Edentulism and Obstructive Sleep Apnea: A Case Report

Purpose: Obstructive sleep apnea (OSA) is a common disease that is estimated to affect 2% of middle-aged women and 4% of middle-aged men. Reported risk factors include obesity, increased neck circumference, male sex and anatomical abnormalities of the face. Although edentulism is reported to change the anatomy and also impair the function of the upper airway, it has not been typically recognized as a risk factor for sleep-related breathing disorders. Methods: The subject of this report is a 55 years old man with a body mass index (BMI) of 33 kg/m 2 . Cephalometric assessments of head radiographs taken in the lateral plane with and without dentures were performed; mandible plane- hyoid (MP-H) distance and the posterior airway space (PAS) were measured. Oxygen saturation (SaO2) and apnea/hypopnea index (AHI) were evaluated. Results: A comparison of the polysomnographies taken with and without wearing the dentures during the night showed that AHI was reduced (from 20.0/h to 5.7/h) and mean SaO2 increased (from 94.0% to 96.0%). Cephalometric analysis showed that the removal of dentures led to a striking increase in the anteroposterior oropharyngeal wall distance from 5 mm to 10 mm, while the mandible plane-hyoid distance does not change. Conclusions: These findings were consistent with the hypothesis that edentulism not always worse OSA by an oropharyngeal collapse. Given the common occurrence of both conditions among the elderly, such as the reduction of obstructive sleep apneas with or without dentures, the observed relationship requires further investigations on the mechanisms through which the loss of teeth could help upper airway collapse during the night. In the present paper a case of reduction of OSA without dentures during sleep is shown.