Lobbezoo F, van der Stelt PF. Three-dimensional imaging of the upper airway anatomy in obstructive sleep apnea: a systematic review. Sleep Med 2016;21:19-27.

Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328(17):1230-5.

Netzer NC, Hoegel JJ, Loube D, Netzer CM, Hay B, Alvarez- Sala R, et al. Prevalence of symptoms and risk of sleep apnea in primary care. Chest 2003;124(4):1406-14.

Tawaranurak K, Leelasawatsuk P, Chaiyarukjirakun V. Prevalence, risk factors and clinical manifestation of patients suspected as having obstructive sleep apnea in Songklanagarind Hospital sleep center. J Health Sci Med Res 2019;37(4):305-12.

Neruntarat C, Chantapant S. Prevalence of sleep apnea in HRH Princess Maha Chakri Srinthorn Medical Center, Thailand. Sleep Breath 2011;15(4):641-8.

Posiri C, Chaiworawitkul M. Risk factors related to obstructive sleep apnea syndrome in children with repaired cleft lip and palate. Thai J Orthod 2024;14(1):68-77.

Behrents RG, Shelgikar AV, Conley RS, Flores-Mir C, Hans M, Levine M, et al. Obstructive sleep apnea and orthodontics: an American association of orthodontists white paper. Am J Orthod Dentofacial Orthop 2019;156(1):13-28.

Ibáñez V, Silva J, Cauli O. A survey on sleep assessment methods. Peer J 2018;6:e4849.

Banhiran W, Durongphan A, Saleesing C, Chongkolwatana C. Diagnostic properties of the STOP-Bang and its modified version in screening for obstructive sleep apnea in Thai patients. J Med Assoc Thai 2014;97(6):644-54.

Hamilton GS, Chai-Coetzer CL. Update on the assessment and investigation of adult obstructive sleep apnoea. Aust J Gen Pract 2019;48(4):176-81.

Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 1999;131(7):485-91.

Chai-Coetzer CL, Antic NA, Rowland LS, Catcheside PG, Esterman A, Reed RL, et al. A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care. Thorax 2011;66(3):213-9.

Neelapu BC, Kharbanda OP, Sardana HK, Balachandran R, Sardana V, Kapoor P, et al. Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: a systematic review and meta-analysis of cephalometric studies. Sleep Med Rev 2017;31:79-90.

McNamara JA Jr. A method of cephalometric evaluation. Am J Orthod 1984;86(6):449-69.

Somboonsap N, Banhiran W, Metheetrairut C, Chiewvit P. Lateral cephalometric analysis in Thai patients without clinical features of obstructive sleep apnea syndrome. Siriraj Med J 2020;63(5):157-62.

Sforza E, Bacon W, Weiss T, Thibault A, Petiau C, Krieger J. Upper airway collapsibility and cephalometric variables in patients with obstructive sleep apnea. Am J Respir Crit Care Med 2000;161(2 Pt 1):347-52.

Banhiran W, Wanichakorntrakul P, Metheetrairut C, Chiewvit P, Planuphap W. Lateral cephalometric analysis and the risks of moderate to severe obstructive sleep-disordered breathing in Thai patients. Sleep Breath 2013;17(4):1249-55.

Major MP, Flores-Mir C, Major PW. Assessment of lateral cephalometric diagnosis of adenoid hypertrophy and posterior upper airway obstruction: a systematic review. Am J Orthod Dentofacial Orthop 2006;130(6):700-8.

Major MP, Saltaji H, El-Hakim H, Witmans M, Major P, Flores-Mir C. The accuracy of diagnostic tests for adenoid hypertrophy: a systematic review. J Am Dent Assoc 2014;145(3):247-54.

Ogawa T, Enciso R, Shintaku WH, Clark GT. Evaluation of cross-section airway configuration of obstructive sleep apnea. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(1):102-8.

Alsufyani NA, Flores-Mir C, Major PW. Three-dimensional segmentation of the upper airway using cone beam CT: a systematic review. Dentomaxillofac Radiol 2012; 41(4):276-84.

Buchanan A, Cohen R, Looney S, Kalathingal S, De Rossi S. Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls. Imaging Sci Dent 2016;46(1):9-16.

