Obstructive sleep apnoea (OSA) affects approximately 30 million Americans — the large majority undiagnosed — and is strongly associated with obesity, male sex, older age, and certain anatomical features including retrognathia and tonsillar hypertrophy. Repetitive upper airway collapse during sleep causes episodes of oxygen desaturation and sleep arousal, with untreated severe OSA increasing the risk of hypertension, atrial fibrillation, stroke, and cardiovascular mortality. Continuous positive airway pressure (CPAP) therapy is the gold standard treatment, effectively splinting the upper airway open during sleep. Consistent CPAP use reduces blood pressure, improves daytime cognitive function, and reduces cardiovascular risk. Mandibular advancement devices are an effective alternative for mild-moderate OSA, particularly in CPAP-intolerant patients.
