Medical and social history and clinic examination used by Dentist’s can help screen for sleep disorders.
History
Symptoms related to insomnia:
- Sleep duration (When the patient goes to sleep and when the patient awakens)
- Number of awakenings
- Trouble of failing or staying asleep (number of nights per week)
- Number of times the patient gets up in the night to go to the bathroom
- Use of medication or alcohol to fall asleep
- Use of pain or anxiety-related medication
Symptoms related to sleep-disordered breathing:
- Snoring
- Cessation of breathing
- Choking
- Awaking gasping for breath
- Tendency to fall asleep during the daytime
- History of hypertension and other cardiovascular disorders ( ischemic heart disease, stroke, night sweating, loss of memory, morning headaches, difficulty concentrating)
- Nocturia/enuresis
Symptoms related to movement disorders:
- Tooth grinding sounds during sleep (sleep bruxism)
- Tooth tapping (faciomandibular myoclonus or sleep-related epilepsy)
- Leg or arm movement during sleep, with or without injuries (periodic limb movement, REM behavior disorder)
- Body rocking or head banging
Other symptoms:
- Eating during sleep period (may exacerbate insomnia or sleep-disordered breathing)
Clinical examination
- Weight, height, and body mass index
- Neck circumference (at risk if greater than 41cm [women] or 43cm [men])
- Retrognathia (class II)
- Deep palate
- Narrow dental arches
- Tongue size (macroglossia)
- Tongue indentations (habit or tic)
- Adenoids or tonsil size
- Oropharyngeal size, view through the mouth (Mallampati classification)
- Nose shape (narrowing) and obstruction
- Usual body position (supine is a risk factor for respiratory disorders and bruxism)
- Tooth wear or damage or use of oral splint (bruxism or orofacial pain)
- Absence of tooth or protrusive mandibular movement (preclude use of oral appliance to treat sleep-disordered breathing)
