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Sunderram J, Legard A, De Resende A, Black K, Udasin IG, Lu SE, Romero Castillo H, Ravi SS, Mullins AE, de la Hoz RE, Rapoport DM, Ayappa I. Lack of association of impaired upper airway sensation with the presence or absence of obstructive sleep apnoea or chronic rhinosinusitis in World Trade Center responders. Occup Environ Med 2024; 81:302-307. [PMID: 38871449 PMCID: PMC11239276 DOI: 10.1136/oemed-2023-109262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/07/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE Examine sensory function of the upper airway in four groups of subjects recruited from the World Trade Centre General Responder Cohort (WTCGRC), with/without obstructive sleep apnoea (OSA), and with/without chronic rhinosinusitis (CRS). METHODS Upper airway sensory function was determined using 2-point discrimination (2-PD) and vibration threshold (VT) in 163 WTCGRC subjects with both OSA and CRS (cases), OSA or CRS alone and without OSA or CRS (controls). Presence of OSA was determined from clinical sleep studies or home sleep testing. Presence of CRS was determined by nasal symptom questionnaire. The relationship between the presence of OSA and CRS and upper airway sensory impairment was assessed using linear regression analysis with each of 2PD and VT sensory threshold values as the dependent variable; OSA, CRS and their interaction were the independent variables. Age, gender and body mass index were covariates in the statistical model. The primary analysis was comparison of OSA+CRS versus controls (no OSA and no CRS) evaluated by linear contrasts. RESULTS There were no differences in 2-PD or VT in those with OSA+CRS, OSA and CRS alone or controls. However, both 2-PD and VT were significantly higher in the WTCGRC controls compared with values seen in historical controls using the same methodology (median 2-PD 13.0; CI (11.0 to 13.5) vs 10.5; CI (8 to 11); VT: mean±SEM (9.3±0.6 vs 2.2±0.1)). CONCLUSION While no differences were found in upper airway sensation between cases of OSA and CRS versus controls in the WTGRC population, there was evidence of impaired upper airway sensation in the WTGRC overall.
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Affiliation(s)
- Jag Sunderram
- Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Alicia Legard
- Environmental and Occupational Health Sciences Institute, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Adriana De Resende
- Environmental and Occupational Health Sciences Institute, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Kathleen Black
- Environmental and Occupational Health Sciences Institute, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Iris G Udasin
- Environmental and Occupational Health Sciences Institute, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Shou-En Lu
- School of Public Health, Rutgers Biomedical and Health Sciences, Piscataway, New Jersey, USA
| | - Horacio Romero Castillo
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Sri Saranya Ravi
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Anna E Mullins
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Rafael E de la Hoz
- Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - David M Rapoport
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Indu Ayappa
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
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Maniaci A, Lavalle S, Anzalone R, Lo Giudice A, Cocuzza S, Parisi FM, Torrisi F, Iannella G, Sireci F, Fadda G, Lentini M, Masiello E, La Via L. Oral Health Implications of Obstructive Sleep Apnea: A Literature Review. Biomedicines 2024; 12:1382. [PMID: 39061956 PMCID: PMC11274061 DOI: 10.3390/biomedicines12071382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/03/2024] [Accepted: 06/12/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep. While the systemic implications of OSA are well documented, the dental consequences are less frequently discussed yet equally significant. This review aims to elucidate the oral health impacts of OSA, emphasizing the importance of interdisciplinary care. METHODS A comprehensive literature search was conducted across several databases to identify studies examining the relationship between OSA and various oral health parameters. The review included observational studies, clinical trials, and systematic reviews published in English up to January 2024. RESULTS OSA was significantly associated with heightened risks of bruxism, dry mouth, periodontal disease, temporomandibular joint disorders, palatal and dental changes, and alterations in taste sensation. Mouth breathing associated with OSA was a critical factor in exacerbating xerostomia and dental caries. Furthermore, the systemic inflammation induced by OSA appeared to correlate with the severity of periodontal disease. Patients using oral appliance therapy for OSA also showed notable changes in dental occlusion and required ongoing dental monitoring. CONCLUSIONS The findings underscore the bidirectional relationship between OSA and oral health, highlighting the need for dental professionals to be integral participants in the management of OSA. Early dental evaluation and intervention can contribute to the overall health and quality of life of individuals with OSA. The review advocates for the development of clinical guidelines to facilitate the early identification and management of OSA-related oral health issues within dental practice and encourages a collaborative approach to patient care.
