Sleep Apnea: What Every Clinician (and Patient) Should Know

Abstract

Obstructive sleep apnea (OSA) is a relatively common disorder characterized by the repeated collapse of the upper airway, resulting in sleep fragmentation and episodic hypoxemia. The consequences of untreated sleep apnea can be significant and include increased risk of cardiovascular events (e.g., heart attack, stroke), decreased quality of life and motor vehicle accidents. It is estimated that over 80% of individuals who have sleep apnea do not know that they have this medical problem, emphasizing the need for greater awareness among both clinicians and the lay population. OSA has a complex multi-factorial etiology and is more common in older adults who are overweight, but it can affect individuals of any age and body type. Even children, especially those with enlarged tonsillar or constricted nasopharyngeal tissues, may have OSA. It requires long- term management; lifestyle changes, positive airway pressure, oral appliances and/or surgery can be used treat sleep apnea successfully once the condition is diagnosed. The Moyers Symposium has had a long history of dealing with interdisciplinary topics and the 44th Annual Moyers Symposium was no exception. We brought together ten healthcare providers in both medicine and dentistry who have expertise in sleep-disordered breathing to discuss the diagnosis and treatment of OSA patients, considering in detail the multiple treatment approaches that are available. Some of the attendees also may have discovered that this condition was relevant personally, as the signs, symptoms and history of OSA were presented during the meeting. The 44th Annual Moyers Symposium was held at The University of Michigan on Saturday and Sunday, March 4-5, 2017. The interdisciplinary audience was large, with approximately 550 individuals in attendance. The annual Presymposium meeting (aka the 42nd Annual International Conference on Craniofacial Research) was held on Friday March 2, 2017 in the 4th Floor Amphitheater of the Horace H. Rackham School of Graduate Studies Building. Thirteen of the 16 papers presented by an international group of investigators were focused specifically on the topic of the 2017 Moyers Symposium. Many of the Presymposium papers are included as chapters in this volume. As in previous years, the Symposium honored the late Dr. Robert Edison Moyers, Professor Emeritus of Dentistry and Fellow Emeritus and Founding Director of the Center for Human Growth and Development at The University of Michigan. This meeting was co-sponsored by the School of Dentistry and the Center for Human Growth and Development. First, I would like to thank my co-editor of this volume, Anita V. Shelgikar, MD, for her tireless work in helping us plan and execute the 2017 Moyers Symposium. Anita was instrumental in identifying out- standing speakers in sleep medicine to participate, as well as delivering the keynote 21st Annual Robert E. Moyers Memorial Lecture entitled Sleep Apnea: What Is It and Why Should We Care? She then demon- strated excellent editing skills in critiquing chapters from both medical and dental disciplines, making many suggestions that have clarified and improved each chapter. Her participation was integral from beginning to end both for the Symposium and the subsequent volume. We continue to recognize the enormous contribution of Kris De Koster, Associate Editor of the Craniofacial Growth Series, for her efforts on this book. For the past ten years, Kris has facilitated the publication of this annual volume through her interactions with the authors, editing, manipulating a variety of figure formats and formatting the layout of the book. It is always a challenge for us to produce such a volume in the time frame prior to the next Symposium; Kris has a stellar record of producing a high-quality book within this limited period. In addition, we recognize the work of Kathy Ribbens who provided assistance in the final format- ting the book for publication. We also thank the contributors for sending us their material in a timely fashion. We acknowledge and thank Dr. Nan Hatch, Chair of the Depart- ment of Orthodontics and Pediatric Dentistry, for providing the financial resources to underwrite partially the publication of this book. We also must thank Dr. Brenda Volling, the Director of the Center for Human Growth and Development, for the continued financial and moral sup- port of the Moyers Symposium provided by the Center for the last 44 years. We are fortunate to work with the staff from the Office of Continuing Dental Education, who organize and run the Presymposium and Symposium. Michelle Jones, Karel Barton and Elizabeth Fee managed both meetings in an exceptionally smooth and efficient fashion. We all are very pleased that the 44th Moyers Symposium was so successful. The topic obviously was of heightened clinical relevance to clinicians and researchers in both medicine and dentistry. The chapters within this volume are written with both the clinician and patients in mind, so that we all can benefit from sharing our knowledge provided from a variety of perspectives.

James A. McNamara, Jr. Editor-in-Chief, Craniofacial Growth Series The University of Michigan Ann Arbor, Michigan December 2017