Oral Appliances May Treat Some Elite Athletes with Obstructive Sleep Apnea.

August 12, 2016

Dentists should ask athletic patients about symptoms such as snoring and daytime sleepiness

BY PETER BLAIS, RPSGT

The Olympic Games captivate audiences around the world, as top athletes vie for gold, silver, and bronze medals. While obstructive sleep apnea (OSA) is not stereotypically linked with elite athletes such as those competing in the Olympics, research has found that there are cases in which athletic body types may actually predispose athletes to OSA.

“Increased neck circumference and short neck are attributes seen in some athletes (such as swimmers, wrestlers, and football players) that may increase the risk of sleep apnea,” says Helene A. Ensellem, MD, director of the Center for Sleep and Wake Disorders in Chevy Chase, Md, in an e-mail to Dental Sleep Corner. Ensellem co-authored a 2005 study titled “Sleep Apnea and Sports Performance” that discusses OSA pathophysiology, diagnostic modalities, and treatment interventions for athletes.

While the thicker necks of older, deconditioned, and obese individuals more stereotypically indicate high OSA risk, the enhanced muscle and fat pads in thinner necks of top athletes can impinge on the well-conditioned individual’s airway, especially during REM sleep.

Another condition sometimes seen among top athletes, recessed jaw or retrognathia, is an anatomical variant that may be associated with a shallower-than-average airway and a greater risk of sleep apnea, Ensellem notes.

“Dentists should screen their athletes for sleep apnea using screening tools such as the STOP-BANG questionnaire or specifically asking about snoring, the restorative nature of sleep, and daytime sleepiness,” Ensellem advises. “Portable home apnea screening devices offer an easy and inexpensive way to evaluate at-risk athletes for possible underlying sleep apnea.”

When asked about oral appliances as a therapy for these athletic OSA sufferers, Ensellem says, “For some of these patients, depending on the severity of the apnea, the use of a mandibular advancement appliance may be appropriate.”