Prevalence of probable obstructive sleep apnea risk and severity in a population of dental patients.

Abstract

Obstructive sleep apnea is a commonly undiagnosed chronic disease. While dentists represent an important resource for identifying people at risk for primary snoring and sleep apnea, less than 50% of dentists are capable of identifying the common signs and symptoms of sleep disordered breathing. The aim of this study is to assess the prevalence of probable obstructive sleep apnea/sleep disordered breathing and symptoms associated with this condition in a population of dental patients using a validated questionnaire and software that could be administered in a dental office. A retrospective analysis conducted at two dental practices using questionnaire responses obtained from 175 men and 156 women, and sleep study data obtained in the patient's homes from 75 men and 30 women with a portable recorder. Forty-six percent of the men and 19% of the women reported snoring frequently or always. Of the 67% of the men and 28% of the women identified as having a high pre-test probability (high risk) of having at least mild sleep apnea, over 33% of the men and 6% of the women surveyed were predicted to have moderate or severe sleep apnea. In a subgroup of 105 patients classified at high risk who completed an overnight sleep study, 96% had an apnea hypopnea index (AHI) greater than five events per hour. Seventy percent of those predicted to have moderate or severe OSA by questionnaire had an AHI greater than 20. All patients previously diagnosed with sleep apnea were correctly classified at high risk by ARES questionnaire. There was a high concordance between the predicted OSA risk and the degree of sleep disordered breathing. The high prevalence of undiagnosed sleep apnea in dental patients suggests that dentists could provide a valuable service to their patients by incorporating sleep apnea screening and treatment into their practice. Those who practice sedation dentistry should consider additional precautions when managing patients with risk of sleep apnea.