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ortho - the international C.E. magazine of orthodontics

20 I I technique_ sleep apnea _Interdisciplinary treatment planning is a con- cept that’s gaining relevance among oral health professionals. It’s one of the chief tenets of the popular Seattle Study Club, and many find it extremely rewarding to work with a group of like-minded professionals when treating their patients. This evolving holistic approach to oral health is exemplified in the evolv- ing role that the orthodontist can play in addressing sleep apnea. Thenotionthatpeopleshouldseeanorthodontist about the sleeping problems they or their children endure might come as a surprise to the general public, but more and more medical and orthodontic experts are pointing toward a future that heads in that direction. Consider, for example, the most common type of sleep-disordered breathing: obsessive sleep apnea syndrome (OSAS). It’s quite common among both children and adults, though precisely how common canbedifficulttosaybecausetheconditionissignifi- cantly under-diagnosed. A 2012 paper in the journal Pediatrics placed sleep apnea numbers among children within the broad range of 1 to 5 percent of the population. The nonprofitSleepFoundationestimatesthatatleast18 million adults have OSAS. The syndrome can affect patients in a range from mild to severe, with the more serious cases being quite dangerous to long-term health. Among children,OSAShasbeenlinkedwithpoorschoolper- formance, learning disabilities, behavior problems andevensomecardiacabnormalities.Inadults,itcan boost the risk of hypertension, cardiovascular dis- ease, coronary artery disease and insulin-dependent diabetes. _What causes sleep apnea? The word apnea comes from the Greek apnoia, which means “breathless.” That’s exactly what hap- pens in OSAS, as sufferers stop breathing for brief intervalsintheirsleep,andtheydothisoverandover again throughout the night. Such breathing gaps create wide variations in the heart rate and in levels of oxygen saturation. Inthesimplestsense,thishappensbecauseeither the upper airway collapses or it’s obstructed. Why that happens is a more complicated question. •  Excessive weight can cause upper airway complications. An estimated two out of three OSAS patients are obese. People with big necks are at higher risk as well; size 17 in men and 16 in women seem to be a cutoff point for medical professionals ortho1_2014 Sleep apnea and orthodontics: An interdisciplinary approach to treating a chronic sleep condition Author_Jim Duffy

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