• Title/Summary/Keyword: 수면무호흡증

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Airway Narrowing Patterns during Obstructive Sleep Apnea : Airway CT and Multi-level Airway Pressure Monitoring (수면무호흡 중에 관찰된 다양한 기도협착의 형태:상기도 CT 및 상기도 압력 측정법)

  • Jeong, Seung-Cheol;Hong, Seung-Bong;Kyung, Seung-Hyun;Kim, Hoo-Won
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.18-26
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    • 2000
  • Objectives: To investigate the airway narrowing patterns by multi-level airway pressure(MAP) monitoring during sleep and to evaluate the value of CT scan taken during waking and sleep apneic periods to identify the level of airway narrowing(LAN) in patients with obstructive sleep apnea syndrome(OSAS). Methods: Eleven patients with OSAS underwent a night polysomnography with continuous MAP monitoring by 4-sensor(placed at nasopharynx, caudal-uvula, hypopharynx, esophagus) or 2-sensor(placed at caudal-uvula and esophagus) catheter. All patients had cine CT at five levels of high retro and alatal, low retropalatal, retroglossal, epiglottis and hypopharynx during awake and sleep periods. In each patient, LAN determined by CT scan($LAN_{CT}$) during sleep apnea was compared with LAN by MAP monitoring($LAN_{MAP}$). Results: MAP monitoring showed that four patients(36%) had a single pattern of LAN while the other seven patients(64%) showed two or more different LANs in different apneic episodes. Velopharynx was the most common level of frequently observed airway narrowing during sleep apnea(63.6%). However, a single pattern of airway narrowing was more frequent(72.7%) in airway CT during sleep apnea. Velopharynx was the most common narrowest level also in apneic CT(66%). In comparing $LAN_{CT}$ with $LAN_{MAP}$, the $LAN_{CT}$ of five patients(45.5%) were high-concordant, those of another five(45.5%) low-concordant, and that of one(9%) discordant with $LAN_{MAP}$. Conclusions: Cine CT scan during the awake state or sleep apnea may not reflect the LAN correctly in OSAS because most patients showed two or more different airway narrowing patterns during different episodes of sleep apnea in each patient.

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Nasal Continuous Airway Pressure Titration Unmasks Periodic Limb Movements in Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증에서 지속적 상기도 양압술에 따른 주기성 사지운동증의 표출)

  • Park, Doo-Heum;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.103-110
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    • 1998
  • Objectives : High co-morbidity of periodic limb movements during sleep(PLMS) and obstructive sleep apnea syndrome(OSAS) is well known and their incidences tend to increase in the elderly. Previous studies have inconsistently rep0l1ed increase or no change of periodic limb movement index(PLMI) by nasal continuous positive airway pressure(CPAP) in OSAS without analyzing possible variables affecting PLMI. We attempted to examine PLMI change evoked during CPAP titration and also factors affecting it in OSAS. Methods : Twenty-nine OSAS patients(M:F=26:3, mean age: $51.6{\pm}10.6\;yrs$) without other sleep disorders except for PLMS were selected, based on the nocturnal (baseline) polysomnograhy. Another night of noctumal polysomnography was performed for CPAP pressure titration. We compared between those two nights PLMI, mean and lowest $SaO_2$, and sleep variables. We also calculated PLMI differences between baseline and CPAP nights, named as delta PLMI (value of CPAP night PLMI minus value of baseline night PLMI). Correlations were calculated between delta PLMI and factors such as age, body mass index, applied CPAP pressure, baseline night values of respiratory disturbance index, mean and lowest $SaO_2$, and sleep parameter differences between baseline and CPAP nights. Results : Decrease of RDI(p<.01) and increase in mean and lowest $SaO_2$ (p<.05, p<.01) were observed during CPAP night. No sleep parameters showed significant change except for the decrease of total stage 1 sleep%(p<.01) during CPAP night. Ten out of 29 patients showed PLMI increase, while the other 19 patients showed either no change(n=14) or even PLMI decrease(n=5) during CPAP night. The 10 patients showing PLMI increase during CPAP night showed a significant positive correlation between delta PLMI and baseline night RDI(p<.05), which meant that PLMI increase was found to be more prominent in higher RDI patients than in lower RDI ones. There were no significant correlations between delta PLMI and other factors in the other 19 patients. Conclusions : We suggest that during the baseline night PLMS would have been underscored and/or masked due to the overlapping of PLMS and apneas/hypopneas or the arousals induced by apneas/hypopneas. Despite its still unknown mechanism, the CPAP application may unmask PLMS and increase PLMI in a subgroup of OSAS patients. It needs to be evaluated further whether the chronic CPAP use sustains the above finding.

