man with hand over mouth

Big tongue and tonsils raise risk for sleep apnea

The best time to identify signs of obstructive sleep apnea may not be at night while snoozing in bed, but while sitting in the dentist’s chair.

A new study finds that oversized tonsils and tongue indentations—teeth imprints along the tongue that indicate it is too large for the mouth—place people at high risk for obstructive sleep apnea (OSA). Obese patients are almost 10 times more likely to report symptoms than non-obese patients.

OSA, a disorder in which breathing repeatedly stops and starts during sleep due to blocked upper airways, affects more than 18 million adults in the United States. Severe cases of the disorder are linked to cardiovascular disease, diabetes, depression, and memory loss.

While dentists can’t diagnose the disorder, they can spot an enlarged tongue or tonsils and recommend a patient see a sleep medicine specialist.

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“Dentists see into their patient’s mouths more than physicians do and the signs are easy to identify,” says Thikriat Al-Jewair, clinical assistant professor in the School of Dental Medicine at the University at Buffalo.

“We need to teach students about this condition before they get out in the field and educate dentists about the major role they play in identifying and treating patients with sleep-related disorders.”

Al-Jewair and colleagues analyzed 200 patients at dental clinics at the University of Dammam’s College of Dentistry in the Kingdom of Saudi Arabia. Testing for OSA was done using the Berlin Questionnaire, a validated assessment used to screen people for the disorder.

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Participants were then screened for potential risk factors of OSA, such as weight, neck circumference, blood pressure, and size of the tongue, tonsils, and uvula– the tissue that hangs in the back of the throat.

The results, published in the Saudi Medical Journal, showed that 23 percent of participants were at risk for OSA, of which nearly 80 percent were male.

The factors most common among people who were identified as high risk for OSA on the Berlin Questionnaire—along with obesity—were large tonsils, tongue indentations, and a high Epworth Sleepiness Scale score, another questionnaire used to measure daytime sleepiness.

Future research will expand the sample size to include various age groups and will monitor participant sleep overnight to confirm the prevalence and severity of OSA.

Source: University at Buffalo