• Journal of Oral Medicine and Pain
• /
• v.34 no.3
• /
• pp.247-256
• /
• 2009

The purpose of this study was to investigate the changes of the pharyngeal space when the following appliances were inserted: the mandibular advancement appliance (MAA), tongue retaining appliance (TRA), and mandibular advancement-tongue retaining appliance (MATRA). Nine male dental students exhibiting Class I occlusion, normal body mass index (BMI), and no signs and symptoms of snoring were selected for this study. The three kinds of snoring appliances (MAA, TRA and MATRA) were fabricated for each subject. The mandibular advancement of the MAA and MATRA was set at a distance of 5 mm, and the TRA and MATRA were made to hold the tongue in front of the maxillary incisors by 10 to 20 mm. Lateral cephalometric radiographs of the following four states - with no appliance, MAA, TRA, and MATRA - were taken to examine any anatomical changes resulting from the application of the appliances. All four radiographs were traced and analyzed for twenty selected variables related to the pharyngeal space, cranio-cervical posture, and position of the soft palate and hyoid bone. According to the results of this study, there were significant increases in both the upper and lower oropharyngeal spaces when the mandible and tongue were protruded simultaneously, although there was a significant increase only in upper oropharyngeal space when the mandible or tongue was advanced separately. In conclusion, it is suggested that the MATRA may result in more positive effect on the control of snoring and OSA compared to a single use of the MAA or TRA, especially for the patients whose upper airway obstruction occurs in the lower oropharynx.

• Korean Journal of Psychosomatic Medicine
• /
• v.10 no.1
• /
• pp.37-47
• /
• 2002

Objective : Previous studies have suggested an association between sleep-related breathing disorder (SRBD) and several psychological problems, and there were increasing recognition of the link. The purpose of this study is to evaluate the characteristic profiles of MMPI and SCL-90-R in patients with SRBD. Methods : This study consisted of 80 SRBD patients(73 men, 7 women) referred from Sleep Disorder Clinic of Dong-A University Hospital, Busan, Korea. Basic informations including demographic findings and physical examination were collected. Subjects completed the Epworth Sleepiness Scale(ESS), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revision (SCL-90-R) prior to standard overnight polysomnography that was performed at hospital sleep laboratory. SRBD was divided into two groups of primary snoring(PS) and obstructive sleep apnea(OSA) according to polysomnographic findings. Results : SRBD showed significant elevation rate of Hs, D, and Hy scales of MMPI and SOM scale of SCL-90-R, which exceeded the rate expected in normal individuals(>5%, 2SD). On comparison of clinical scales of SCL-90-R, OSA group had significantly greater mean score than that of PS group in terms of O-C, DEP, PAR, GSI(p<0.05), SOM and PST(p<0.01). OSA group also showed significantly higher elevation rate in Hs scale of MMPI and SOM scale of SCL-90-R than that of PS. Among OSA group, three scales of MMPI(D, Pt, Si) and three scales of SCL-90-R(ANX, PAR, PSDI) had significant correlation with some PSG variables including total sleep time and sleep efficiency. Among PS group, two scales of MMPI(Hy and Pt), elevation rate of MMPI scales and three scales of SCL-90-R(I-S, PAR, PSDI) had significant correlation with some PSG variables including sleep efficiency, sleep latency and REM sleep percent. Conclusion : The above results suggest that SRBD show neurotic profiles in MMPI and SCL-90-R. This study also clearly indicates that PS group are suffered from clinically meaningful psychiatric symptoms, which are quantitatively lessened but qualitatively similar as compared to that of OSA group.

• Korean Journal of Clinical Laboratory Science
• /
• v.48 no.3
• /
• pp.255-261
• /
• 2016

