5 Causes of OSA and How You Can Address Them

March 1, 2022

In the United States, one in three adults suffers from obstructive sleep apnea (OSA), a potentially life-threatening condition in which the individual affected repeatedly stops and starts breathing during periods of sleep. OSA is the most common form of sleep apnea and occurs when

  • the throat muscles relax,
  • the tongue creates an airway obstruction,
  • excessive weight cuts off airflow,
  • the individual is male and older, or
  • the individual is impaired by alcohol or sedatives.

Let’s discuss these five causes of OSA and how you can address them as a dental professional.

The Throat Muscles Relax

The first potential cause of OSA is weakened muscles in the throat and airway. In this case, the muscles in the back of the throat relax during periods of sleep. These muscles are responsible for supporting the soft palate, the uvula, the tonsils, and the walls of the throat and tongue. However, if they are weak, they cause our airways to significantly narrow or close altogether.

During an apneic period, the patient’s brain quickly senses that their body cannot get substantial airflow as the oxygen saturation level in their blood drops rapidly, issuing a panic signal, which rouses the individual from their sleep to manually reopen the airway. This might lead to an audible choke, gasp, or snort.

However, this sleep disruption is typically so brief that despite occurring many, many times during the night, the patient naturally doesn’t remember it. Unaware of their condition, the inability to maintain deep and restful sleep typically worsens health and wellness during the daytime.

If the patient has a bed partner, it is helpful to ask them if they notice any restlessness, snoring, or audible grinding during the night, as these are indicators of a sleep and breathing disorder. They are excellent resources and consultants.

The Tongue Creates an Airway Obstruction

Another cause of OSA is the tongue creating an airway obstruction. And the most common root cause of tongue obstruction is an underdeveloped airway. When the arch is narrow and high, the tongue has difficulty maintaining proper suction in the palette. Therefore, it can easily fall back into the throat during periods of sleep and trigger bouts of OSA. As dental professionals, the question we need to address here is “Why is the airway underdeveloped?”

The answer lies in Western culture, wherein the soft food diet, use of pacifiers, and a lack of breastfeeding are common.

In a scientific article by Brian Palmer, DDS, he shares

The American Academy of Pediatric Dentistry noted that 89 percent of children between the ages of 12 and 17 had some form of occlusal disharmony, and that 16 percent of youth had such a severe, handicapping malocclusion that treatment was mandatory. These figures are staggering when compared to my skull research, . . . which shows that before the invention of the modern baby bottle about 200 years ago, people had minimal malocclusion or decay. . . .

An article published in 1997 by a sleep research team from Stanford describes a formula for predicting OSA. It states that individuals with high palates, narrow dental arches, overjets (lower jaw retruded), and large necks who are overweight are at risk for OSA. The information is extremely significant when one realizes that evidence from skulls shows that before the invention of baby bottles and pacifiers, high palates, narrow dental arches, and overjets were rare.

As we can see, the aforementioned western factors caused weakened muscles in the orofacial region, improper sucking habits, and underdevelopment. Thankfully, methods and treatment options are available to tackle the root cause early and prevent many downstream comorbidities, such as diabetes, high blood pressure, heart disease, certain cancers, and dementia. We will discuss these in a later section.

Excessive Weight Cuts off Airflow

Another potential cause of OSA is excessive weight. Individuals who are obese and have excess weight, especially around the throat, are at an increased risk for OSA. Fat deposits in this region can easily obstruct breathing and place additional pressure on the airway.

Think about it: When you have a 20-, 30-, or 50-pounds overweight patient, that pressure pushes down on the body when resting in a supine position. Because of this, breathing takes additional effort, and the airway is much more likely to collapse.

One study in the US National Library of Medicine (NCBI) found that

People who are obese (with a BMI of more than 30) with shorter sleep duration have twice as many subjective sleep problems compared to non-obese people. Being obese or overweight is associated with decreased amount of sleep compared to non-obese patients. Obesity is associated with poor sleep quantity and quality; thus weight reduction can ameliorate sleep problems.

You’re Male and Older

Unfortunately, if you are a male and in late adulthood, you are more susceptible to developing OSA. Studies show that males are two to three times more likely to have sleep apnea than women. The reasoning behind this is described in an NCBI study: “Differences in upper airway anatomy, neurochemical mechanisms, the response to arousal, fat distribution, and sex hormones all contribute to the pathogenesis of the disease.” This is because gender plays a substantial role in each of these variables. However, it is worth noting that women can also face increased risk if they’re overweight or postmenopausal.

You’re Impaired by Alcohol or Sedatives

Alcohol and sedatives relax the muscles in our body, including the throat muscles, which, as we know, can worsen OSA.

The reasoning behind this is described in an NCBI study:

It is plausible that alcohol increases the risk of OSA because alcohol consumption reduces genioglossal muscle tone, predisposing patients to upper airway collapse and generally increasing upper airway resistance. High alcohol intakes also contribute to dietary energy intake, and hence in some cases a high body mass index, which is itself a risk factor for OSA.

In addition, individuals who smoke are also three times more likely to develop OSA versus their nonsmoking counterparts. This is because smoking increases the amount of inflammation in the body and can cause fluid retention in the upper airway.

How a Dentist Can Help Treat OSA

If your patient falls into one or many of these categories, don’t fret. As a dental professional, you are in the best position to screen and treat OSA. And revolutionary new treatments, such as Vivos Therapeutics oral appliances, are on the market, cost-effective, and simple to use for patients.

The first step is to ask your patients questions about their sleeping habits, quality, and ability to function well during the day. If your patient reports one or more of the following signs and symptoms, it is essential to have them complete an at-home sleep test:

  • Daytime fatigue, exhaustion, and sleepiness
  • Snoring or audible grinding during sleep
  • Mouth breathing
  • Apneic periods during sleep
  • Arousal during sleep, accompanied by gasping or choking
  • Waking with a dry mouth or sore throat
  • Morning headaches
  • An inability to concentrate
  • Inefficiency, brain fog, and memory impairment
  • Moodiness, depression, anxiety, or a failure to maintain stable emotions
  • High blood pressure
  • Decreased libido

As a dental professional, it is essential to understand these five causes of OSA and actively screen and treat patients. If you are interested in expanding your practice and education to encompass OSA and other sleep and breathing disorders, don’t hesitate to contact us at vivos.com.

Your help means the world as our team unites medical professionals globally. With your support, we can rid the world of obstructive sleep apnea forever.