Edentulism Is Associated With More Severe Obstructive Sleep Apnea Syndrome

The relationship between edentulism and the severity of obstructive sleep apnea syndrome (OSAS) is not well established. The purpose of the present study was to evaluate the relationship of edentulism on the severity of OSAS compared with equally at-risk dentate subjects. We performed a retrospective matched cohort study of edentulous and dentate subjects with OSAS matched by age, gender, and body mass index (BMI). The primary predictor variable was dentate status (dentate vs edentulous) and the primary outcome variable was the OSAS severity measured using apnea hypopnea index (AHI). The secondary outcome variables were the Epworth sleepiness scale (ESS) score and nadir oxygen level. Inferential, univariate, and multivariate statistical analyses were completed. A total of 26 subjects (13 edentulous and 13 dentate) were included in the present study. The edentulous subjects had more severe OSAS compared with the equally at-risk dentate subjects, with statistically significant differences between the 2 groups for AHI (47 ± 25 vs 23 ± 11; P = .0044) and ESS score (16 ± 4.2 vs 11 ± 5.2; P = .0094). A significant multivariate effect for OSAS was only found for the covariates of gender (female vs male; P = .016) and edentulism status (yes vs no; P = .01), with no significant interaction between them (P = .24). Within the limits of the present study, edentulous subjects, compared with dentate subjects, and controlling for age, gender, and BMI, had more severe OSAS, as evidenced by the significantly increased AHI and ESS. Male gender and edentulism are significant risk factors for more severe OSAS compared with equally at-risk dentate patients.