• Sleep Medicine and Psychophysiology
• /
• v.11 no.1
• /
• pp.50-54
• /
• 2004

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.27 no.2
• /
• pp.162-166
• /
• 2001

Obstructive sleep apnea syndrome(OSAS) is a complex sleep disorder characterized by intermittent apnea secondary to sleep-induced obstruction of the upper airway. It occurs because of an airway obstruction anywhere between the trachea and the oronasal apparatus. The hallmark of OSAS is snoring, which is caused by vibration of the tissues of the pharynx as the airway narrows. The consequences of OSAS have focused on excessive daytime sleepiness resulting from sleep fragmentation and the cardiovascular derangements producing hypertension and arrhythmias. The primary method of controlling OSAS has been surgery. The current surgical procedures used for OSAS are tracheostomy, tonsillectomy, nasal septoplasty, uvulopalatopharyngoplasty, anterior mandibular osteotomy with hyoid myotomy and suspension, and maxillary, mandibular and hyoid advancement. We report a case of OSAS that was improved by genial advancement with infrahyoid myotomy and suspension. The patient was objectively documented by polysomnography, cephalometric analysis, and physical examination before the surgical procedure. The patient underwent genial advancement with infrahyoid myotomy and suspension. Patient had a good response from surgery.

• Korean Journal of Clinical Laboratory Science
• /
• v.38 no.3
• /
• pp.212-217
• /
• 2006

Obstructive sleep apena syndrome (OSAS) is accompanied by the following symptoms: apnea caused by upper respiratory tract obstruction while sleeping, repetitive lowering of $SpO_2$, severely affected excessive daytime sleepiness (EDS), suffocation/frequent awakeness while sleeping, daytime lethargy, and lack of concentration. OSAS was investigated with sex, age, body weight, body mass index (BMI), neck circumference and snoring sound as clinical characteristics and the anticipating factors of OSAS were studied in relation with the apnea-hypopnea index (AHI). The subjects were 42 people (male 34/female 8) who visited the clinic due to snoring and had polysomnography evaluation. AHI was differenciated into normal (less than 0~5/hr), mild (5~15/hr), moderate (15~30/hr) and severe (more than 30/hr). As the apnea-hypopnea index (AHI) gets higher, the snoring sound was louder (p<0.01), neck circumference was thicker (p<0.05) and also there were relative correlations with body weight (p<0.01), body mass index (p<0.05), snoring sound (p<0.01) and neck circumference (p<0.01). Since the snoring sound and neck circumference explained 32.8% of the AHI distribution, if the patient was severely snoring or had a thick neck circumference due to obesity, the apnea-hypopnea index showed a predisposition to the obstructive sleep apnea syndrome.

• 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.

• 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.

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

• Sleep Medicine and Psychophysiology
• /
• v.3 no.2
• /
• pp.90-96
• /
• 1996

• Sleep Medicine and Psychophysiology
• /
• v.30 no.1
• /
• pp.9-12
• /
• 2023

Periodic limb movements during sleep (PLMS) are prevalent in various sleep disorders, such as restless legs syndrome (RLS), periodic limb movements disorder, obstructive sleep apnea (OSA), REM sleep behavior disorder (RBD), and narcolepsy. PLMS has been hypothesized to be related to the decline of dopaminergic transmission. In RLS, PLMS is suggested to be related to iron deficiency and symptom severity. PLMD is a rare sleep disorder, and the role of PLMS in PLMD has not been clearly investigated yet. PLMS in OSA, which remain after proper PAP therapy, may need further management. The clinical relevance of PLMS in RBD and narcolepsy have not been investigated thoroughly and need further studies. Whether PLMS are to be considered as a mere symptom of individual sleep disorders or not can be elucidated through studies investigating the efficacy of therapeutic approaches to reduce PLMS in various sleep disorders.

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

• Sleep Medicine and Psychophysiology
• /
• v.18 no.2
• /
• pp.72-75
• /
• 2011

Sleep disorders such as insomnia, obstructive sleep apnea (OSA), and restless legs syndrome (RLS) are very common disorders and may cause significant burden in terms of individual as well as societal aspects. Sleep insufficiency from such sleep disorders may cause deleterious effects on daily work life and may be associated with other major medical or psychiatric disorders including cardiovascular disease, diabetes mellitus, depression, and anxiety disorder. Various motor or occupational accident may result from the sleep problems. In addition, recent researches provide the method to evaluate the lost productivity time in terms of absenteeism and presenteeism. Moreover, several studies on cost-effectiveness of treatment of sleep disorders show that it is cost-effective.