Is Your Mouth Showing Signs of Bad Sleep?

Obstructive sleep apnea present with large tonsils, tongue indentations


Many people who have sleep apnea don’t know anything is amiss until a family member points out their relentless snoring or irregular breathing at night. However, new research suggests that the family dentist may have had a clue.

According to research by the University at Buffalo (UB), a new study found that people with oversized tonsils and tongue indentations (teeth imprints that indicate the tongue is too large for the mouth) are at higher risk for obstructive sleep apnea (OSA). This puts dentists in a unique position to recognize symptoms of OSA first.

People with OSA repeatedly stop and start breathing during sleep due to blocked upper airways. Though the disorder affects more than 18 million adults in the US, it often goes undiagnosed. Serious cases have been linked to cardiovascular disease, diabetes, depression and memory loss.

To conduct the study, researchers analyzed 200 patients at the dental clinics of the University of Dammam's College of Dentistry in the Kingdom of Saudi Arabia. Researchers gave the participants the Berlin Questionnaire, an effective tool used to screen for OSA.

The participants were also examined for weight, neck circumference, blood pressure and size of the tongue, tonsils and uvula—all of which are risk factors for OSA.

The study found that of the 23 percent of the participants at risk for OSA, 80 percent were male. And the most common factors among those at risk were large tonsils, tongue indentations and a high score on the Epworth Sleepiness Scale Score (another questionnaire used by the researchers).

Though dentists can’t diagnose sleep apnea, the authors believe they play a critical role in recognizing the symptoms.

"Dentists see into their patient's mouths more than physicians do and the signs are easy to identify," lead author Thikriat Al-Jewair said in the press release.

Al-Jewair is a clinical assistant professor in the UB School of Dental Medicine.

"We need to teach students about this condition before they get out in the field and educate dentists about the major role they play in identifying and treating patients with sleep-related disorders," Al-Jewair said.

Al-Jewair said that future studies will use a larger and more varied sample of people and watch the participants overnight to decide the presence and severity of OSA.

The study was published in the Saudi Medical Journal.

It was funded by the Deanship of Scientific Research grant from the University of Dammam. The authors declared no conflicts of interest.