Bruwier A, Poirrier R, Albert A, Maes N, Limme M, Charavet C, et al. Three-dimensional analysis of craniofacial bones and soft tissues in obstructive sleep apnea using cone beam computed tomography. Int Orthod 2016;14(4): 449-61.

Hatcher DC. Cone beam computed tomography: craniofacial and airway analysis. Dent Clin North Am 2012;56(2):343-57.

Lavigne GJ, Cistulli PA, Smith MT. Sleep medicine for dentists. Chicago: Quintessence; 2009.p.210.

Rodrigues MM, Pereira Filho VA, Gabrielli MFR, Oliveira TFM de, Batatinha JAP, Passeri LA. Volumetric evaluation of pharyngeal segments in obstructive sleep apnea patients. Braz J Otorhinolaryngol 2018;84(1):89-94.

Guijarro-Martínez R, Swennen GR. Cone-beam computerized tomography imaging and analysis of the upper airway: a systematic review of the literature. Int J Oral Maxillofac Surg 2011;40(11):1227-37.

Alsufyani NA, Noga ML, Witmans M, Major PW. Upper airway imaging in sleep-disordered breathing: role of cone-beam computed tomography. Oral Radiol 2017;33(3):161-9.

Steffy DD, Tang CS. Radiographic evaluation of sleepdisordered breathing. Radiol Clin North Am 2018;56(1): 177-85.

Obelenis Ryan DP, Bianchi J, Ignácio J, Wolford LM, Gonçalves JR. Cone-beam computed tomography airway measurements: Can we trust them? Am J Orthod Dentofacial Orthop 2019;156(1):53-60.

Zimmerman JN, Lee J, Pliska BT. Reliability of upper pharyngeal airway assessment using dental CBCT: a systematic review. Eur J Orthod 2017;39(5):489-96.

Ps I, Jose R, Shanmugham AM, Ramachandran A, Nair PK, Kumar KS, et al. Evaluation of presence of nasal deviation in patients presenting with obstructive sleep apnea using cone beam computed tomography. Cranio 2023;13:1-7.

Yeom SW, Kim MG, Lee EJ, Chung SK, Kim DH, Noh SJ, et al. Association between septal deviation and OSA diagnoses: a nationwide 9-year follow-up cohort study. J Clin Sleep Med 2021;17(10):2099-106.

Jafari-Pozve N, Kiani H, Aryanezhad SS. Comparing dimensions of upper airway in patients with nasal septal deviation and healthy people in CBCT. Am J Nucl Med Mol Imaging 2022;12(1):33-40.

Momany SM, AlJamal G, Shugaa-Addin B, Khader YS. Cone beam computed tomography analysis of upper airway measurements in patients with obstructive sleep apnea. Am J Med Sci 2016;352(4):376-84.

Lowe AA, Gionhaku N, Takeuchi K, Fleetham JA. Threedimensional CT reconstructions of tongue and airway in adult subjects with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1986;90(5):364-74.

Campbell M, Sapra A. Physiology, Airflow Resistance. StatPearls [Internet]. 2023 [cited 2024 Jan 22]. Available from: https://pubmed.ncbi.nlm.nih.gov/32119288

Lenza MG, Lenza MM, Dalstra M, Melsen B, Cattaneo PM. An analysis of different approaches to the assessment of upper airway morphology: a CBCT study. Orthod Craniofac Res 2010;13(2):96-105.

Enciso R, Nguyen M, Shigeta Y, Ogawa T, Clark GT. Comparison of cone-beam CT parameters and sleep questionnaires in sleep apnea patients and control subjects. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109(2):285-93.

Ghoneima A, Kula K. Accuracy and reliability of conebeam computed tomography for airway volume analysis. Eur J Orthod 2013;35(2):256-61.

Theprungsirikul W, Sutthiprapaporn P. Relationship between obstructive sleep apnea and extraction teeth in orthodontic treatment. Thai J Orthod 2024;14(1):41-67.

Chaudhry U, Cohen JR, Al-Samawi Y. Use of cone beam computed tomography imaging for airway measurement to predict obstructive sleep apnea. Cranio 2022;40(5):418-24.