• Sleep Medicine and Psychophysiology
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• v.14 no.1
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• pp.13-19
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• 2007

Sleep disordered breathing is highly prevalent in the elderly and affects older men and women similarly. Nocturia, cardiovascular diseases, cognitive impairment, traffic accidents and repeated falls are common manifestations of sleep apnea in the elderly and sleep study may be indicated in these patients. When a sleep study is planned, reliable markers of respiratory efforts and a tibial EMG should be included because central sleep apneas and periodic leg movements are common in the elderly patients. Although cardiovascular morbidity and mortality seem to be lower in the elderly than in middle-aged adults, these may not be as low as commonly believed. Excessive daytime sleepiness, cognitive dysfunction and nocturia can be improved by effective treatment with continuous positive airway pressure and a therapeutic trial should be recommended to all symptomatic patients. It is still unclear whether sleep apnea in older adults is a specific entity or the same disease as in younger adults. Further clinical research is warranted.

• The Journal of the Korean dental association
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• v.57 no.5
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• pp.288-295
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• 2019

Sleep-disordered breathing (SDB) is defined as a disturbed breathing during sleep caused by repetitive upper airway collapse. Complete collapse causes a cessation of breathing, known as obstructive sleep apnea (OSA) and snoring can arise from partial collapse. Undiagnosed and untreated OSA means recurrent intermittent hypoxemia and leads to a variety of cardiovascular disorders, disturbed neurocognition, and excessive daytime sleepiness. Various behavioral modalities have been suggested for treating snoring and sleep apnea including changing the sleep position, avoiding alcohol, and weight loss. Until now continuous positive airway pressure (CPAP) therapy is one of effective treatment for patients with OSA, but its discomfort causes less tolerance and compliance. Therefore, clinical effectiveness and convenience for oral appliance have emerged and the role of dentists has become more important in the management of OSA.

• The Journal of the Korean dental association
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• v.57 no.5
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• pp.279-287
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• 2019

Obstructive sleep apnea syndrome (OSAS) is characterized by obstructive events of the upper airway (UAW) during sleep, which can be associated with clinical signs and symptoms such as snoring, excessive daytime sleepiness, impaired memory, and fatigue. It is associated with many problems like psychosocial problems, physiologic alterations in the cardiovascular and respiratory systems as a result of hypoxia and repeated awakenings during sleep. Conservative treatments such as weight loss, sleep positioning, improvement of sleep hygiene, CPAP and MAD can be performed for the obstructive sleep apnea. However, their effect for the OSA is limited and differs by patient's individual properties. Accordingly, surgical reconstructions of the upper airway must be carried out for the treatment of OSA.

• The korean journal of orthodontics
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• v.27 no.6 s.65
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• pp.865-870
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• 1997

The submental region in patients with Obstructive Sleep Apnea (OSA) is Perceived to be larger than normal. Therefore, neck thickness has become a variable routinely measured during clinical screening of OSA subjects. In general, OSA Patients are believed to have a large tongue and a narrow airway. To test if OSA patients have a larger face and tongue than non-apneics, eighty pairs of upright and supine cephalograms were obtained from four groups of subjects subclassified in accordance with severity. The sum of distances between pairs of landmarks was calculated for each subjects and employed as a pure size variable for the face and tongue. Only tongue size becomes larger in accordance with apnea severity in both body positions (P<.01). Tongue size reflects apnea severity, yet it Provides only a small fraction of the explanation with regard to apnea severity. We conclude that size may be one factor of many which are significantly related to OSA severity.

• Korean Journal of Clinical Laboratory Science
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• v.40 no.2
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• pp.129-134
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• 2008

