Evaluation of Obstructive Sleep Apnea by Drug Induced Sleep Endoscopy in Pateints Presenting with Stroke or Transient Ischemic Attack.

Background: Obstructive Sleep Apnea Hypopnea (OSAHS) Syndrome is defined by repetitive episodes of apneas or hypopneas, excessive daytime somnolence; waking up during sleep with gasping, choking, or breath holding; or witnessed reports of apneas, loud snoring, or both. The current gold standard diagnostic test for OSAS is polysomnography. Material and Methods: A total of 30 patients diagnosed with stroke and OSA at tertiary care hospital were included in this study. They underwent clinical evaluation and investigations including polysomnography. They were then subjected to drug induced sleep endoscopy and findings were noted according to VOTE classification. Result: Patients belonged to age groups ranging from 3 to 8 decade of life. Mean BMI was found to be 33.02 (+/-8.37) where 73.33% patients were overweight and obese category. Multilevel obstruction was present in 96.67% of patients Oropharynx was most common site of obstruction in our study. Velum(86.6%) was 2nd most common site of obstruction. This was the most common type of obstruction in our study was multilevel collapse (46.67%) including all 4 sites i.e. velum, oropharynx, tongue base and epiglottis. BMI in this study was found to have insignificant correlation with multi-level severe obstruction (p = 0.306). Conclusion: Obstructive sleep apnoea is a common finding in majority of patients suffering from chronic lifestyle diseases. In our study, we found that DISE is easy to perform, safe and reliable tool for evaluation of OSA with CVA patients as the majority of these patients have multi-level obstruction. The procedure also provides important information about dynamic changes in upper airway during sleep. Multilevel obstruction is the most common obstruction. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04758-w.

An Objective Study to Establish Incidence of True Obstructive Sleep Apnoea (OSA) in Sleep Disordered Breathing in the Paediatric Age Group and Assessment of Benefit of Surgery (Tonsillectomy and Adenoidectomy) in Non Responders to Medical Treatment in Mild OSA.

Obstructive sleep apnea (OSA) is identified by instances of either full or partial collapse of the airway during sleep, leading to reduced oxygen levels or awakening from sleep. This disruption causes interrupted and insufficient sleep, impacting cardiovascular well-being, mental health, and overall quality of life. Pediatric OSA is more challenging to diagnose and a single apnoea is considered to be significant in this age group. A hospital based prospective study with 100 children between the ages of 4 and 12 years with sleep disordered breathing. Evaluated for the severity of obstructive sleep apnea and also assessed if surgery was beneficial to treat OSA in mild cases. General physical examination, evaluation of facial/oral features were conducted to rule out adenoid facies. Additionally, ENT examination was conducted. Medical history and lateral neck radiographs were reviewed, and the paediatric sleep questionnaire was administered to evaluate neurobehavioral morbidities associated with OSA. These children were evaluated for sleep disorders by conducting the polysomnography. Pediatric sleep questionnaire was also administered. The scoring and results analysis were conducted according to standardised guidelines provided by the American association for sleep medicine. Furthermore, medical management protocols were outlined, including a 6-week course of intranasal steroids and leukotriene receptor antagonist therapy, with consideration of adenotonsillectomy for patients failing medical therapy. In our study on paediatric obstructive sleep apnea (OSA), medical treatment significantly reduced clinical symptom scores in cases of mild OSA, as evidenced by pre- and post-parental sleep questionnaire scores of 23.62 ± 8.24 and 13.55 ± 6.05, respectively (paired samples test, P = 0.00). Similarly, both the pre- and post-Apnoea/Hypopnoea Index (AHI) scores (2.278 ± 1.5658 and 1.19 ± 1.420) and central sleep apnea index scores (1.252 ± 0.8972 and 0.61 ± 0.815) significantly improved post-treatment (paired samples test, P = 0.03, respectively). Additionally, significant changes were observed in tonsillar grade after the 12-week medication course, and sleep architecture showed notable improvement during the repeat follow-up study. These findings highlight the efficacy of treatment interventions in alleviating symptoms and enhancing sleep efficiency in paediatric OSA. The findings of this study underscore the efficacy of a medical management using intranasal corticosteroids and oral montelukast in mitigating the severity of mild obstructive sleep apnea (OSA) in children. This research substantiates the therapeutic value of corticosteroids and oral montelukast in paediatric patients with mild OSA, offering compelling evidence for their use as beneficial interventions in this population. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-024-04813-6.

