Diagnostic algorithm used in orthodontic patients with a positive ENT history of breathing disorders during sleep

Introduction
Obstructive sleep apnoea is a common but still rarely diagnosed disease involving peripheral respiratory dysfunctions during sleep.

Aim
The aim of this paper is to present diagnostic possibilities of obstructive sleep apnoea based on the literature from 1998–2019.

Material and methods
A review of the literature from the years 1998–2019 was conducted using the PubMed database and the following keywords: obstructive sleep apnoea, syndrome of sleep apnoea, snoring, polysomnography, diagnosis of sleep apnoea.

Results
Out of 180 literature papers, 23 were selected and analysed from the period 1998–2019. Diagnosis of OSA should be based on a medical history review in the form of a questionnaire, concerning the characteristic symptoms observed by a patient and their relatives (the well-known Epworth sleepiness scale questionnaire is vital here), a physical examination, combined with appropriate additional investigations. The ENT diagnosis of OSA is based on a survey and functional examination, namely, polysomnography, which is still a golden standard for the diagnosis of respiratory disorders during sleep, although it is not entirely perfect. Additional investigations used to confirm the results of a physical examination may include a CT or MRI of the head as well as an airway spatial examination during CBCT.

Conclusions
If untreated, OSA is a significant risk factor for the development of systemic diseases and death. Due to the fact that treatment is multi-specialist, it is necessary to create an algorithm for the diagnostic management of orthodontic patients with a positive ENT history, where an important role will be played by an orthodontist who can make an initial assessment of the airway width using routine orthodontic tests.