Obstructive sleep apnea syndrome (OSAS) is occurred by apnea by the obstruction of upper trachea while sleeping, followed by repetitive drop on arterial oxygen saturation ($SpO_2$). Therefore, the present study was focused on relation between $SpO_2$ of while having difficulty in breathing and clinical characteristics of OSAS while sleeping. The study took place at Ewha women university Mokdong hospital with 149 subjects (male 121, female 28) who were examined for polysomnography (PSG) from May 2007 to February 2008. All subjects were adhered to electrodes and sensors to measure electroencephalogram (EEG), electrooculogram (EOG), chin & leg electromyogram (EMG), airflow at nasal and oral cavities, breathing movement of chest and abdominal snoring sound and $SpO_2$. Lowest $SpO_2$ in male was meaningfully low with higher body mass index (BMI), louder snoring sound and thick neck circumference (p<0.01). While mean $SpO_2$ based on the degree of AHI did not show significant difference, lowest $SpO_2$ was significantly low with high AHI (p<0.001). Also, lowest $SpO_2$ was closely correlated with BMI (r=-00.343, p<0.001), snoring sound (r=0.177, p<0.05), apnea index (r=-0.589, p<0.001), hypopnea index (r=-0.336, p<0.001) and apnea-hypopnea index (r=-0.664, p<0.001). $SpO_2$ was closely related to clinical characteristics of OSAS, like male, BMI, snoring sound and neck circumference. Also, polysomnography accompanied by recent development of sleep study is considered as critical test to diagnose OSAS, decide the severity of illness, and evaluate the treatment plan.

• Journal of Oral Medicine and Pain
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• v.22 no.2
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• pp.383-394
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• 1997

The purpose of this study was to examine the anatomic changes in the upper airway with a dental orthosis. the effectiveness and side effects of orthosis in the treatment of snoring and obstructive sleep apnea. To meet this puppose a dental orthosis, designed to increase the size of the upper airway by advancing the mandible, was used in 42 patients (30 M, 12 F), aged 29 - 69 years, to treat snoring and varying decrees of obstructive sleep apnea. Cephalometric study of anatomic featured was made with and without a dental orthosis, and the evaluation of the effectiveness and side effects of orthosis was done by questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 32 patients comp1ained the loudness of snoring as severe as be heard outside of the patient's room. 2. According to the degree of respiratory distirbance index(RDI) and aprea index(Al) from the polysomnograph in 34 patient, mild obstructive sleep apnea patients were 5, moderate 6 and severe 16. 3. Various anatomic changes in the upper airway with denta1 orthosis were as follows : (1) More superioly positioned hyoid bone ( p<0.001) (2) Enlarged oropharyngeal (superior p<0.01, middle p<0.01. inferior p<0.01) and hypopharyngeal (P<0.05) airway space. 4. According to the results of the changes of clinical syptoms after the usage of the dental orthosis acquired from questionnaires, there was significant improvement in the frequently, the loudness and the severity of snoring, cessation of breathing and awakening from the difficulty of breathing during sleep. 5. The effectiveness and side effects of dental orthosis by questionnaires were as follows ; (1) Dental orthosis satisfied almost all the patients (68±20%). (2) Snoring was improved in all the patients (73±19%). (3) Obstructive sleep aphea was improved in all the patients (61 ± 37%) (4) Sleepiness in the daytime was significantly improved (61 ±37%). (5) The sleep quality was significantly improved (61±37%). (6) The discomfort of the dental orthosis was minor (33±18%) and no serious complications were observed. 6. The dental orthosis is an effective treatment for the symptom of snoring, and it can also effectively treat varying degrees of obstructive sleep apnea.

• The Journal of Korean Medicine
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• v.35 no.2
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• pp.12-18
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• 2014

Objectives: This was a retrospective case series about the clinical effect of integrated approach with behavior therapy for obstructive sleep apnea (OSA). Methods: Medical records of twelve patients with OSA who were treated with behavior modification including nasal breathing with oral appliances and sleep in lateral position, oral administration of herbal medicines and acupuncture treatment between January and September of 2013 were reviewed. Apnea-hypopnea index (AHI), day time sleepiness, apneas and hypopneas counts during sleep, risk indicator (RI), oxygen desaturation index, average saturation during sleep, lowest desaturation, lowest saturation, snoring events ratio and number of desaturations (%) were assessed before and after treatments with the ApneaLink device, which is a portable diagnostic apparatus for monitoring airflows of the patient's breath at home. Results: After an average 62.67 (SD 37.16) days of treatment, AHI (from 17.67, 12.79 to 8.75, 8.25, p=0.007), RI (from 22.00, 13.26 to 12.09, 8.03, p=0.004), oxygen desaturation index (from 17.33, 12.17 to 8.17, 7.86, p=0.005), and number of desaturations (from 7.00 times, 9.79 to 0.92 times, 1.39, p=0.044) showed significant improvement. Daytime sleepiness improved from 6.5 (3.2) to 3.8 (1.8) but there was no significant difference after treatment (p=0.17). No adverse events related to treatment were observed during participation in the treatment. Conclusion: From this case series, we found that behavior modification with herbal medication and acupuncture may be effective for improving sleep apnea without serious adverse events. Future randomized controlled trials with larger sample size will be necessary for concrete evidence on the benefit of this integrated treatment for OSA.

