• Journal of Acupuncture Research
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• v.39 no.4
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• pp.275-282
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• 2022

The purpose of this study was to analyze acupuncture treatment methods and acupoints used to treat obstructive sleep apnea (OSA) or obstructive sleep apnea-hypoapnea syndrome (OSAHS). The data were retrieved from January 2010 to May 2022 from the China National Knowledge Infrastructure database. The search terms included "adult," "obstructive sleep apnea," "obstructive sleep apnea hypoapnea syndrome," "acupuncture," and "electro-acupuncture." Clinical trials for acupuncture treatment of OSA or OSAHS were included in this review (4 non-randomized controlled studies, 1 was a case report, and 10 randomized controlled studies). For OSA and OSAHS treatment, the acupoints that were most frequently used included REN23, LU7, ST40, EX9, LI11, and DU20. Compared with the control or Western treatment group, the treatment outcome measures of participants in the acupuncture treatment group significantly improved. In some studies, participants in the acupuncture group did not have side effects and the treatment was cost-effective. The data analyzed in this review suggest that acupuncture is an effective treatment for OSA or OSAHS.

• 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.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.5-9
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• 2004

Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent cessation of breathing due to complete or partial upper airway occlusion during sleep. The incompetent tone of palatal, pharngeal, and glossal muscles which fail to maintain airway patency during sleep causes narrowing of the airway dimension and increased resistance of breathing. The identification of the sites of upper airway obstruction in patients with OSA is important in understanding the pathogenesis and deciding the treatment modality of snoring and/or OSA. Various upper airway imaging modalities have been used to assess upper airway size and precise localization of the sites of upper airway obstruction during sleep. Dynamic imaging modalities enabled assessment of dimensional changes in the upper airway during respiration and sleep. This article focused on reviews of various upper airway imaging modalities, especially dynamic upper airway imaging studies providing important information on the pathogenesis of OSA.

• Clinical and Experimental Pediatrics
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• v.55 no.6
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• pp.212-214
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• 2012

Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our case, pulmonary hypertension was caused, successively, by congenital heart defects (a large patent ductus arteriosus and arch hypoplasia) and obstructive sleep apnea during early infancy. The congenital heart defects were surgically corrected, but persistent pulmonary hypertension was identified 2 months after the operation. This pulmonary hypertension was due to OSA, and it was relieved by nasal continuous positive airway pressure. This case is the first report of pulmonary hypertension from OSA in a young infant with RTS.

• Sleep Medicine and Psychophysiology
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• v.15 no.1
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• pp.25-32
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• 2008

Objectives: A few studies have compared REM sleep-dependent obstructive sleep apnea syndrome (REM-OSA) with sleep stage non-dependent apnea syndrome (SND-OSA). Despite that REM-OSA might be more common in women than men, no studies have examined the probable characteristics of women patients with obstructive sleep apnea syndrome (OSAS). This study aimed at finding out the characteristics of REM-OSA in women by comparing it with SND-OSA. Methods: Fifty-three subjects diagnosed as OSAS (AHI>5 ; AHI : apnea-hypopnea index) with nocturnal polysomnography at the Center for Sleep and Chronobiology of the Seoul National University Hospital between October 2004 and February 2006 were studied. Of them, 44 subjects with OSAS severity of mild (52 and AHI-NR<15 (AHI-R : AHI during REM sleep, AHI-NR : AHI during non-REM sleep). We compared REM-OSA group with SND-OSA as well as the criteria-determined REM-OSA cases with the visually-determined ones. Results: Among 44 subjects, 28 persons (63.6%) turned out to have REM-OSA by our criteria and 24 persons (54.5%) by visual determination. Statistically significant differences (p<0.05) were found between REM-OSA and SND-OSA groups in AHI, hypopnea index, total sleep time, total wake time, sleep efficiency index, percents of stage 1, 2 and REM sleep, and REM latency. Percent of stage REM sleep (%REM) turned out to have influence on AHI ratio (AHI-R/AHI-NR) (B=0.537, p=0.002). REM-OSA was likely to be diagnosed in milder severity of OSAS (${\chi}^2=13.117$, p<0.001) and those with higher %REM (${\chi}^2=11.325$, p=0.001). There was no significant difference between the criteria-determined and the visually-determined cases of REM-OSA. Conclusion: We suggest that REM-OSA and SND-OSA patients be differentiated in terms of pathophysiology and treatment strategies. Visual determination of REM-OSA might be useful as the screening procedure of REM-OSA. Further studies on women with OSAS and REM-OSA need to be done.