Remote monitoring to improve low adherence in non-invasive ventilation: a protocol for a randomised controlled clinical trial (READ-NIV trial).

Background: Obstructive sleep apnoea (OSA) is the most common sleep-related breathing disorder. Non-invasive ventilation (NIV) is essential for managing hypercapnic respiratory failure in patients with obesity hypoventilation syndrome (OHS) and those with co-existing OSA, where continuous positive airway pressure (CPAP) alone is insufficient. However, adherence to NIV can be challenging, with substantial non-compliance occurring due to factors such as discomfort and phobia. The objective of this protocol is to assess the improvement of adherence to NIV remotely monitored, as well as to record symptom control and long-term clinical outcomes, and to optimise healthcare resource usage. Methods: This is a prospective, randomised, and controlled (usual care) trial with a two-arm parallel group design, testing remote monitoring of home NIV (T4P device, SRETT, Paris, France) for 3 months in patients with OSA/OHS who have previously had low NIV adherence (<4 hours/night). This project has been approved by the research ethics committee/Health Research Authority (HRA) [Integrated Research Application System (IRAS) ID: 270108], as well as by Guy's & St Thomas' NHS Foundation Trust R&D Department. Discussion: Outcomes will be compared between the intervention and the control group (NIV with vs. without remote monitoring). The trial will also assess suitability of the outcome parameters, and test whether the data collection, symptom questionnaires, and used healthcare resources are suitable to describe the impact on patient-related outcomes. Trial Registration: This study is registered at ClinicalTrials.gov (NCT04884165).

The Association Between Obesity and the Development and Severity of Obstructive Sleep Apnea: A Systematic Review.

Obesity has reached epidemic proportions globally, accompanied by a parallel rise in the incidence of obstructive sleep apnea (OSA). The systematic study aims to assess the association between obesity and the onset and severity of OSA. A comprehensive computerized search of pertinent databases was done to find studies that fit the inclusion requirements. A comprehensive search was carried out on PubMed, SCOPUS, Science Direct, Systematic Library, and Web of Science to locate relevant material. Our data included 12 trials with 4095 participants, and 1456 (35.6%) were men. In individuals who were obese, the prevalence of OSA varied from 12.6% to 88.9%, with a total prevalence of 1291 (31.5%). One major factor that determined the level of OSA was obesity. It was consistently discovered by studies that there was a positive correlation between body mass index (BMI), and measures such as the Apnea-Hypopnea Index (AHI) are crucial in determining the extent of OSA. Besides, it was also observed that these comorbid conditions made OSA more severe and difficult to manage. Variability in findings suggests the influence of additional factors such as age, sex, and ethnicity on the obesity-OSA relationship. This comprehensive study offers strong evidence that OSA development and severity are significantly influenced by fat. The results emphasize the significance of weight control, especially for obese people, in treating and preventing OSA.

The Self-Assessment, Perturbation, and Resonance Values of Voice and Speech in Individuals with Snoring and Obstructive Sleep Apnea.

PURPOSE: The static and dynamic soft tissue changes resulting in hypopnea and/or apnea in the subjects with obstructive sleep apnea (OSA) occur in the upper airway, which also serves as the voice or speech tract. In this study, we looked for the Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (V-RQOL) scores in addition to perturbation and formant values of the vowels in those with snoring and OSA. METHODS: Epworth Sleepiness Scale (ESS), STOP-Bang scores, Body-Mass Index (BMI), neck circumference (NC), modified Mallampati Index, tonsil size, Apnea-Hypopnea Index, VHI-10 and V-RQOL scores, perturbation and formant values, and fundamental frequency of the voice samples were taken to evaluate. RESULTS: The data revealed that not the perturbation and formant values but scores of VHI-10 and V-RQOL were significantly different between the control and OSA subjects and that both were significantly correlated with ESS and NC. Further, a few significant correlations of BMI and tonsil size with the formant and perturbation values were also found. CONCLUSIONS: Our data reveal that (i) VHI-10 and V-RQOL were good identifiers for those with OSA, and (ii) perturbation and formant values were related to particularly tonsil size, and further BMI. Hence, we could say that in an attempt to use a voice parameter to screen OSA, VHI-10, and V-RQOL appeared to be better than the objective voice measures, which could be variable due to the tonsil size and BMI of the subjects.

