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Obstructive Sleep Apnea and Neurocognitive Dysfunction in Edentulous Patients.

Soumyojeet Bagchi1, Arvind Tripathi2, Suryakant Tripathi3

  • 1Department of Prosthodontics, Saraswati Dental College & Hospital, Lucknow, Uttar Pradesh, India.

Journal of Prosthodontics : Official Journal of the American College of Prosthodontists
|February 23, 2018
PubMed
Summary

Edentulous patients with obstructive sleep apnea (OSA) often experience cognitive dysfunction. Treatment with a modified mandibular advancement device improved cognitive function, suggesting a link between OSA severity, edentulousness, and cognitive impairment.

Keywords:
Comorbiditiescognitive dysfunctionincidenceobstructive sleep apneapolysomnography

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Area of Science:

  • Dental Sleep Medicine
  • Neuroscience
  • Gerontology

Background:

  • Obstructive sleep apnea (OSA) is linked to cognitive deficits.
  • Edentulousness, the state of being toothless, may exacerbate cognitive dysfunction.
  • Understanding this relationship is crucial for patient management.

Purpose of the Study:

  • To determine the incidence of cognitive dysfunction in edentulous patients with OSA.
  • To explore the correlation between OSA severity, edentulousness, and cognitive impairment.
  • To hypothesize the underlying mechanisms connecting these conditions.

Main Methods:

  • 315 edentulous patients (60-65 years) were assessed using the Prosthodontic Diagnostic Index (PDI) for edentulousness.
  • Sleep-disordered breathing was diagnosed via the BERLIN questionnaire and Epworth Sleepiness Scales, followed by polysomnography to determine the apnea-hypopnea index (AHI).
  • Cognitive dysfunction was evaluated using SGRQ-C and SCD, with data analyzed using SPSS v15.0 and a novel CDDSMP classification.

Main Results:

  • Cognitive dysfunction scores showed a significant improvement within 3 months of treatment (p ≤ 0.001).
  • Mean scores decreased from 3.03 ± 1.76 at 3 months to 2.81 ± 1.84 at 9 months.
  • Median scores improved from 3 [1 to 5] to 2 [1 to 5] at 9 months.

Conclusions:

  • The severity of OSA and cognitive dysfunction is directly related to PDI classification and the duration of edentulousness.
  • Modified mandibular advancement device treatment significantly improved patients' cognitive function.
  • Improvements were evident as early as 3 months post-intervention.