Jauhar Snoring Research

Restorative Dentistry 674 DentalUpdate December 2010 Sachin Jauhar The Role of the Dentist in Sleep Disorders Abstract: Snoring and sleep apnoea are common. The demand for sleep medicine ser vices has increased exponentially since the recognition of sleep apnoea as a disease in the 1960s. The involvement of dentists in the treatment of sleep apnoea has increased. This article provides an overview of the disorders and options for management. Clinical Relevance: It is important that dentists are aware of the problem of sleep disorders and the potential they have to help in their management. Dent Update 2010; 37: 674–679 Patients with snoring problems are becoming increasingly aware that dental appliances may provide a solution. The areas of sleep medicine that dentists can be of help with are the treatment of snoring, obstructive sleep apnoea hypopnoea syndrome (OSAHS) and bruxism, but this review will focus only on snoring and OSAHS. The social disturbance caused by the snorer can result in marital disharmony . In this respect, in a Scottish study it was found that 85% of snorers were sleeping in another room owing to their snoring noise. 1 Snoring is more common in males than females and in overweight people of both sexes. Its prevalence rises markedly after the age of 40 years, with 63% of males and 44% of females being habitual snorers. 2 Most snorers are unaware of their snoring, with 471 of 613 patients in one study answering ‘don’t know’ when asked if they snore ( Ta ble 1). 3 Therefore, it would seem appropriate to ask the patient’s bed partner about the snoring problem. This presents a challenge, as many patients will attend either without their bed partner or they may be single. In addition, there is variability in snoring intensity and frequency from night to night. In addition to the obvious social problems with snoring, it has been associated with vascular disease, and other conditions such as daytime dysfunction, asthma and hearing loss. It is important to recognize that these studies have conflicting results and there is no clear evidence that snoring, on its own, has a significant impact on health. If a patient has simple snoring, with no soci al implications, they may be managed by lifestyle advice and made aware of the signs and risk factors for sleep apnoea. If the patient has daytime dysfunction due to unrefreshing sleep or social issues due to snoring, their management is similar to that of sleep apnoea. Sachin Jauhar, BDS, MFDS, RCS(Edin), FDS(Rest Dent), RCPS(Glasg), Consultant and Honorary Senior Clinical Lecturer in Restorative Dentistry, Glasgow Dental Hospital and School, Robert Orchardson, BSc, BDS, PhD, FDS RCPSG, Senior Lecturer Oral Biology, University of Glasgow, Ingrid Jauhar, BDS, MFDS, Senior Salaried Dental Officer (Special Needs) NHS Lanarkshire, Stephen Banham, MB ChB, MD, Consultant Department of Respiratory Medicine Gartnavel General Hospital, Mervyn Lyons, BDS, MSc, PhD, FDS RCPS, FDS RCS(Edin), Senior Lecturer and Honorary Consultant in Restorative Dentistry, University of Dundee, UK. Obstructive sleep apnoea hypopnoea syndrome A significant health risk is associated with OSAHS and it is important that dentists are aware of the aetiology, pathogenesis and treatment of this condition. Sleep apnoea is the popular term for obstructive sleep apnoea hypopnoea syndrome (OSAHS). OSAHS consists of lengthy pauses in breathing during sleep and this causes recurrent arousals, sleep fragmentation, and nocturnal hypoxemia. The condition results in daytime sleepiness, impaired vigilance and cognitive functioning, and reduced quality of life. 4,5 The prevalence of mild OSAHS ranges from 17–25.9%, with moderate OSAHS ranging from 3.1–9.1%, and severe from 3.1–4%. Prevalence is Robert Orchardson, Ingrid Jauhar, Stephen Banham and Mervyn Lyons Male Obesity Smoker Ingestion of tranquillizers or muscle relaxants Alcohol consumption Table 1. Risk factors for snoring. 3

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Jauhar Snoring Research