The aim of this systematic review was to answer the focused question, "Is there an association between obstructive sleep apnea (OSA) and alcohol, caffeine or tobacco use?" Five electronic databases (Cinahl, Literatura Latth American and Caribbean, PubMed, Scopus, Web of Science) and 3 grey literature (Google Acadêmico, ProQuest, OpenGrey) were searched, as well as search on reference list of included papers and contacts with study authors. Observational studies were included. The Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI) tool assessed the potential risk of bias (RoB) among the studies, while the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach determined the level of evidence. Meta-Analysis was performed with RevMan 5.3 software. Among 3,442 identified studies, 14 were included. Eleven studies were classified as moderate RoB and 3 as high RoB. Meta-analysis showed OSA has no association with tobacco and presented a positive association with alcohol. The odds ratio for OSA increased almost 1.33 times (95% confidence interval [CI]; 1.10-1.62) for alcohol users. There was insufficient published data to evaluate whether OSA is associated with caffeine. The overall quality of evidence ranged from low to very low. OSA was associated with the use of alcohol, however there is not enough evidence to confirm the association with tobacco or caffeine. Due to the very low GRADE level of evidence, caution should be applied when considering these findings.

RESUMOO presente trabalho tem por objetivo relatar um caso clínico diagnosticado como Síndrome da apnéia obstrutiva do sono, e expor uma sequência lógica para o tratamento de pacientes que sofrem desta doença. Através da interpretação do exame de polissonografia, da anamnese, exame clínico e, ainda, por meio da realização do traçado e análise cefalométrica para apnéia do sono, indicou-se de forma segura e efetiva a terapia com aparelho intra-oral. Desta maneira, foi confeccionado um aparelho de avanço mandibular, o PLG. Após quatro semanas de uso do aparelho, o paciente foi encaminhado à realização de uma nova polissonografia, a qual revelou ausência de apnéias obstrutivas durante o sono. As etapas seguidas no tratamento deste estudo de caso destacaram a importância e a necessidade de uma abordagem correta e criteriosa dos casos de pacientes com apnéia do sono encaminhados ao consultório odontológico. A abordagem e sequência apresentadas garantiram o sucesso no tratamento deste estudo de caso. Obstructive episodes are usually accompanied by loud snoring and a drop in blood oxygen saturation (hypoxemia), ending in short micro-awakenings, which result in sleep fragmentation 4 . Sleep basically consists of two moments that alternate between waking states: non-rapid eye movement (NREM) and rapid eye movement (REM). Sleep apnea events last longer and have higher hypoxemia during REM sleep than during NREM sleep in patients with OSAS 5 . Termos de indexação:According to Jauhar et al. 2 , the deterioration of sleep quality caused by OSAS significantly contributes to excessive daytime sleepiness, loss of cognitive capacity, and mood swings and personality changes. It has also been associated with a worsening in the quality of life and in relationships with spouses and partners, decreased alertness, and an increased risk of traffic accidents. In addition, there are indications of an increase in cardiovascular diseases among untreated OSAS patients, and it is a potentially life-threatening condition 1,3,[6][7] that requires an early diagnosis and effective treatment.

No abstract

MULTIDISCIPLINARY CENTER FOR OROFACIAL PAIN AT UFSC -CEMDOR: REPORT OF EXPERIENCE AbstractThe aim of this work is to present the activities performed at the Multidisciplinary Center of Orofacial Pain at UFSC in Florianopolis. The CEMDOR performs the diagnosis, treatment and follow-up of patients with Temporomandibular Disorders, Sleep Disorders and Orofacial Pain (TMD/SD/OFP) and aim mainly the recovery of function, pain relief and the improvement of the patients life quality, collaborating with their well-being. The patients are evaluated on the clinic and later the clinical cases are debated in classroom with the presence of professors of the Dentistry and Speech Therapy course. This activity allows the elaboration of treatment plans more complete and individualized. Moreover, this practice foments questions and increases knowledge. The services offered by CEMDOR are important and timely to the community due to the high incidence of patients with TMD/SD/OFP in the population, which affects the quality of life with high health impact.