Sleep Apnea Identification & Treatment in Dentistry

DESCRIPTION (provided by applicant): Obstructive Sleep Apnea (OSA) is the most common disorder observed in the practice of sleep medicine and is responsible for more mortality and morbidity than any other sleep disorder. OSA causes daytime drowsiness and cognitive impairment, and has been associated with hypertension and increased risk of cardiovascular disease, diabetes and stroke. Untreated OSA patients are 3-7 times more likely to be involved in industrial and motor vehicle accidents. Recent population-based epidemiological studies reveal OSA is highly prevalent in adults. One in five adults was identified with mild OSA; one in fifteen have moderate to severe OSA. These studies reported that even mild OSA is associated with significant morbidity. Despite the growing evidence that untreated OSA threatens public health, safety and productivity, current estimates reveal that more than 85% of individuals with moderate to severe OSA remain undiagnosed largely as a result of lack of awareness among healthcare professionals and the public. One goal of the proposed research is to increase awareness of undiagnosed OSA through collaboration with dentists and dental sleep specialists because they are increasingly involved with the identification and treatment of OSA with oral appliances or Mandibular Advancement Devices (MAD). Advanced Brain Monitoring, Inc. developed and validated the Apnea Risk Evaluation System (ARES), an easy to administer, in-home diagnostic test for OSA to provide an alternative to time-consuming, expensive laboratory sleep studies. ARES provides a cost-effective method for dental sleep specialists to evaluate patients for OSA. ARES can also be applied repeatedly following the insertion of the oral appliances to provide guidance in adjusting the devices and to document treatment efficacy. The Phase I study is designed to demonstrate the utility of ARES in evaluating 30 patients prior to and following treatment with oral appliance therapy. A preliminary investigation will also be conducted to identify predictors of treatment success with oral appliances to allow selection of patients most likely to benefit from it.