The purpose of this study was to investigate the relationship between excessive daytime sleepiness (EDS) and blood pressure (BP) in patients with obstructive sleep apnea-hypopnea (OSAH). Patients were classified into four groups based on their severity of polysomnographic data: the snoring group (n=108)-characterized by Apnea-Hypopnea Index (AHI<5); the mild OSA group (n=186)-AHI $5{\leq}AHI$<15; the moderate OSA group (n=179)- AHI $15{\leq}AHI$<30; and the severe OSA group (n=233)-$AHI{\geq}30$. On the same night of polysomnography (PSG), BP levels were measured before sleeping (bedtime BP) and immediately after waking up on the following morning (morning BP). EDS was recognized as ESS (epworth sleepiness scale)${\geq}9$. The differences and correlations between BP and PSG parameters in the EDS and non-EDS groups of OSAH patients were analyzed. MAP was positively correlated with BMI, AHI, and total arousal (r=0.099, r=0.142, r=0.135, p<0.01, p<0.01, p<0.01), while negatively correlated with mean $SaO_2$ (r=-0.258, p<0.01). The EDS group had overall younger population ($47.2{\pm}11.3$ vs $50.3{\pm}11.4$, p=0.023), higher DBP (both bedtime and morning, $83.1{\pm}9.7$ vs $81.4{\pm}8.8$ and $86.4{\pm}9.2$ vs $83.6{\pm}9.7$)(p=0.031, p=0.047), and higher SBP (both bedtime and morning, $126.7{\pm}11.2$ vs $123.4{\pm}12.4$, $128.9{\pm}12.4$ vs $125.3{\pm}12.9$)(p=0.021, p=0.021) than compared with the non-EDS group. In hypertensive OSAH patients, patients with EDS were also younger and had higher total arousal number, as well as higher morning and bedtime DBP and SBP than compared with the non-EDS group (p<0.005, p=0.008, p<0.001 and p<0.001). EDS in OSAHS patients is a special phenotype characterized by younger age, higher DBP, more severe desaturation, and hypertension.

• Tuberculosis and Respiratory Diseases
• /
• v.58 no.3
• /
• pp.295-298
• /
• 2005

We report a case of a 48-year-old man with a paradoxic upper airway obstruction and central sleep apnea that developed after an anterior cervical spinal fusion. Nine months before being admitted to this hospital, he was diagnosed with a herniated intervertebral disc between the 5th and 6th cervical spine, and the first operation was carried out. Two months later, a pseudoarthrosis has developed and a second operation, an anterior interbody fusion of the C5 and C6 using autogenous strut bone graft, was performed. After the second operation, he began to complain of snoring, excessive daytime sleepiness, insomnia, and a bizarre sound heard near the upper airway during breathing. Nasopharyngoscope and magnetic resonance imaging disclosed a paradoxical narrowing of the nasopharynx during expiration. On the overnight polysomnography, the apnea index was 8.7/h (central apnea, 7.0/h; obstructive apnea, 1.7/h). Nasal continuous positive airway pressure was applied, but he complained of pressure-intolerance, and laser-assisted uvulopalatoplasty was then performed. Two months after surgery, clinical symptoms as well as the apneas had improved markedly. We suggest that this paradoxic upper airway obstruction might be associated with the anterior cervical spinal surgery even though the mechanism is unclear. This case also emphasizes that an upper airway obstruction can contribute to the development of central sleep apnea.

• Journal of Korean society of Dental Hygiene
• /
• v.22 no.4
• /
• pp.249-257
• /
• 2022

Objectives: This study aimed to investigate the effect of the oral health status on risk factors for obstructive sleep apnea (OSA) using data from the 2019 National Health and Nutrition Examination Survey. Methods: Of a total of 2,422 persons, 1,295 and 1,127 were categorized into the control group (CG) and OSA risk group (OSARG), respectively. The effect of the oral health status on OSA risk factors was presented in Model 1 by performing a complex sample linear regression analysis. Results: Our findings showed that OSA risk factors decreased by 0.075 points when there were no speaking problems with demographic characteristics adjusted. In addition, when systemic diseases were adjusted for, OSA risk factors decreased to 0.074 points (p<0.05). Conclusions: Therefore, in order to reduce oral problems that affect OSA risk factors, dentists and dental hygienists should seek accurate recognition of OSA and effective oral care methods.

• Sleep Medicine and Psychophysiology
• /
• v.1 no.2
• /
• pp.117-124
• /
• 1994

Obstructive Sleep Apnea Syndrome(OSAS), that is a complex disease of neuromuscular, respiratory and cardiovascular system, can be cured by various treatment such as weight control, medical and surgical intervention. As most of OSAS may be caused by various anatomical abnormalities, preoperative evaluation for exact anatomical site of obstruction must be needed. And various diagnostic procedures such as fiberoptic nasopharyngoscopy, Mueller test, cinefluoroscopy, cephalometry, computerized tomography, polysomnography would be used for this purpose. Uvulopalotopharyngplasty is currently the most popular method for the patient with OSAS among various surgical maneuvers and is very effective for the relieving the symptoms as like snoring, daytime somnolence, and nocturnal restlessness etc. Although subjective improvement is not compatible with it's objective assessment in postoperative evaluation for it's results, uvulopalatopharyngoplasty could be a recommandable surgical procedure because of it's ample effectiveness in promoting symptom improvement without any risk of serious complications.