Obstructive sleep apnea and genotype rs6843082 as a risk factor for cerebrovascular accident.

NO previous studies have examined the simultaneous effects of obstructive sleep apnea (OSA), hypertension, and the SNP rs68430822 on stroke. We aimed to explore whether these elements together, play a role as risk factors for stroke. Data was obtained from the Taiwan Biobank and the National Health Insurance database. We used logistic regression analysis to investigate the effect of OSA and hypertension as a risk factor for stroke in different genotypes. We found that OSA and hypertension was associated with stroke in those with the rs6843082 genotype. People with OSA and hypertension together with the rs6843082 genotype (GA + AA) showed a statistically significant difference as a risk for stroke (OR,2.57; 95% CI,1.53 to 4.33). However, there was no statistically significant difference in those people with OSA but without hypertension (OR, 0.53; 95% CI,0.13 to 2.25). After further stratification by combination of OSA and hypertension, those with genotype rs6843082 (GG) had higher risk odds than those with OSA and those with hypertension alone (OR,5.46, 95% CI,3.46 to 8.60). Individuals with genotype rs6843082(GA + AA), OSA and hypertension together had the highest risk for stroke (OR,6.25, 95% CI,3.63 to 10.76) and those with OSA and no hypertension (OR,0.57, 95% CI,0.14 to 2.36) had no significant risk. Our findings showed that people with genotype rs6843082 (GG), with or without hypertension had OSA as a risk factor for stroke. For individuals with the genotype rs6843082 (GA + AA), those with hypertension, OSA is a risk factor for stroke, and for those without hypertension, OSA is not associated with stroke.

Effectiveness of mandibular advancement orthodontic appliances with maxillary expansion device in children with obstructive sleep apnea: a systematic review.

BACKGROUND: The current review aims to explore the evidence regarding the effectiveness of mandibular advancement orthodontic appliances with maxillary expansion device in treating pediatric Obstructive Sleep Apnea (OSA). MATERIALS AND METHODS: A systematic literature search was conducted across PubMed, Cochrane Central, Web of Science, Embase, Scopus databases, Chinese Biomedical Database, Chinese National Knowledge Infrastructure, and Wanfang. The research involved children and adolescents (under 16 years old) who received mandibular advancement and maxillary expansion functional orthopedic appliances for OSA treatment. We performed narrative reviews and subsequently amalgamated the findings from the studies. RESULTS: Six articles were included for review. Although a small number of studies were included, the research suggested the potential advantages of mandibular advancement for children with OSA. Following treatment, there was a decrease in AHI/RDI, an improvement in sleep quality, and the increase in oxygen saturation. CONCLUSIONS: The limited quantity and quality of existing studies necessitate caution when drawing conclusions about the effectiveness of mandibular advancement and maxillary expansion for OSA. In the future, larger and well-designed randomized controlled trials (RCTs) are needed to provide more robust evidence. Patients should be carefully selected, and their orthodontic indications should be thoroughly evaluated before inclusion in such trials.We encourage researchers to design studies that monitor patients over several years to provide a comprehensive understanding of the long-term effectiveness. TRIAL REGISTRATION: This study was registered in PROSPERO(CRD42023480407) on November 20, 2023.

[Obstructive apnea hypopnea syndrome in pregnancy]. / Le syndrome d'apnées hypopnées obstructives de la femme enceinte.

Obstructive sleep apnea hypopnea syndrome (OSA) in pregnant women is an under-diagnosed but common condition, due to the numerous physiological changes favoring upper airway collapse. Risk factors such as significant weight gain during the 1st trimester, maternal age and parity should be systematically investigated. Diagnosis is made by sleep recording. OSA can lead to maternal and fetal complications (gestational diabetes, eclampsia, intrauterine growth restriction, prematurity…) during pregnancy, delivery and the post-partum period. It is therefore essential to treat apneic patients as early as possible in pregnancy. Treatment includes hygienic and dietary measures, as well as continuous positive airway pressure (CPAP). Systematic post-partum follow-up with polygraphic monitoring should be proposed.

Sleep Deficiency in Obstructive Sleep Apnea.