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Affiliation(s)
- Antonino Maniaci
- Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (F.T.)
| | - Salvatore Lavalle
- Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (F.T.)
| | - Riccardo Anzalone
- Otorhinolaryngology Section, Biomedicine, Neuroscience and Advanced Diagnostic Department, University of Palermo, 90127 Palermo, Italy; (R.A.); (F.S.)
| | - Antonino Lo Giudice
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, 95123 Catania, Italy;
| | - Salvatore Cocuzza
- Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia” ENT Section, University of Catania, 95124 Catania, Italy; (S.C.); (F.M.P.)
| | - Federica Maria Parisi
- Department of Medical, Surgical Sciences and Advanced Technologies “GF Ingrassia” ENT Section, University of Catania, 95124 Catania, Italy; (S.C.); (F.M.P.)
| | - Filippo Torrisi
- Department of Medicine and Surgery, University of Enna Kore, 94100 Enna, Italy; (S.L.); (F.T.)
| | - Giannicola Iannella
- Otorhinolaryngology Department, Sapienza University of Rome, 00161 Rome, Italy;
| | - Federico Sireci
- Otorhinolaryngology Section, Biomedicine, Neuroscience and Advanced Diagnostic Department, University of Palermo, 90127 Palermo, Italy; (R.A.); (F.S.)
| | - Gianluca Fadda
- Department of Otolaryngology, San Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano, Italy;
| | - Mario Lentini
- ASP Ragusa-Hospital Giovanni Paolo II, 97100 Ragusa, Italy;
| | - Edoardo Masiello
- Department of Radiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy;
| | - Luigi La Via
- Department of Anesthesia and Intensive Care, Azienda Ospedaliero Universitaria Policlinico “G.Rodolico-San Marco”, 95123 Catania, Italy;
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Wallace ES, Carberry JC, Toson B, Eckert DJ. A Systematic Review and Meta-Analysis of Upper Airway Sensation in Obstructive Sleep Apnea – Implications for Pathogenesis, Treatment and Future Research Directions. Sleep Med Rev 2022; 62:101589. [DOI: 10.1016/j.smrv.2022.101589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 10/19/2022]
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Liu Y, Fang F, Zhan X, Yao L, Wei Y. The impact of obstructive apnea sleep syndrome on chemical function. Sleep Breath 2020; 24:1549-1555. [PMID: 32034614 DOI: 10.1007/s11325-020-02022-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 01/07/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE/HYPOTHESIS To investigate the impact of obstructive sleep apnea syndrome (OSAS) on the olfactory and gustatory functions, and the potential mechanisms affecting olfactory and gustatory functions. MATERIALS AND METHODS A total of 120 men between the ages of 41 and 70 (mean age (SD) = 56 ± 7.5) were divided into three groups according to polysomnography results: snoring group, mild to moderate OSAS group, and severe OSAS group. Olfactory and gustatory functions were evaluated by the Sniffin' Sticks test and the triple-drop method, respectively. Otorhinolaryngologic examination, as well as sleep and quality of life questionnaires, were completed by all subjects one day before or after polysomnography. RESULTS There was a significant difference in odor thresholds (THR), odor discrimination (OD), odor identification (OI), thresholds-discrimination-identification (TDI) (p < 0.001, p < 0.001, p = 0.003, p < 0.001), and total taste score (p = 0.004, p = 0.021, p = 0.006) in all three groups. Of the subjects in the OSAS group, 43 (54%) exhibited olfactory dysfunction, including 18 subjects (45%) in the mild to moderate group and 25 subjects (63%) in the severe group. Significant negative correlations were found between all olfactory parameters and polysomnography parameters. Furthermore, a negative correlation was present between the total taste scores and the apnea-hypopnea index (AHI). CONCLUSION Men with OSAS exhibited impairment in olfactory and gustatory functions. Significant correlations were found between AHI and olfactory parameters, as well as between AHI and total taste scores.
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Affiliation(s)
- Yifan Liu
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China
| | - Fang Fang
- Department of Sleep Medical Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China
| | - Xiaojun Zhan
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China
- Department of Sleep Medical Center, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China
| | - Linyin Yao
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China
| | - Yongxiang Wei
- Department of Otolaryngology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Beijing, 100029, China.
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