• The korean journal of orthodontics
• /
• v.30 no.3 s.80
• /
• pp.287-296
• /
• 2000

It is well known that oral appliance could improve respiratory difficulty in patients with obstructive sleep apnea (OSA). To evaluate the effect of oral appliance, polysomnography and cephalometry were performed in OSA patients before and after oral appliance was used. Twenty four OSA patients were included in this study. Respiratory difficulty index (RDI) was obtained from polysomnography and the movement of soft palate, tongue, posterior pharygeal wall, hyoid bone, and mandible and the variables of the facial pattern were measured on the cephalogram. The changes of cephalometric parameters were compared to the RDI changes and the correlation was tested. After oral appliance was used, RDI decreased from 46.8 to 13.3. There was significant relationship between RDI improvement and the anterior movement of the mandible and superior movement of the hyoid bone. In 8 patients whose RDI was most improved, RDI improvement rate was correlated with the anterior movement of the tongue and anterior-posterior (AP) diameter of the airway at the levels between the lower portion of the soft palate and epiglottis. These results could conclude that anterior movement of the tongue and superior movement of the hyoid bone would be favorable cephalometric parameters for the improvement of OSA.

• Clinical and Experimental Pediatrics
• /
• v.51 no.6
• /
• pp.646-649
• /
• 2008

Hallermann-Streiff syndrome is a rare disease. Approximately 150 cases have been reported, including 6 cases in Korea. The authors experienced a case of Hallermann-Streiff syndrome in a 6-year-old female with aphakia. The syndrome is characterized by a bird-like face, dental abnormalities, hypotrichosis, atrophy of the skin, bilateral microphthalmia, and proportionate dwarfism. A brief review of the literature was conducted.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.37 no.3
• /
• pp.374-380
• /
• 2010

Treacher Collins syndrome(TCS) is a rare, incurable condition occurring in approximately 1 of 25,000 to 50,000 births. It may occur as a spontaneous mutation out of genetically normal parents or it may be manifested as an autosomal dominant pattern. TCS is characterized by facial deformities such as, underdevelopment of the maxilla, mandible and zygoma, malocclusion, bilateral deformities of auricles, antimongoloid slant of the palpebral fissures. The syndrome is often associated with cleft lip and palate, ear malformations and hearing loss, short stature, and anomalies of the heart and skeleton. Respiratory difficulty associated with air way obstruction may also be observed, and there is considerable difficulty in airway management during general anesthesia. It is necessary that dentists provide safe dental treatments and guidelines to TCS patients by providing adequate understanding about the characteristics of the syndrome and proper ways of managements. The purpose of this study is to report the dental and medical characteristics of the patient who visited the Department of Pediatric Dentistry, Yonsei University for multiple dental caries treatment and to review the literatures of TCS.

• Tuberculosis and Respiratory Diseases
• /
• v.42 no.4
• /
• pp.610-617
• /
• 1995

Sleep apnea occurs in approximately 50% of patients with acromegaly, and sleep apnea is associated with increased cardiovascular diseases and mortality. In view of these findings, sleep apnea may be a factor in the increased incidence of cardiovascular deaths in acromegaly patients. We experienced a case of active acromegaly patient, 54-yr-old man, associated with obstructive sleep apnea syndrome, congestive heart failure with dilated cardiomyopathy and serious cardiac arrhythmias. He was treated for obstructive sleep apnea syndrome, diagnosed by overnight polysomnography, with nasal continuous positive airway pressure(CPAP) for 4 months, which successfully controlled his loud snoring, sleep apnea, nocturnal hypoxemia and apnea-related symptoms. And also he was treated for underlying acromegaly and cardiac complications with bromocriptine and cardiogenic drugs for 4 months, but still had elevated growth hormone(GH) and insulin like growth factor-1(IGF-1) levels and serious cardiac arrhythmias. We describe our experience about the effect of CPAP treatment in an active acromegaly patient associated with obstructive sleep apnea syndrome and cardiac complications with review of literature.