Skip to main content

Advertisement

SpringerLink
Log in

Obstructive sleep apnea-related knowledge, attitude, experience, and behaviors among orthodontic professionals: a survey

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
Sleep and Breathing Aims and scope Submit manuscript

Abstract

Purpose

To assess obstructive sleep apnea (OSA)-related experience, knowledge, attitude, and behaviors among orthodontic professionals in China and identify factors associated with their knowledge levels, attitude toward referring, and self-confidence in the management of patients with OSA.

Methods

An online cross-sectional survey was conducted using a 31-item questionnaire developed with a professional online survey tool (www.wjx.cn) and distributed via WeChat (Tencent, Shenzhen, China). Data were collected between January 16 and 23, 2022 and analyzed using the chi-square test, Fisher’s exact test, and multivariate generalized estimation equations.

Results

A total of 1760 professionals responded to the survey, and responses to 1611 questionnaires were valid. The average score of correct answers to the 15 OSA knowledge questions was 12.1 ± 2.0. Most of the professionals agreed that it was necessary to identify patients who might have OSA in practice. The top three sources for gaining knowledge of OSA according to the survey were classrooms and textbooks (76.3%), medical lectures (75.7%), and academic conferences (73.2%). The level of knowledge was significantly correlated with self-confidence in treatment (P < 0.001) and willingness to refer patients to otolaryngologists or clinicians of related disciplines (P < 0.001).

Conclusions

Most orthodontic professionals agreed that there was a need to identify patients with OSA and learn further about related problems. Treatment confidence and willingness of professionals to refer patients were related to the level of OSA knowledge. These findings suggest that promotion of OSA-related education may help improve the care of patients with OSA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

References

  1. Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, Hamilton GS, Dharmage SC (2017) Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev 34:70–81. https://doi.org/10.1016/j.smrv.2016.07.002

    Article  PubMed  Google Scholar 

  2. Behrents RG, Shelgikar AV, Conley RS, Flores-Mir C, Hans M, Levine M, McNamara JA, Palomo JM, Pliska B, Stockstill JW, Wise J, Murphy S, Nagel NJ, Hittner J (2019) Obstructive sleep apnea and orthodontics: an American Association of Orthodontists White Paper. Am J Orthod Dentofacial Orthop 156:13-28.e1. https://doi.org/10.1016/j.ajodo.2019.04.009

    Article  PubMed  Google Scholar 

  3. Young T, Peppard PE, Taheri S (2005) Excess weight and sleep-disordered breathing. J Appl Phycol 99:1592–1599. https://doi.org/10.1152/japplphysiol.00587.2005

    Article  Google Scholar 

  4. Parati G, Lombardi C, Castagna F, Mattaliano P, Filardi PP, Agostoni P (2016) Heart failure and sleep disorders. Nat Rev Cardiol 13:389–403. https://doi.org/10.1038/nrcardio.2016.71

    Article  CAS  PubMed  Google Scholar 

  5. Lechat B, Appleton S, Melaku YA, Hansen K, McEvoy RD, Adams R, Catcheside P, Lack L, Eckert DJ, Sweetman A (2022) Comorbid insomnia and sleep apnoea is associated with all-cause mortality. Eur Respir J 60:2101958. https://doi.org/10.1183/13993003.01958-2021

  6. Sowho M, Sgambati F, Guzman M, Schneider H, Schwartz A (2020) Snoring: a source of noise pollution and sleep apnea predictor. Sleep 43:zsz305. https://doi.org/10.1093/sleep/zsz305

  7. Sedky K, Bennett DS, Carvalho KS (2014) Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis. Sleep Med Rev 18:349–356. https://doi.org/10.1016/j.smrv.2013.12.003

    Article  PubMed  Google Scholar 

  8. Olaithe M, Bucks RS, Hillman DR, Eastwood PR (2018) Cognitive deficits in obstructive sleep apnea: insights from a meta-review and comparison with deficits observed in COPD, insomnia, and sleep deprivation. Sleep Med Rev 38:39–49. https://doi.org/10.1016/j.smrv.2017.03.005

    Article  PubMed  Google Scholar 

  9. Lee YH, Huang YS, Chen IC, Lin PY, Chuang LC (2020) Craniofacial, dental arch morphology, and characteristics in preschool children with mild obstructive sleep apnea. J Dent Sci 15:193–199. https://doi.org/10.1016/j.jds.2019.09.005

