Adults with obstructive sleep apnea may have frailer bones

Adults with obstructive sleep apnea demonstrated low predicted bone mineral density, which could impact the strength of their bones and teeth, according to study results published in Cranio.

“While the link between obstructive sleep apnea and low bone mineral density has yet to be fully explored, this study offers new evidence on their connection that could have several implications for orthodontic treatment,” Thikriat Al-Jewair, DDS, MSc, MS, FRCD(C), associate professor of orthodontics at University at Buffalo School of Dental Medicine and director of the school’s Advanced Education Program in Orthodontics, said in a university press release.

In a retrospective cross-sectional study, Al-Jewair and colleagues analyzed 19 adults (mean age, 53.7 years; 73% men) with moderate to severe OSA and 19 adults (mean age, 52.6 years; 59% women) without OSA to find out how the disease impacts bone mineral density (BMD).

In order to assess BMD, researchers looked at pre-treatment cone beam CT (CBCT) images to calculate radiographic density (RD) in Hounsfield units (HU) of the left and right sides of the first cervical vertebrae (CV1) and dens of the second cervical vertebrae.

Mean RD of all the tested areas did not differ among patients with and without OSA in the independent sample t tests.

This nonsignificance continued when evaluating OSA status and sex for the left and right sides of CV1; however, researchers observed significantly lower mean RD at the dens among men with vs. without OSA (67.24 ± 60.5 HU vs. 234.22 ± 135.12 HU; P = .032).

Researchers additionally found significant differences between both sets of patients after adjusting for age, sex and BMI. In this analysis, those with OSA had lower mean RD than those without OSA at the left CV1 (36.69 ± 84.50 HU vs. 81.67 ± 93.25 HU; P = .031), right CV1 (30.59 ± 81.18 HU vs. 74.26 ± 91.81 HU; P = .045) and dens (159.25 ± 115.96 HU vs. 223.94 ± 106.09 HU; P = .038).

Further, this analysis found a significant relationship between OSA status and sex but not with BMI or age.

“If a patient has been diagnosed with sleep apnea, this can influence treatment planning and management,” Al-Jewair said in the release. “CBCT imaging has become an integral part of daily orthodontic practice and could be used as a screening tool for low bone mineral density. Orthodontists could then inform their patients of their propensity for low bone mineral density and encourage them to seek further consultation with their physician, as well as warn the patient of possible adverse outcomes, increased risks and effects on treatment time.”

Reference:

• Obstructive sleep apnea tied to weaker bones and teeth in adults. https://www.buffalo.edu/news/releases/2023/01/017.html. Published Jan. 26, 2023. Accessed Feb. 1, 2023.