Sleep deficiency in patients with obstructive sleep apnea (OSA) includes abnormal quality, timing and duration of sleep, and the presence of other comorbid conditions. These include insomnia, circadian misalignment disorders, and periodic limb movements of sleep, among others. The co-occurrence of these conditions with OSA likely plays a role in pathogenesis, clinical presentation, and management of OSA. Considering these conditions and their treatment in evaluating sleep deficiency in OSA may help improve patient outcomes. However, future research is needed to understand the intersection between OSA and these disorders.

A deep learning algorithm model to automatically score and grade obstructive sleep apnea in adult polysomnography.

Objective: Polysomnography (PSG) is unique in diagnosing sleep disorders, notably obstructive sleep apnea (OSA). Despite its advantages, manual PSG data grading is time-consuming and laborious. Thus, this research evaluated a deep learning-based automated scoring system for respiratory events in sleep-disordered breathing patients. Methods: A total of 1000 case PSG data were enrolled to develop a deep learning algorithm. Of the 1000 data, 700 were distributed for training, 200 for validation, and 100 for testing. The respiratory events scoring deep learning model is composed of five sequential layers: an initial layer of perceptrons, followed by three consecutive layers of long short-term memory cells, and ultimately, an additional two layers of perceptrons. Results: The PSG data of 100 patients (simple snoring, mild, moderate, and severe OSA; n = 25 in each group) were selected for validation and testing of the deep learning model. The algorithm demonstrated high sensitivity (95% CI: 98.06-98.51) and specificity (95% CI: 95.46-97.79) across all OSA severities in detecting apnea/hypopnea events, compared to manual PSG analysis. The deep learning model's area under the curve values for predicting OSA in apnea-hypopnea index ≥ 5, 15, and 30 groups were 0.9402, 0.9388, and 0.9442, respectively, showing no significant differences between each group. Conclusion: The deep learning algorithm employed in our study showed high accuracy in identifying apnea/hypopnea episodes and assessing the severity of OSA, suggesting the potential for enhancing both the efficiency and accuracy of automated respiratory event scoring in PSG through advanced deep learning techniques.

Evaluating the Spectrum of Sleep Abnormalities in Patients With Primary Hypothyroidism.

Introduction and aim: Primary hypothyroidism is a common endocrine disorder. While thyroid dysfunction is recognized for impacting numerous bodily systems, the connection between thyroid disorders and sleep function remains unclear. Since sleep disorders seldom manifest as the sole presenting symptom of thyroid dysfunction, it is crucial to examine the interplay between thyroid function and sleep when implementing a comprehensive treatment approach for these individuals. This study aimed to assess sleep dysfunction in patients with primary hypothyroidism using validated questionnaires. METHOD: This cross-sectional study included 81 participants attending the endocrinology outpatient department. The participants included those with both overt and subclinical primary hypothyroidism who were drug-naive or had a thyroid-stimulating hormone (TSH) level >4.5 µIU/L while on treatment. The study subjects were assessed based on various validated questionnaires for sleep disturbance. RESULTS: The study predominantly comprised 64 (79%) female participants. Overall, poor sleepers in subclinical and overt hypothyroidism were 66.7 and 60.8%. The Berlin Risk Score Questionnaire showed the occurrence of sleep apnea to be 26.7% and 27.5% in subclinical and overt groups, respectively. However, the occurrence of sleep dysfunction did not correlate with TSH values alone. CONCLUSION: Our findings demonstrate that sleep dysfunction is prevalent in patients with both overt and subclinical primary hypothyroidism. Furthermore, the severity of sleep disruption appears independent of the degree of thyroid dysfunction.

Sleep apnoea phenotypes in women: A cluster analysis from the ESADA cohort.

