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Dental Comorbidities and Risk Factors of Sleep-Disordered Breathing

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Dental Sleep Medicine

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Abstract

Sleep-related breathing disorders refer to several pathologies, which include snoring, upper airway resistance syndrome, and obstructive sleep apnea. The pathophysiology of OSA is characterized by repetitive oropharyngeal collapse and occlusions during sleep, which obstructs the airway. It is associated with sleep fragmentation, hypoxemia, hypercapnia, marked swings in intrathoracic pressure, increased sympathetic activity and inflammatory markers and cytokines, and cardiovascular complications.

The prevalence of OSA in the adult population is estimated to be between 2 and 4%, with the major factors being age, sex, and weight. There are multiple structural, orthopedic, and physical contributing factors for OSA. Neck size and intraoral structures are common factors that contribute to the collapse of the oropharyngeal structures. These factors can include elongation of the soft palate and uvula from the pulling forces due to snoring and loss of vertical dimension shortening the lower one-third of the face. OSA can be influenced by bruxism, resulting in attrition of teeth, extraction of teeth causing a loss in jaw support, increase in tongue size due to fat deposition in the tongue, constriction of dental arches due to extraction of first bicuspids during orthodontics, and negative transmural pressure gradient and tissue weight.

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Abbreviations

AHI:

Apnea-hypopnea index

BMI:

Body mass index

DSA:

Dental sleep appliance

HH:

Hypnic headache

OAT:

Oral appliance therapy

OHS:

Obstructive hypopnea syndrome

OSA:

Obstructive sleep apnea

RDI:

Respiratory distress index

REM:

Rapid eye movement

RERA:

Respiratory effort-related arousal

RME:

Rapid maxillary expansion

SB:

Sleep bruxism

SRBD:

Sleep-related breathing disorder

T&A:

Adenotonsillectomy

TMD:

Temporomandibular joint dysfunction

TTH:

Tension-type headache

UARS:

Upper airway resistance syndrome

VDO:

Vertical dimension of occlusion

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Authors and Affiliations

  1. Center for TMJ and Sleep Therapy, Glendora, CA, USA

    G. Gary Demerjian & Rachel-Marie Demerjian

  2. Smile for life Dental Group, Santa Clara, CA, USA

    Pooja Goel

  3. Craniofacial Pain and Dental Sleep Center, Atlanta, GA, USA

    Mayoor Patel

  4. Maryland Center for Craniofacial TMJ and Dental Sleep Disorders, Ellicott City, MD, USA

    Anthony Sims

  5. Department of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, CA, USA

    André Barkhordarian

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  1. G. Gary Demerjian
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  2. Pooja Goel
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  3. Mayoor Patel
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  4. Anthony Sims
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  5. Rachel-Marie Demerjian
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  6. André Barkhordarian
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Correspondence to G. Gary Demerjian .

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  1. Center For TMJ & Sleep Therapy, Glendora, CA, USA

    G. Gary Demerjian

  2. Craniofacial Pain & Dental Sleep Center, Atlanta, GA, USA

    Mayoor Patel

  3. Dental Group of Sherman Oaks, Los Angeles, CA, USA

    Francesco Chiappelli

  4. Department of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, CA, USA

    André Barkhordarian

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Demerjian, G.G., Goel, P., Patel, M., Sims, A., Demerjian, RM., Barkhordarian, A. (2022). Dental Comorbidities and Risk Factors of Sleep-Disordered Breathing. In: Demerjian, G.G., Patel, M., Chiappelli, F., Barkhordarian, A. (eds) Dental Sleep Medicine. Springer, Cham. https://doi.org/10.1007/978-3-031-10646-0_6

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