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Design of Smart Pillow System for Managing Sleep Apnea (수면무호흡증을 관리를 위한 스마트 베개 시스템의 설계)

  • Lee, Jong Chan
    • Journal of the Korea Convergence Society
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    • v.11 no.1
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    • pp.33-39
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    • 2020
  • Specialists have developed pillows that take into account sleep science and ergonomics, such as comfort for lying on your side. This pillow is made of natural latex material, and improved resilience after a certain period of time. A new idea was added to the pillow, which was naturally used for sleep, but could it add additional features for health care. Here, health care targets sleep apnea, which is known to be associated with serious illness. The purpose of this paper is to design a comprehensive service that uses a pressure sensor and a voice sensor to obtain information and to identify abnormal symptoms related to diseases from this information and to refer them to a specialist. It also covers the basic design and implementation to confirm the success of this system. Based on this design, the information obtained will be converted into a DB, and a server system for consultation with a specialist will be completed to upgrade the role of assistive health devices for sleep apnea.

Usefulness of the Chin Press Maneuver in Assessing the Severity of Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증후군의 진단에 있어 턱 압박술의 유용성)

  • Kim, Moo-Jin
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.22-29
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    • 2001
  • Objectives: Obstructive sleep apnea syndrome (OSA) is a moderately prevalent disorder. Even though much progress has been made in the diagnosis of this disorder, the cost-effectiveness of nocturnal polysomnography is undertermined and physicians and patients are still hesitant to undergo this procedure. The authors wanted to see the validity of chin press/tongue curl maneuver in estimating the severity of OSA which is easy to measure and was originally proposed by Simmons etc. by looking at the correlations between this score and the conventional respiratory disturbance indices. Methods: Forty-three sleep-related breathing disorder patients (28 OSA patients and 15 upper airway resistance syndrome (UARS) patients) who underwent investigation for posssible OSA were studied. Two conventional indices of OSA (apnea/hypopnea index (AHI) and oxygen saturation dip rate (SaO2 dips)), four other sleep variables (lowest SaO2, % of time with SaO2<90% (%SaO2 <90), % of sleep stage 1, mean length of SaO2 dips) and the score of Epworth sleepiness scale (ESS) were compared with the chin press score (CPS) which was newly revised by the author and ranges from 0 to 6. Results: The age of subjects was $45.95{\pm}12.47$ (range 14-76) and their average BMI was $25.98{\pm}3.61$ (range 19.65-37.64). There were no significant differences in age, sex and BMI except repiratory disturbance indices and ESS (p<0.05) between OSA and UARS group. Grouped median CPS of the all subjects was 4.14 (range 1-6). There was a remarkable relationship between CPS and diagnosis category (Likelihood Ratio $X^2$ test; $X^2$=17.41, df=5, p=0.004) and measures of association (Somers' $d=0.65{\pm}0.12$, t=4.83, p=0.000) indicated that CPS increased when the diagnosis changed from UARS to OSA. Spearman's rank correlations between CPS and SaO2 dips (R=0.83), between CPS and AHI (R=0.77) were good (p<0.001). Other variables except mean length of SaO2 dips showed good correlations with CPS as well (p<0.05). Regression analysis indicated that when CPS is 3 there is a provability of 0.35 to have AHI of less than 5. Conclusion: Chin press scores that can be measured easily is well correlation with the conventional sleep apnea indices. They may therefore provide a useful guide in diagnosing obstructive sleep apnea synrome.

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Detrended Fluctuation Analysis of Sleep Electroencephalogram between Obstructive Sleep Apnea Syndrome and Normal Children (소아기 수면무호흡증 환자와 정상 대조군 수면 뇌파의 탈경향변동분석)

