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Obstructive sleep apnoea syndrome presenting as lingual ulceration
A G Smyth1, R P Ward-Booth, A F Henderson
1Department of Oral and Maxillofacial Surgery, Sunderland District General Hospital.
The British Journal of Oral & Maxillofacial Surgery
|August 1, 1992
Summary
Lingual ulceration can be an unusual presenting symptom of obstructive sleep apnoea syndrome. This condition, characterized by frequent apnoeic episodes, can be diagnosed with common hospital investigations.
Area of Science:
- Otolaryngology
- Sleep Medicine
- Dentistry
Background:
- Obstructive sleep apnoea syndrome (OSAS) is a common sleep disorder.
- Diagnosis typically relies on symptoms like snoring and daytime somnolence, and polysomnography.
- Lingual ulceration is not a commonly recognized initial symptom of OSAS.
Observation:
- Two patients presented with lingual ulceration as their primary complaint.
- Both patients had frequent apnoeic episodes during sleep, leading to significant drops in oxygen saturation.
- The ulceration was hypothesized to be caused by repeated tongue trauma during forceful inspiratory efforts at the end of apnoea.
Findings:
- Sleep apnoea syndrome diagnosis was confirmed based on symptoms and a high number of apnoeic episodes per hour.
- Standard hospital investigations were sufficient for diagnosis.
- Referral to a specialized sleep centre may be needed before treatment initiation.
Implications:
- Highlights an unusual oral manifestation of obstructive sleep apnoea syndrome.
- Suggests considering OSAS in patients presenting with unexplained lingual ulcers.
- Emphasizes the importance of thorough investigation for sleep-disordered breathing.
- Standard medical management includes weight loss and nasal continuous positive airway pressure (CPAP).