    Article  PubMed  Google Scholar 

  10. Neelapu BC, Kharbanda OP, Sardana HK, Balachandran R, Sardana V, Kapoor P, Gupta A, Vasamsetti S (2017) Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: a systematic review and meta-analysis of cephalometric studies. Sleep Med Rev 31:79–90. https://doi.org/10.1016/j.smrv.2016.01.007

    Article  PubMed  Google Scholar 

  11. Zhao T, Ngan P, Hua F, Zheng J, Zhou S, Zhang M, Xiong H, He H (2018) Impact of pediatric obstructive sleep apnea on the development of Class II hyperdivergent patients receiving orthodontic treatment: (a pilot study). Angle Orthod 88:560–566. https://doi.org/10.2319/110617-759.1

    Article  PubMed  PubMed Central  Google Scholar 

  12. Abtahi S, Witmans M, Alsufyani NA, Major MP, Major PW (2020) Pediatric sleep-disordered breathing in the orthodontic population: prevalence of positive risk and associations. Am J Orthod Dentofacial Orthop 157:466-473.e1. https://doi.org/10.1016/j.ajodo.2019.05.015

    Article  PubMed  Google Scholar 

  13. Rohra AK Jr, Demko CA, Hans MG, Rosen C, Palomo JM (2018) Sleep disordered breathing in children seeking orthodontic care. Am J Orthod Dentofacial Orthop 154:65–71. https://doi.org/10.1016/j.ajodo.2017.11.027

    Article  PubMed  Google Scholar 

  14. Fagundes NCF, Flores-Mir C (2022) Pediatric obstructive sleep apnea-dental professionals can play a crucial role. Pediatr Pulmonol 57:1860–1868. https://doi.org/10.1002/ppul.25291

    Article  PubMed  Google Scholar 

  15. Williams NJ, Nunes JV, Zizi F, Okuyemi K, Airhihenbuwa CO, Ogedegbe G, Jean-Louis G (2015) Factors associated with referrals for obstructive sleep apnea evaluation among community physicians. J Clin Sleep Med 11:23–26. https://doi.org/10.5664/jcsm.4356

    Article  PubMed  PubMed Central  Google Scholar 

  16. Cherrez Ojeda I, Jeffe DB, Guerrero T, Mantilla R, Santoro I, Gabino G, Calderon JC, Caballero F, Mori J, Cherrez A (2013) Attitudes and knowledge about obstructive sleep apnea among Latin American primary care physicians. Sleep Med 14:973–977. https://doi.org/10.1016/j.sleep.2013.06.005

    Article  PubMed  Google Scholar 

  17. Tamay Z, Akcay A, Kilic G, Suleyman A, Ones U, Guler N (2006) Are physicians aware of obstructive sleep apnea in children? Sleep Med 7:580–584. https://doi.org/10.1016/j.sleep.2006.04.004

    Article  PubMed  Google Scholar 

  18. Eysenbach G (2004) Improving the quality of web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res 6:e34. https://doi.org/10.2196/jmir.6.3.e34

    Article  PubMed  PubMed Central  Google Scholar 

  19. Uong EC, Jeffe DB, Gozal D, Arens R, Holbrook CR, Palmer J, Cleveland C, Schotland HM (2005) Development of a measure of knowledge and attitudes about obstructive sleep apnea in children (OSAKA-KIDS). Arch Pediatr Adolesc Med 159:181–186. https://doi.org/10.1001/archpedi.159.2.181

    Article  PubMed  Google Scholar 

  20. Schotland HM, Jeffe DB (2003) Development of the obstructive sleep apnea knowledge and attitudes (OSAKA) questionnaire. Sleep Med 4:443–450. https://doi.org/10.1016/s1389-9457(03)00073-x

    Article  PubMed  Google Scholar 

  21. Vuorjoki-Ranta TR, Lobbezoo F, Vehkalahti M, Tuomilehto H, Ahlberg J (2016) Treatment of obstructive sleep apnoea patients in community dental care: knowledge and attitudes among general dental practitioners and specialist dentists. J Oral Rehabil 43:937–942. https://doi.org/10.1111/joor.12441