• Journal of Biomedical Engineering Research
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• v.35 no.4
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• pp.75-80
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• 2014

This paper proposed a method that can automatically classify sleep apnea by using features extracted from pulse rate variability(PRV) signals induced from piezo snoring sensor for patients with obstructive sleep apnea(OSA). We have extracted eight features(NN, SDNN, RMSSD, NN10, NN50, LF, HF and LF/HF ratio) based on time and frequency analyses of PRV. Sleep apnea was classified by a linear discriminant analysis(LDA). A performance was evaluated using snore recordings from 13 patients with OSA (ages: $54.5{\pm}10.5$ years, body mass index: $26.3{\pm}2.5kg/m^2$, apnea-hypopnea index: $19.2{\pm}6.0/h$). The sensitivity and specificity were $78.9{\pm}0.9%$ and $78.9{\pm}0.9%$ for training set and $77.7{\pm}10.9%$ and $79.0{\pm}2.8%$ for test set, respectively. Our study demonstrated the feasibility of implementing a piezo snoring sensor based on a portable device as a simple and cost-effective solution for contributing to the OSA screening.

• Sleep Medicine and Psychophysiology
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• v.5 no.1
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• pp.88-102
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• 1998

Objectives : We attempted to study obstructive sleep apnea symptoms prevalence and sleep apnea-associated factors in Korean rural adult population. Methods : In 1,441 adult subjects of three rural communities selected by cluster sampling, we administered an epidemiologic survey using questionnaire methods from July 14, 1996 to July 28, 1996. Results : 1) In 14.1% of the subjects, snoring was reported to occur almost daily and 2.9% of the subjects reported sleep apnea symptoms occurring almost daily. 2) Snoring and sleep apnea symptoms were found more frequently in males or in mid-aged group(45 - 64 years old) than in females or in younger- and older-aged groups, respectively. Compared with the subjects who have no snoring, the subjects who have snoring or sleep apnea symptoms had greater body mass index(BMI), waist-hip ratio, hemoglobin level, RBC count, and higher diastolic blood pressure. 3) Cigarette smoking and alcohol drinking more than once a week were significantly associated with suffering from sleep apnea symptoms. 4) In multiple logistic regression analysis, being male, mid-aged, and greater BMI were independently associated with the presence of snoring and sleep apnea symptoms. Conclusion : We conclude that, in the Korean rural adult population, males or mid-aged group suffers more from snoring and sleep apnea symptoms than females or younger- and older-aged groups. In addition, being male, mid-aged, and greater BMI were significantly associated independently with the presence of snoring and sleep apnea symptoms.

• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.74-78
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• 2009

Objective: It has been reported that the sleep apnea syndrome in the asthmatic patients is prevalent, however, the systematic study in this field using polysomnography has rarely been performed. The aim of this study is to investigate the relationship between the apnea-hypopnea index (AHI) and the pulmonary function in asthmatic children. Methods: This study enrolled 19 male and 12 female asthmatic children aged 6-13 years (average $8.2{\pm}1.7$ years old). Complete overnight polysomnography and pulmonary function test were performed for the participants. Results: Of the 31 asthmatic children, 21 (67.7%) met the diagnostic criteria of the pediatric sleep apnea and the average AHI was $1.7{\pm}1.5/h$. The children with higher AHI showed poorer pulmonary function ($FEV_1$/FVC ratio: p=0.002, $FEV_1$%pred: p=0.047). Conclusion: These results suggest that the prevalence of the pediatric sleep apnea could be very high among the asthmatic children and the severity of the sleep apnea correlates with the pulmonary function. However, the case-control study to compare the AHI between the asthma and control groups is absolutely necessary because few normative data are available for the children.