  • Kim, Eui-Joong;Ahn, Young-Min;Shin, Hong-Beom;Kim, Jong-Won
    • Sleep Medicine and Psychophysiology
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    • v.17 no.1
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    • pp.41-49
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    • 2010
  • Unlike the case of adult obstructive sleep apnea syndrome (OSAS), there was no consistent finding on the changes of sleep architecture in childhood OSAS. Further understanding of the sleep electroencephalogram (EEG) should be needed. Non-linear analysis of EEG is particularly useful in giving us a new perspective and in understanding the brain system. The objective of the current study is to compare the sleep architecture and the scaling exponent (${\alpha}$) from detrended fluctuation analysis (DFA) on sleep EEG between OSAS and normal children. Fifteen normal children (8 boys/7 girls, 6.0${\pm}4.3$2.2 years old) and twelve OSAS children (10 boys/2 girls, 6.4${\pm}4.3$3.4 years old) were studied with polysomnography (PSG). Sleep-related variables and OSAS severity indices were obtained. Scaling exponent of DFA were calculated from the EEG channels (C3/A2, C4/A1, O1/A2, and O2/A1), and compared between normal and OSAS children. No difference in sleep architecture was found between OSAS and normal controls except stage 1 sleep (%) and REM sleep latency (min). Stage 1 sleep (%) was significantly higher and REM latency was longer in OSAS group (9.3${\pm}4.3$4.3%, 181.5${\pm}4.3$59.9 min) than in controls (5.6${\pm}4.3$2.8%, 133.5${\pm}4.3$42.0 min). Scaling exponent (${\alpha}$) showed that sleep EEG of OSAS children also followed the 'longrange temporal correlation' characteristics. Value of ${\alpha}$ increased as sleep stages increased from stage 1 to stage 4. Value of ${\alpha}$ from C3/A2, C4/A1, O1/A2, O2/A1 were significantly lower in OSAS than in control (1.36${\pm}4.3$0.05 vs. 1.41${\pm}4.3$0.04, 1.37${\pm}4.3$0.04 vs. 1.41${\pm}4.3$0.04, 1.37${\pm}4.3$0.05 vs. 1.41${\pm}4.3$0.05, and 1.36${\pm}4.3$0.07 vs. 1.41${\pm}4.3$0.05, p<0.05). Higher stage 1 sleep (%) in OSAS children was consistent finding with OSAS adults. Lower $'{\alpha}'$ in OSAS children suggests decrease of self-organized criticality or the decreased piling-up energy of brain system during sleep in OSAS children.

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A development of sleep apnea diagnosis system using an Arduino (아두이노를 이용한 수면무호흡 진단 시스템 개발)

  • Kim, Youseong;Lee, Jusung;Han, Sangwook;Lee, Hwamin
    • Proceedings of the Korea Information Processing Society Conference
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    • 2015.10a
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    • pp.929-931
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    • 2015
  • 고열량 식단이 많아지면서 비만 인구가 증가하면서 비만을 원인으로 하는 수면무호흡증도 증가하고 있다. 이 연구는 아두이노를 이용하여 수면 중인 사용자의 무호흡 횟수와 실시간 호흡 상황을 입력받아 입력된 값을 계산하고 분석한 뒤, 블루투스를 통해 사용자가 깨어났을 때 사용자의 스마트폰으로 사용자의 수면무호흡 상태를 표시하도록 구현하였다.

Implemetation of Real-time Monitoring System for Obstructive Sleep Apnea Based on Smart-phone (스마트폰 기반의 실시간 수면 무호흡 모니터링 시스템 구현)

  • Ju, Seok-Il;Hong, Seong-Gyun;Ye, Soo-Young;Jeong, Do-Un
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2011.05a
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    • pp.791-792
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    • 2011
  • 폐쇄성 수면 무호흡증 환자 중 가장 위험한 2~8세 아동들의 지속적인 수면 상태를 모니터링하는 것은 중요하며, 야간에 수면 상태를 모니터링 하는 것은 보호자에게 스트레스와 일상생활에 지장을 초래할 수 있다. 본 연구에서는 아동들의 수면 상태를 측정하기 위한 스마트폰 기반의 실시간 호흡 모니터링 시스템을 구현하였다. 구현된 시스템은 아동의 수면 중 자세 변화로 인한 잦은 폐쇄성 수면 무호흡을 지속적으로 모니터링 함으로써 수면 상태 모니터링 및 위험 상황을 인지할 수 있으며, 보호자에게 편안한 수면을 제공한다.

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Detection of Tracheal Sounds using PVDF Film and Algorithm Establishment for Sleep Apnea Determination (PVDF 필름을 이용한 기관음 검출 및 수면무호흡 판정 알고리즘 수립)

  • Jae-Joong Im;Xiong Li;Soo-Min Chae
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.23 no.2
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    • pp.119-129
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    • 2023
  • Sleep apnea causes various secondary disease such as hypertension, stroke, myocardial infarction, depression and cognitive impairment. Early detection and continuous management of sleep apnea are urgently needed since it causes cardio-cerebrovascular diseases. In this study, wearable device for monitoring respiration during sleep using PVDF film was developed to detect vibration through trachea caused by breathing, which determines normal breathing and sleep apnea. Variables such as respiration rate and apnea were extracted based on the detected breathing sound data, and a noise reduction algorithm was established to minimize the effect even when there is a noise signal. In addition, it was confirmed that irregular breathing patterns can be analyzed by establishing a moving threshold algorithm. The results show that the accuracy of the respiratory rate from the developed device was 98.7% comparing with the polysomnogrphy result. Accuracy of detection for sleep apnea event was 92.6% and that of the sleep apnea duration was 94.0%. The results of this study will be of great help to the management of sleep disorders and confirmation of treatment by commercialization of wearable devices that can monitor sleep information easily and accurately at home during daily life and confirm the progress of treatment.