    Article  PubMed  Google Scholar 

  22. Liu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, Wu L, Sun Z, Zhou Y, Wang Y, Liu W (2020) Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: gender differences matter. Psychiatry Res 287:112921. https://doi.org/10.1016/j.psychres.2020.112921

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Iwasaki T, Sato H, Suga H, Takemoto Y, Inada E, Saitoh I, Kakuno E, Kanomi R, Yamasaki Y (2017) Relationships among nasal resistance, adenoids, tonsils, and tongue posture and maxillofacial form in class II and class III children. Am J Orthod Dentofacial Orthop 151:929–940. https://doi.org/10.1016/j.ajodo.2016.10.027

    Article  PubMed  Google Scholar 

  24. dela Cruz GG, Rozier RG, Slade G (2004) Dental screening and referral of young children by pediatric primary care providers. Pediatrics 114:e642–e652. https://doi.org/10.1542/peds.2004-1269

    Article  Google Scholar 

  25. Ozoh OB, Iwuala SO, Desalu OO, Ojo OO, Okubadejo NU (2015) An assessment of the knowledge and attitudes of graduating medical students in Lagos, Nigeria, regarding obstructive sleep apnea. Ann Am Thorac Soc 12:1358–1363. https://doi.org/10.1513/AnnalsATS.201412-561OC

    Article  PubMed  Google Scholar 

  26. Alzahrani MM, Alghamdi AA, Alghamdi SA, Alotaibi RK (2022) Knowledge and attitude of dentists towards obstructive sleep apnea. Int Dent J 72:315–321. https://doi.org/10.1016/j.identj.2021.05.004

    Article  PubMed  Google Scholar 

  27. Mor-Anavy S, Lev-Ari S, Levin-Zamir D (2021) Health literacy, primary care health care providers, and communication. Health Lit Res Pract 5:e194–e200. https://doi.org/10.3928/24748307-20210529-01

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to express our sincere gratitude to all the orthodontic professionals that participated in this survey.

Funding

This work was supported by the CSA Orthodontic Clinical Research Project for Central and West China (no. CSA-MWO2021-01), the Wuhan Knowledge Innovation Project (no. 2022020801020502), the Wuhan University School & Hospital of Stomatology Clinical Research Project (no. LYZX202101), the Sanming Project of Medicine in Shenzhen Nanshan (no. SZSM202103005), and the International Orthodontics Foundation (no. IOF2022C01).

Author information

Author notes

  1. Lizhuo Lin and Tingting Zhao contributed equally to this work.

Authors and Affiliations

  1. Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China

    Lizhuo Lin, Tingting Zhao, Danchen Qin & Hong He

  2. Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China

    Lizhuo Lin, Tingting Zhao, Danchen Qin & Hong He

  3. Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China

    Tingting Zhao, Fang Hua & Hong He

  4. Department of Orthodontics, School of Dentistry, West Virginia University, Morgantown, USA

    Peter Ngan

  5. Nanshan Maternity & Child Healthcare Hospital, Shenzhen, China

    Yimin Zhuang

  6. Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China

    Fang Hua

  7. Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China

    Fang Hua

  8. Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK

    Fang Hua

Authors
  1. Lizhuo Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tingting Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Peter Ngan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yimin Zhuang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Danchen Qin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fang Hua
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hong He
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Lizhuo Lin and Tingting Zhao contributed to material preparation, data curation, formal analysis, and manuscript writing. Danchen Qin, Peter Ngan, and Yimin Zhuang contributed to formal analysis and data interpretation. Fang Hua and Hong He contributed to the study conception, methodology, and supervision. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Fang Hua or Hong He.

Ethics declarations

Ethical approval and consent to participate

This study was reviewed and approved by Ethics Committee of School & Hospital of Stomatology, Wuhan University (no. 2021-B47). Informed consent was obtained from all individual participants included in the study.

Competing interests

The authors declare no competing interests.

Disclaimer

The funding sources had no involvement in the study design, collection, analysis, and interpretation of data, preparation of the manuscript, or in the decision to publish.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 41 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, L., Zhao, T., Ngan, P. et al. Obstructive sleep apnea-related knowledge, attitude, experience, and behaviors among orthodontic professionals: a survey. Sleep Breath 27, 2361–2369 (2023). https://doi.org/10.1007/s11325-023-02852-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11325-023-02852-x

Keywords

Search

Navigation