• Journal of Korean Biological Nursing Science
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• v.18 no.3
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• pp.135-143
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• 2016

Purpose: This study was conducted to identify the factors associated with obstructive sleep apnea (OSA) risk in patients with metabolic syndrome (MS). Methods: Patients with MS between 30 and 74 years of age were recruited in an outpatient clinic of a cardiovascular center in Seoul, South Korea. MS and the risk of OSA were evaluated by Berlin questionnaire survey, the medical records of the participants were reviewed and a comprehensive lifestyle survey was performed. SPSS WIN 21.0 was used for statistical analysis. Results: BMI (OR: 1.31, CI: 1.14-1.51, p<.001) and lifestyle score (OR: 0.96, CI: 0.93-0.99, p=.028) were associated with the risk of OSA. Physical activity, weight control and diet were specifically associated with the risk of OSA after controlling for age, gender and BMI. Conclusion: This study demonstrated that lifestyle was an important factor associated with OSA risk in patients with MS.

• Sleep Medicine and Psychophysiology
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• v.12 no.2
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• pp.105-110
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• 2005

The pathogenesis and mechanism of obstructive sleep apnea (OSA) has been under investigation for over 25 years, but its etiology and mechanism remains elusive. Skeletal (maxillary and/or mandibular hypoplasia or retrodisplacement, inferior displacement of hyoid) and soft tissue (increased volume of soft tissue, adenotonsillar hypertrophy, macroglossia, thickened lateral pharyngeal walls) factors, pharyngeal compliance (increased), pharyngeal muscle factors (impaired strength and endurance of pharyngeal dilators and fixators), sensory factors (impaired mechanoreceptor sensitivity, impaired pharyngeal dilator reflexes), respiratory control system factors (unstable respiratory control) and so on facilitate collapse upper airway. Therefore, OSA may be a heterogeneous disorder, rather than a single disease entity and various pathogenic factors contribute to the OSA varies person to person. As a result, patients may respond to different therapeutic approaches based on the predominant abnormality leading to the sleep-disordered breathing.

• The Journal of the Korean dental association
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• v.53 no.4
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• pp.238-248
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• 2015

Sleep related breathing disorders(SRBDs) are a group of diseases accompanied by difficulties in respiration and ventilation during sleep. Central sleep apnea, obstructive sleep apnea(OSA), sleep-related hypoventilation, and hypoxemia disorder are included in this disease entity. OSA is known to be the most common SRBDs and studies show its significant correlation with general health problems including hypertension, arrhythmia, diabetes, and metabolic syndrome. The diagnostic process of OSA is composed of physical examinations of the head and neck area and also the oral cavity. Radiologic studies including cephalography, CT, MRI, and fluoroscopy assist in identifying the site of obstruction. However, polysomnography(PSG) is still considered the gold standard for the diagnosis of OSA since it offers both qualitative and quantitative recording of the events during a whole night's sleep. The dentist who is trained in sleep medicine can easily identify patients with the risk of OSA starting from simple questions and screening questionnaires. Diagnosis is the first step to treatment and considering the high rate of under-diagnosis for OSA the dentist may play a substantial role in the diagnosis and treatment of OSA which will eventually lead to the well-being of the patient as a whole person. So the objective of this article is to assist dental professionals in gaining knowledge and insight of the diagnostic measures for OSA including PSG.

• Korean Journal of Clinical Laboratory Science
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• v.43 no.2
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• pp.82-88
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• 2011

Mandibular advancement devices (MAD) are therapeutic options for obstructive sleep apnea (OSA). The aim of study was to investigate treatment outcomes of before and after insertion of MAD in OSA patients. We retrospectively selected a total of 13 patients who were diagnosed with OSA syndrome. All sleep-related parameters including apnea-hypopnea index (AHI), oxygen desaturation index (ODI), wake after sleep onset (WASO), total arousal were measured by before and after MAD. The use of MAD proves to be efficient in reducing snoring, apnea-hypopne index ($17.2{\pm}14.6$ vs $20.9{\pm}14.6$), WASO ($27.4{\pm}28.8$ vs $47.9{\pm}43.6$), oxygen desaturation index ($9.0{\pm}11.6$ vs $16.4{\pm}11.7$), stage N3 ($54.8{\pm}45.2$ vs $36.6{\pm}22.0$), REM sleep times ($73.3{\pm}19.4$ vs $66.0{\pm}31.0$) and increases sleep efficiency ($92.6{\pm}6.6$ vs $87.2{\pm}11.2$). The decreases in apnea index based on a reduction in the overall and supine AHI values after MAD therapy were significantly greater for the positional OSA than nonpositional OSA patients. The use of MAD proves to be efficient in snoring, WASO, sleep efficiency, reduced AHI and associated with good compliance of patients.