INTRODUCTION: and Objectives: The clinical presentation of Obstructive Sleep Apnoea (OSA) differs between genders. This study aimed to identify the specific OSA phenotypes of women in the European Sleep Apnoea Database (ESADA) cohort. MATERIALS AND METHODS: Latent class cluster analysis was applied to data from 9710 female OSA patients. Variables used included age, Body Mass Index (BMI), Epworth Sleepiness Scale (ESS), comorbidities (cardiovascular, pulmonary, psychiatric, metabolic, other) and the Apnoea Hypopnea Index (AHI). RESULTS: Four different clusters were found: Cluster 1"Women with ischemic heart disease" (38.3 %):middle aged (59 years [53-65]),overweight to obese (BMI 30.1 kg/m2 [26.9-33.5]), AHI 22.9 events/h[17.4-30], ESS 9 [5,12] with the highest prevalence of ischemic heart disease (56 %). Cluster 2"Elderly women with comorbidities" (23 %): oldest (66 years[60-71]), obese (BMI 36 kg/m2 [31.6-40.4]),AHI 46 events/h [30-60.1]),ESS 9 [6-13] with the highest prevalence of comorbidities. Cluster 3"Sleepy obese women" (16.2 %): the youngest (49 years [42-55]), sleepiest (ESS 12 [8-16]), most obese(BMI 43 kg/m2[37.6-48.9]) females with severe OSA (AHI 53.3 events/h [32-80.5]). Cluster 4 "Women with mild OSA and low comorbidities" (22.5 %): middle aged (53.5 years [46-60]) with BMI 29 kg/m2[25-34.1],ESS9 [5,13]),AHI 8.6events/h[6.9-10.4])and low prevalence of comorbidities. The distribution of the clusters differed across Europe. PAP administration was higher in Clusters 2 and 3 but low in Cluster 4. CONCLUSION: Four distinct female phenotypes were identified with different clinical presentation and comorbidities. Sex-based phenotyping may provide improved risk stratification and personalized treatment.

The bidirectional interplay of obstructive sleep apnea and viral respiratory infections in children: A novel opportunity for primary prevention.

Obstructive sleep apnea (OSA) and viral respiratory infections are highly prevalent conditions in children and a major cause of respiratory morbidity in this age group. Severe viral respiratory infections are a known risk factor for pediatric OSA, which is primarily caused by hypertrophy of upper airway lymphoid tissues (adenoids and tonsils). This review examines recent progress in understanding early-life development of lymphoid tissues in the human upper airway, with a particular focus on how respiratory viruses may influence this process and contribute to OSA pathogenesis. It also explores the bidirectional relationship between OSA and severe viral infections, highlighting the need for ongoing monitoring and novel primary prevention strategies to address these interconnected conditions.

Rostral fluid shifts and other mechanisms of interaction between obstructive sleep apnea and heart failure - a systematic review.

<b>Introduction:</b> Obstructive sleep apnea (OSA) is a chronic inflammatory disorder characterized by episodes of total or partial upper airway obstruction during sleep. Untreated OSA leads to various cardiovascular complications, including heart failure (HF), both involving complex and detrimental pathophysiological processes.<b>Aim:</b> The aim of this study is to describe the role of rostral fluid shifts and other mechanisms responsible for the co-existence of OSA and HF, providing insight into potential diagnostic and therapeutic strategies.<b>Materials and methods:</b> Two authors independently searched the literature and assessed articles following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analytics) guidelines.<b>Results:</b> Rostral fluid shifts, characterized by nocturnal redistribution from the lower limbs to the neck tissues, exacerbate upper airway obstruction by increasing neck circumference and predisposing individuals to respiratory events. This phenomenon is particularly significant in patients with HF due to impaired cardiovascular function leading to fluid retention. The repetitive collapse of the upper airway during sleep triggers abrupt changes in intrathoracic pressure negatively impacting cardiac tissue remodeling by promoting inflammation and fibrosis. Moreover, sleep fragmentation and arousals activate the sympathetic nervous system (SNS), imposing additional strain on the cardiovascular system. Accumulated data suggest that rostral fluid shifts are a clinically significant pathomechanism in the coexistence of OSA and HF. Therapeutic strategies, including the benefits of continuous positive airway pressure (CPAP) therapy and lifestyle modifications, have been discussed. This systematic review highlights the need for integrated treatment approaches to manage both OSA and HF effectively.<b>Conclusions:</b> Understanding and addressing these interconnected mechanisms is essential to offer an integrated diagnostic and therapeutic management of patients, highlighting the importance of multidisciplinary care to optimize patient health and quality of life.

Chasing sleep physicians: ChatGPT-4o on the interpretation of polysomnographic results.

