Obstructive Sleep Apnea and Neurocognitive Dysfunction in Edentulous Patients

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.