Ethnic variations in the association between obstructive sleep apnea and tooth loss

Abstract

OBJECTIVES: Obstructive sleep apnea (OSA) is the most prevalent life-threatening sleeping disorder with adverse consequences. Tooth loss is a suggested morphologic risk factor for OSA with a scope of racial variation. The goal of this study is to examine the racial variations that different group experiences for the tooth loss-Obstructive Sleep Apnea relationship. METHODS: A cross-sectional study was done to assess the racial variation for the tooth loss-Obstructive Sleep Apnea relationship using data from the 2005–2006 and 2007–2008 cycles of NHANES. It included the sleep health questionnaire to identify the primary outcome variable, OSA, and received an oral health examination that counted the number of teeth. We chose to explore OSA using the OSA questions and summary OSA variables based on Sanders et al who used the STOP questionnaire including snoring, snorting/gasping daytime sleepiness, and hypertension based on signs and symptoms recommended by the Academy of Sleep Medicine. RESULTS: Non-Hispanic whites constituted the highest percentage of people with high-risk OSA based on the STOP questionnaire. They had the highest percentage of individuals responding ‘yes’ to the OSA component questions for snorting/gasping, daytime sleepiness, and having been told by a healthcare professional that they had a sleep disorder. After controlling for potential confounders, in our race/ ethnicity stratified models, Hispanics had lower odds of OSA for each additional tooth present. CONCLUSION: OSA is underdiagnosed in the US population, and in a consistent manner across various race categories. Dentists should consider identifying individuals who are currently underdiagnosed or undiagnosed and refer them to a specialist. The effects of tooth loss on OSA are stronger for Hispanics than for other races, hence Hispanics should be targeted since they have the lowest diagnosis rate.