BACKGROUND: From a healthcare professional's perspective, the use of ChatGPT (Open AI), a large language model (LLM), offers huge potential as a practical and economic digital assistant. However, ChatGPT has not yet been evaluated for the interpretation of polysomnographic results in patients with suspected obstructive sleep apnea (OSA). AIMS/OBJECTIVES: To evaluate the agreement of polysomnographic result interpretation between ChatGPT-4o and a board-certified sleep physician and to shed light into the role of ChatGPT-4o in the field of medical decision-making in sleep medicine. MATERIAL AND METHODS: For this proof-of-concept study, 40 comprehensive patient profiles were designed, which represent a broad and typical spectrum of cases, ensuring a balanced distribution of demographics and clinical characteristics. After various prompts were tested, one prompt was used for initial diagnosis of OSA and a further for patients with positive airway pressure (PAP) therapy intolerance. Each polysomnographic result was independently evaluated by ChatGPT-4o and a board-certified sleep physician. Diagnosis and therapy suggestions were analyzed for agreement. RESULTS: ChatGPT-4o and the sleep physician showed 97% (29/30) concordance in the diagnosis of the simple cases. For the same cases the two assessment instances unveiled 100% (30/30) concordance regarding therapy suggestions. For cases with intolerance of treatment with positive airway pressure (PAP) ChatGPT-4o and the sleep physician revealed 70% (7/10) concordance in the diagnosis and 44% (22/50) concordance for therapy suggestions. CONCLUSION AND SIGNIFICANCE: Precise prompting improves the output of ChatGPT-4o and provides sleep physician-like polysomnographic result interpretation. Although ChatGPT shows some shortcomings in offering treatment advice, our results provide evidence for AI assisted automation and economization of polysomnographic interpretation by LLMs. Further research should explore data protection issues and demonstrate reproducibility with real patient data on a larger scale.

Sleep-disordered breathing - clinical spectrum.

The clinical spectrum of sleep-disordered breathing comprises a range of diverse conditions including obstructive sleep apnoea, central sleep apnoea and sleep-related hypoventilation syndromes. These distinct conditions have specific diagnostic features and are managed differently from one another. Therefore, it is useful for dental practitioners to have a working knowledge of sleep-disordered breathing beyond that of uncomplicated obstructive sleep apnoea (OSA). This review paper summarizes the diagnosis and management of commonly encountered clinical sleep-disordered breathing syndromes, with a particular focus on management from a dental perspective.

Validation of the European Obstructive Sleep Apnea Screening (EUROSAS) in Professional Male Drivers.

(1) Background: The European Union Driver License Committee recently developed a questionnaire as a screening tool for obstructive sleep apnea (OSA), named the European Obstructive Sleep Apnea Screening (EUROSAS) questionnaire for drivers. The aim of the current study was to investigate the diagnostic performance of the EUROSAS to predict risk of OSA in professional male drivers. (2) Methods: Fifty-eight drivers were included in the current study. All participants were asked to fill out the EUROSAS before an overnight polysomnography (PSG) in the hospital. OSA was defined as an apnea-hypopnea index (AHI) 5 events/hour on the PSG. (3) Results: Out of 58 participants, the EUROSAS correctly identified 39 (67.2%) cases as having high-risk OSA and one patient as having low-risk OSA, using AHI ≥ 5 events/h. The results indicated that the EUROSAS has a sensitivity of 67.2%, a specificity of 33.3%, a positive predictive value of 94.8%, and a negative predictive value of 5.2%. Similar results were obtained using AHI cut-offs of 15 and 30 events/h. (4) Conclusions: The EUROSAS provides a moderate level of accuracy for the screening of OSA in the professional male drivers. It seems that the diagnostic performance of the EUROSAS is not promising as an alternative questionnaire to identify professional drivers with OSA, probably due to participant response bias. Despite its limited evidence, the EUROSAS might have potential as a clinical screening tool in the general population.

Exploring the links between periodontal diseases and obstructive sleep apnoea: An overview for clinicians.

Both periodontal diseases (PDs) and obstructive sleep apnoea (OSA) are highly prevalent disorders with global impact, associated with a large burden at individual patient and health system levels. These disorders often co-exist, but there is growing evidence that the association between the disorders goes beyond an overlap between two highly prevalent diseases that have shared risk factors. Evidence suggests a potential causal relationship, although further research is required to verify this. Regardless of any causal relationship, the co-existence of these disorders is important to recognize since they may act in combination to heighten health risks, particularly cardiovascular risk. Thus, dentists have an important role in screening for OSA in patients presenting with PDs, and similarly, they need to evaluate periodontal health in patients requiring treatment for OSA. Here we provide a narrative review of the association between PDs and OSA to raise awareness among clinicians and promote multidisciplinary collaborations that aim at an evidence-based and effective management of such patients.