Sleep apnea, and particularly Obstructive Sleep apnea, is a common disorder that is characterized by a repetitive, partial or complete cessation of air flow, associated with oxyhemoglobin desaturation and an increased effort to breath. In recent years, orthodontists have been interested and involved in the management of this disorder since it has been shown that oral appliance therapy can be an effective treatment approach for Obstructive Sleep apnea (OSA). The purpose of this article is to present a review of OSA by describing this disorder, its diagnosis, currently available treatment modalities and, in particular, the role of oral appliance therapy in its treatment.

Background: One of the main challenges of surgical treatment in Obstructive Sleep Apnea (OSA) is identifying the correct site of upper airway obstruction in an individual patient. Drug-Induced Sleep Endoscopy (DISE) in sedated patients with Obstructive Sleep apnea is the technique of choice for revealing anatomic and dynamic collapsible areas. Materials and Methods: In a prospective cross-sectional study adult patients with OSA documented by polysomnography were evaluated by Sleep endoscopy. DISE had been done by an otolaryngologist in the setting of operating room during infusion of propofol and after the start of snoring. Endoscopic findings were recorded and evaluated from the aspect of obstruction level, severity, and multiplicity. Results: Twenty OSA patients (60% men) with mean± SD age of 38. 9± 9. 26 years and mean Body Mass Index (BMI) of 26. 57 kg/m2 were included in the study. OSA was severe in 11(55%) and moderate in 5(25%) subjects. Unilevel airway collapse was observed as retropalatal in 4(20%) and retrolingual in 3(15%) subjects. Multilevel collapse had been observed in the other 13(65%) patients. Most patients (65%) had multilevel obstruction especially those with BMI>30 (p<0. 05). With increasing BMI, obstruction changed from unilevel to multilevel. None of the subjects showed complications with propofol or endoscopy procedure. Conclusion: Our study showed DISE is safe, easy to perform, and informative in OSA patients. In particular, we observed a significant association between obesity and multilevel upper airway collapse.

The number of patients who suffer from snoring and Sleep apnea in Iran has been increasing in proportionate to the rest of the world as the prevalence of obesity has soared within the last two decades. This pandemic obesity is blamed on consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats. Obesity is one of the major contributing factors of Obstructive Sleep apnea. The number of people snoring in Iran is not well established, but since many years ago this bizarre behavior was looked upon as an annoying sound that some people have and it was thought that they have to live with it. It was not until early twentieth century that scientists began to relate an association between snoring, obesity, and Sleep-related disorders. At present time, it is well documented and universally agreed that snoring as well as Sleep apnea are far more prevalent in societies and can lead to other serious illnesses including heart attack, stroke, and even nocturnal death. Obstructive Sleep apnea is a term used to describe cession of breathing while Sleep for a period of 10 seconds or more and repeated over five times per hour of Sleep. In this article, we review various methods of surgical treatments and the long-term relapse potential for each.