culminating in this second edition. This is especially true of our spouses who have supported the long hours of dedication required to make this a reality. In addition, the support at Wiley‐Blackwell has always been appreciated. A textbook of this nature is also dedicated to those pioneers in sleep medicine who have done research and published learned texts and scientific articles that are the basis for creating each and every chapter in this edition. More importantly, this text is dedicated to those who are willing to spend the time to foster their education in this very dynamic and exciting area, all in an effort to provide optimum patient care.
List of Contributors
Contributing Authors
Noura Alsufyani, BDS, PhD, DipFHID, FRCD(C), Diplm. ABOMR Oral & Maxillofacial Radiologist Associate Professor, King Saud University, Saudi Arabia Adjunct Professor, University of Alberta, Canada
Giulio Fortuna, DMD, PhD Editor‐in‐Chief of American Journal of Oral Medicine Clinical Senior Lecturer in Oral Medicine Honorary Consultant in Oral Medicine Glasgow Dental School & Hospital University of Glasgow Glasgow, Scotland, UK; D.eb.RA. Mexico Foundation, casi esq. P. Elías Calles Colonia Azteca, Guadalupe N.L., Monterrey, Nuevo Leon, Mexico; Federico Navarro Institute – School of Orgonomy “Piero Borrelli”, Corso Umberto I, Naples, Italy
Gary D. Klasser, DMD Cert.Orofacial Pain Professor Louisiana State University Health Sciences Center School of Dentistry, Department of Diagnostic Sciences New Orleans, LA, USA
Isabel Moreno Hay, DDS, PhD, ABOP, ABDSM Division Chief, Orofacial Pain Program Director, Orofacial Pain Assistant Professor, College of Dentistry University of Kentucky Lexington, KY, USA
Lori Reisner, Pharm.D., FCSHP Clinical Pharmacist, Neurological Surgery Department of Pharmaceutical Services Clinical Professor of Pharmacy Department of Clinical Pharmacy School of Pharmacy University of California, San Francisco Medical Center San Francisco, CA, USA
Content Reviewers
Massimiliano Di Giosia, DDS Diplomate, American Board of Orofacial Pain Fellow, European Academy of Dental Sleep Medicine Visiting Clinical Associate Professor Department of Oral‐Maxillofacial Surgery and Hospital Dentistry Indiana University School of Dentistry Indianapolis, Indiana, USA
Diana Guth, BA, RRT Owner, Home Respiratory Care Los Angeles, CA, USA
Edward T. Sall, DDS, MD, MBA Medical Center Drive Fayetteville, NY, USA
Preface
The importance of sleep, the disciplines of sleep medicine and more specifically dental sleep medicine as well as the management of sleep disorders, has continued to develop over the past 10 years. In like manner, the involvement and contribution of dentistry has also grown. The role of the dentist has and continues to be primarily focused on the recognition and management of sleep‐related breathing disorders (SRBDs) primarily associated with the use of oral appliance therapy (OAT). It is recognized that dental practices see a significant number of patients on a regular basis, and this positions them such that screening for a variety of health‐related concerns potentially has a significant impact on the lives of the patients they encounter. This now applies to the recognition of a sleep disorder as well, estimated to involve 50–70 million people in the United States. In 2010, the Journal of the American Dental Association (JADA) indicted that 65% of patients between the age of 18 and 65 visit the dentist once a year. When considering the SRBD, in particular sleep apnea, it is recognized that roughly 80% of people who are at risk for this are currently undiagnosed, let alone adequately managed.
The role of dentistry has also been recognized and substantiated by the American Dental Association (ADA), with publication of guidelines in 2017 for screening and the use of OAT. The essence here is that every dentist should be familiar with SRBDs and how to screen for them as well as in the use of oral appliances (OAs). The second edition of this textbook is intended to meet and even exceed those objectives. This edition is intended as a basic understanding of sleep, sleep disorders, the role of the dentist, the use of oral appliances, and to also become familiar with other options for the management of the SRBD. Conceptually, this edition is intended for those seeking a basic understanding of sleep as well as the more common sleep disorders. It is applicable to anyone wishing to learn more, from the dental student to those in a postdoctoral program and for the practicing dentist or hygienist. More importantly the intent is for this edition to offer information and guidance that is clinically applicable. This involves the screening process, the clinical evaluation, and the use of OAT.
The second edition is an expanded version of the first edition. The explosion of information and evidence since the first edition was released has been important for this current edition. This edition has been broken down into five sections that will allow the reader to focus on a particular area that may be of particular interest. Additionally, this edition involved contributing authors with expertise in their respective discipline of interest to enhance that specific chapter and provide a higher level of evidence. Throughout the book and in the appendix a variety of documents for screening as well as tracking patient progress have been referenced or created to aid the practitioner with their involvement in this discipline. It is important for the reader and student to realize that even though the dentist may not be involved in the management of most of the sleep disorders reviewed, it is important to be familiar with many simply to improve patient care and one’s quality of life.
A text such as this involves many people. The contributing authors; the staff at Wiley‐Blackwell, especially Tanya, Erica, and Krishna; and the many people who contribute to the production of this second edition. Recognition of the many people in research, education, and practice who publish the information used as a basis for the creation of each chapter have also impacted a text such as this one. Hopefully this edition will act as the catalyst for continued education and learning that involves sleep medicine resulting in improved health and quality of life for the patients we serve.
Dennis R. Bailey, DDS, FAGD, D,ABOP, D,ABDSM
Ronald Attanasio, DDS, MSEd, MS
Section 1 Overview of Sleep Medicine
This section provides an overview of sleep medicine specifically as it applies to the practice of dentistry and in particular to anyone interested in becoming involved in this discipline or those already involved with the desire to develop and include this in their practice. In this section, there is a discussion related not only to the science of sleep medicine but also to the recognition that many of the patients who are seen daily may be at risk for a sleep disorder, based on history as well as conditions that the dentist encounters daily, with an emphasis on sleep‐related breathing disorders (snoring and sleep apnea). Additionally, the need to understand the impact sleep disorders have on our everyday life is discussed along with the wide variety of sleep disorders that exist and may go undetected.
This discipline is very dynamic. There are areas that are of interest and will continue to develop over time. Areas to monitor in the future are:
The developing statistics relative to prevalence.
Understanding the role of neurotransmitters in sleep as research discovers
