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Sleep Apnea Syndromes: HELP
Articles by R. J. Thomas
Based on 2 articles published since 2010
(Why 2 articles?)
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Between 2010 and 2020, R. J. Thomas wrote the following 2 articles about Sleep Apnea Syndromes.
 
+ Citations + Abstracts
1 Review Biomechanics of the upper airway: Changing concepts in the pathogenesis of obstructive sleep apnea. 2010

Susarla, S M / Thomas, R J / Abramson, Z R / Kaban, L B. ·Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA. ssusarla1@partners.org ·Int J Oral Maxillofac Surg · Pubmed #21030210.

ABSTRACT: Obstructive sleep apnea (OSA) is a disorder characterized by repetitive, episodic collapse of the pharyngeal airway. Over the last two decades, understanding of the pathophysiology of sleep disordered breathing, which includes OSA, has improved. Once thought to be predominately related to anatomic constriction of the maxillomandibular complex, central nervous system regulation of breathing is now recognized as a significant contributor to the pathogenesis of OSA. Ventilator control, the central response to chemoreceptor phenomena, has important implications for oral and maxillofacial surgeons who treat OSA, particularly for patients who appear refractory to treatment with maxillomandibular advancement (MMA). The purpose of this article is to review the biomechanics of the upper airway as it relates to the pathophysiology of OSA, to discuss emerging concepts of ventilator control mechanisms in normal sleep versus sleep-disordered breathing and to discuss the concept of complex sleep apnea, a new category of sleep disordered breathing with both obstructive and central features.

2 Article The association between periodontitis and obstructive sleep apnea: a preliminary study. 2013

Seo, W H / Cho, E R / Thomas, R J / An, S-Y / Ryu, J J / Kim, H / Shin, C. ·Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. ·J Periodontal Res · Pubmed #23199371.

ABSTRACT: BACKGROUND AND OBJECTIVE: Periodontitis is becoming a highly prevalent disease worldwide. Obstructive sleep apnea (OSA) is a common disorder that is characterized by repeated disruptions in breathing during sleep, and mouth breathing is a common characteristic among patients with OSA. We aimed to assess the hypothesis that OSA is associated with the onset and progression of periodontal disease. MATERIAL AND METHODS: This is a cross-sectional study of a total of 687 participants (460 men and 227 women), 47-77 years of age, who were examined between August 2009 and September 2010 as part of the Korean Genome and Epidemiology Study. The participants underwent standard polysomnography, clinical periodontal examination and health-screening examinations. Periodontitis was defined as clinical attachment level (CAL) ≥ 6 mm and probing pocket depth ≥ 4 mm. OSA was determined using the apnea-hypopnea index (AHI), and an AHI score of ≥ 5 was the cut-off used to indicate the presence of OSA. RESULTS: The results showed that 17.5% of the participants had periodontitis, 46.6% had OSA and 60.0% who were diagnosed with periodontitis had OSA. In our study, old age, male gender, current smoking status, mouth breathing during sleep and high AHI were identified as risk factors for periodontitis. OSA was positively associated with periodontitis [odds ratio (OR) = 1.84, 95% confidence interval (CI) = 1.18-2.87], probing pocket depth (OR = 2.22, 95% CI = 1.30-3.77) and CAL (OR = 1.86, 95% CI = 1.07-3.21) in a dose-response manner. Additionally, OSA was positively associated with periodontitis (OR = 2.51, 95% CI = 1.37-4.62) in subjects ≥ 55 years of age, but not in subjects < 55 years of age. CONCLUSION: There is a significant association between OSA and periodontal disease. Further research is needed to clarify the causal relationship between the two conditions.