Sleep-disordered breathing is a spectrum of conditions that disrupt normal breathing during sleep, ranging from simple snoring to obstructive sleep apnoea (OSA).
For dental professionals, understanding the treatment landscape for sleep-disordered breathing is increasingly relevant. The British Academy of Dental Sleep Medicine (BADSM) trains dentists to play an active, evidence-based role in this area, using oral appliance therapy alongside a multidisciplinary care model to deliver meaningful clinical benefit.
Understanding Sleep-Disordered Breathing
Sleep-disordered breathing is not a single condition. It describes a continuum of disorders characterised by abnormal respiratory patterns during sleep. These include:
- Snoring – partial narrowing of the upper airway without apnoeic events
- Upper airway resistance syndrome (UARS) – repeated arousals caused by increased airway resistance, even without measurable oxygen desaturation
- Obstructive sleep apnoea (OSA) – repeated episodes of partial or complete airway collapse during sleep, associated with oxygen desaturation and fragmented sleep
Sleep-disordered breathing symptoms vary by condition and severity. Patients often present with daytime sleepiness, morning headaches, unrefreshing sleep, mood changes, and difficulty concentrating. Bed partners frequently report loud snoring or witnessed apnoeic episodes. Identifying these symptoms is a key first step in clinical assessment.
Treatment of Sleep-Disordered Breathing: The Main Options
Treatment of sleep-disordered breathing depends on the type and severity of the condition, the patient’s anatomy, and their ability to tolerate different interventions.
CPAP Therapy
Continuous positive airway pressure (CPAP) is the most widely prescribed treatment for moderate to severe OSA. It works by delivering a continuous stream of pressurised air through a mask, keeping the upper airway open throughout the night. CPAP is effective when used consistently, but adherence rates vary considerably. Many patients find the mask uncomfortable or claustrophobic, leading to inconsistent use or early discontinuation.
Oral Appliance Therapy
Oral appliances are a well-established treatment for mild to moderate OSA and represent the primary intervention within dental sleep medicine. Mandibular advancement devices (MADs) are the most widely used type, working by repositioning the lower jaw and tongue during sleep to increase the space in the upper airway and reduce the likelihood of obstruction.
The clinical evidence for oral appliance therapy is substantial and continuing to grow. For patients who cannot tolerate CPAP, or those with mild to moderate OSA who prefer a less invasive option, a custom-fitted MAD is a clinically appropriate and guideline-supported treatment. Major bodies including NICE and the British Sleep Society recommend oral appliances for these patient groups.
Benefits of sleep-disordered breathing treatment with oral appliances include reduced apnoea-hypopnoea index scores, improved sleep quality, better daytime functioning, and, in many patients, measurable improvements in cardiovascular risk markers over time.
Positional Therapy
For some patients, sleep-disordered breathing is position-dependent, occurring primarily when lying on the back. Positional therapy aims to maintain a lateral sleeping position throughout the night. It is not appropriate as a standalone treatment for moderate to severe OSA but can be used as an adjunct alongside other interventions.
Surgical Options
Surgical interventions for sleep-disordered breathing include uvulopalatopharyngoplasty (UPPP), maxillomandibular advancement (MMA), and hypoglossal nerve stimulation. These are generally reserved for patients who have not responded adequately to other treatments and require specialist referral.
Lifestyle Modification
Weight management, reduction in alcohol consumption, and changes to sleep positioning can reduce the severity of sleep-disordered breathing in appropriate patients. While these measures rarely resolve OSA entirely in moderate to severe cases, they can improve outcomes when combined with primary treatments.
Sleep-Disordered Breathing Treatment in Children
Sleep-disordered breathing in children presents differently from the adult pattern and requires a specific clinical approach. Paediatric OSA is most commonly associated with adenotonsillar hypertrophy, and adenotonsillectomy is often the first-line intervention. However, orthodontic and myofunctional factors also contribute, and dentists are increasingly involved in identifying children at risk during routine oral assessments.
Sleep-disordered breathing treatment for children may include orthodontic expansion to improve palatal dimensions, myofunctional therapy to address tongue posture and oral breathing habits, and multidisciplinary referral for complex cases. Dentists who understand the oral markers of paediatric airway dysfunction are well placed to initiate appropriate referrals early.
The Dental Sleep Medicine Approach
What distinguishes the dental sleep medicine approach is its integration of thorough clinical assessment, patient-centred treatment planning, and interdisciplinary collaboration. A trained dental sleep medicine practitioner does not simply fit an appliance: they screen comprehensively, stratify risk appropriately, and coordinate with sleep physicians and other clinicians. They also monitor outcomes over time.
This approach draws on the clinical framework for dental sleep medicine that BADSM promotes through its education and membership programmes. It positions the dentist as a core member of the sleep care team, working alongside GPs, sleep physicians, ENT surgeons, and respiratory physiologists.
The clinical benefits are clear. Patients who access coordinated treatment through a trained dental professional receive evidence-based care. This care is personalised to their anatomy, lifestyle, and treatment tolerance.
To learn more about the dental sleep medicine approach to treating sleep-disordered breathing, explore BADSM’s clinical training courses or become a BADSM member and be part of the UK’s leading network for dental sleep medicine professionals.*
Frequently Asked Questions
What is sleep-disordered breathing?
Sleep-disordered breathing describes a range of conditions in which normal breathing is disrupted during sleep, from chronic snoring to obstructive sleep apnoea. It is associated with poor sleep quality and a range of systemic health risks.
What are the symptoms of sleep-disordered breathing?
Common sleep-disordered breathing symptoms include loud snoring, witnessed breathing pauses, daytime sleepiness, unrefreshing sleep, morning headaches, and difficulty concentrating. Symptoms in children may also include behavioural problems and poor school performance.
What are the treatment options for sleep-disordered breathing?
Treatment depends on the type and severity of the condition. Options include CPAP therapy, oral appliance therapy using mandibular advancement devices, positional therapy, surgical interventions, and lifestyle modifications.
What are the benefits of sleep-disordered breathing treatment?
Treatment can significantly improve sleep quality, daytime functioning, mood, and cardiovascular health. Benefits of sleep-disordered breathing treatment with oral appliances include reduced apnoea frequency, improved oxygen saturation, and better quality of life.
How do dentists treat sleep-disordered breathing?
Dentists trained in dental sleep medicine assess patients for signs of sleep-disordered breathing and provide treatment using custom-fitted oral appliances. They also screen for risk factors, refer to sleep physicians when appropriate, and monitor outcomes over time.
