• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.18 no.3
• /
• pp.463-469
• /
• 1996

Sonoring is caused by the repeated obstructions of versatile upper air way structure during sleep and is known as a kind of disease entity varing from simple snoring to obstructive sleep apnea syndrome(OSAS) which can cause serious cardiopulmonary complications due to its hypoxic pathophysiology. It has been reported that over 30% of middle-aged person have the problems of snoring and its accompanied symptomes and signs. Cephalometric measurements, frequently used to measure sella-nasion-subspinale(SNA) and sella-nasion-supramentale(SNB) angles, can provide the informations about the posterior airway space(PAS), the mandibular plane(MP) and the position of hyoid bone. These informations are useful in determining the therapeutic modalities of the snoring and OSAS patients. However, with conventional routine upright position, it does not represent the actual images of obstructive mechanism during sleep but only show the images of awaken normal upper airway anatomy. Therefore we have taken dual images of a routine upright lateral and a supine cephalometric view to compare both.

• Tuberculosis and Respiratory Diseases
• /
• v.67 no.3
• /
• pp.183-190
• /
• 2009

Background: Repeated arousals during sleep have been known to be associated with excessive daytime sleepiness and cardiovascular complications. We investigated the relationship between arousal indices and clinical parameters. Methods: We retrospectively reviewed medical records of 41 patients who performed polysomnography for a diagnosis of obstructive sleep apnea syndrome. We defined total arousal index (TAI) as the number of arousals per hour and respiratory arousal index (RAI) as the number of arousals associated with apnea or hypopnea per hour. Results: There were significant positive correlations between arousal indices and apnea-hypopnea index (AHI) (RAI vs. AHI, r=0.958, p<0.001; TAI vs. AHI, r=0.840, p<0.001). RAI and mean oxygen saturation showed a significant negative correlation with each other (r=-0.460, p=0.002). TAI revealed a significant positive correlation with mean systolic blood pressure (MSBP) and mean diastolic blood pressure (MDBP) (TAI vs. MSBP, r=0.389, p=0.014; TAI vs. MDBP, r=0.373, p=0.019). There was no significant correlation between arousal indices and parameters of sleepiness. RAI had a significant positive correlation with body mass index (BMI) and neck circumference (NC) (RAI vs. BMI, r=0.371, p=0.017; RAI vs. NC, r=0.444, p=0.004). When partial correlation analysis was performed to adjust for other variables, there was significant correlation between RAI and AHI (r=0.935, p<0.001). Conclusion: This study shows that respiratory arousal index could be a useful index reflecting of severity of obstructive sleep apnea syndrome. Arousal during sleep would be concerned in the development of cardiovascular complication of obstructive sleep apnea. And some anthropometric factors would contribute to the development of arousals during sleep. Further studies are needed to clarify any cause-effect relationship.

• Journal of the Institute of Electronics and Information Engineers
• /
• v.51 no.4
• /
• pp.201-209
• /
• 2014

Obstructive sleep apnea syndrome(OSAS) is a respiratory disease caused by partial or complete obstruction of the upper airway during sleep. In this paper, we proposed the optical flow method to analyze the upper airway dynamic changes during respiration for children with OSAS and control subjects. We compared the absolute value of difference between inspiration and expiration for airway area analysis method and optical flow method for 5 children with OSAS and 6 control subjects. From the statistical analysis, airway area analysis method and optical flow method are statistically significant at the 0.1 (p value is 0.0977) and 0.01 (p value is 0.0011) significance level respectively. From this simulations, the optical flow method could provide more accurate information to diagnose the OSAS patients than the traditional airway area analysis method.

• Sleep Medicine and Psychophysiology
• /
• v.13 no.2
• /
• pp.52-58
• /
• 2006

Objectives: Continuous positive airway pressure (CPAP) is effective in the treatment of obstructive sleep apnea syndrome (OSAS), but the major limitation of CPAP may be poor compliance. The aims of the study were to investigate the compliance and side effects of CPAP, and to evaluate the efficacy of CPAP in patients with OSAS. Methods: This study enrolled 106 patients with OSAS who took the CPAP treatment. The severity of daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and sleep quality and depressive symptoms were assessed by Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), respectively. Results: During 29 months of the study period, 41.5% of patients were using CPAP and 38.7% of patients stopped using it. Compared to non-compliant patients, compliant patients had a higher PSQI score and obstructive apnea index. Among non-compliant patients, 51.2% of them stopped using CPAP within 1months. 85.7% of non-compliant patients were discomforted by the CPAP, but much more nasopharyngeal symptoms were reported in the compliant group. ESS (p<0.01), PSQI (p<0.01) and BMI (p<0.01) were reduced significantly after CPAP treatment but not BDI (p=0.86). Conclusions: We concluded that CPAP can reduce the daytime sleepiness, nocturnal sleep disturbance, and body mass index. To increase the compliance of CPAP, we suggest that some education and support are needed at the early stage of the CPAP treatment.

• Korean Journal of Bronchoesophagology
• /
• v.6 no.1
• /
• pp.72-79
• /
• 2000

Background and Objectives : Adenotonsillar hypertrophy is the most common disorder in pediatric otolaryngology, which should be suspected as a possible cause of obstructive sleep apnea syndrome (OSAS). In the past, most of the adenotonsillectomy were performed because of recurrent infection, but now OSAS is the most common indication in many centers. Materials and Method : A review of 1,945 adenotonsillectomy performed between 1990 and 1998 is presented. We classified into two categories of indication for adenotonsillectomy and analyzed changing trends of indication for adenotonsillectomy. Results : Although recurrent infection remains the predominant indication for surgery, there has been a rise in OSAS as a significant indication from 13.67% in 1990 to 24.26% in 1998. Conclusion : An increase has occurred in the percentage of adenotonsillectomy performed for OSAS due to adenotonsillar hypertrophy. This trend promises to continue as physicians become increasingly aware of the prevalence and seriousness of adenotonsillar hypertrophy as a cause of sleep apnea.

• Tuberculosis and Respiratory Diseases
• /
• v.47 no.2
• /
• pp.218-230
• /
• 1999

Background: Craniofacial anatomic abnormalities related to structural narrowing of the upper airway have been reported in patients with obstructive sleep apnea syndrome. In this study, we evaluated the craniofacial anatomic characteristics of Korean patients with obstructive sleep apnea syndrome, and the role of cephalometric analysis in the prediction of abnormal breathing during sleep. Methods: Thirty-nine patients with obstructive sleep apnea syndrome(OSAS), 39 simple snorers(simple snorers) and 20 controls(control) had cephalometric analysis using the technique of Riley et al, and underwent standardized polysomnographic recordings. Different variables, including sex, body mass index, cephalometric and polysomnographic data, were statistically analyzed. Results: Pm-UPW and V-LPW distances were significantly shorter in OSAS when compared with simple snorers or control. PAS in simple snorers was shorter than in control. ANS-Gn distance in OSAS was significantly longer than in control. PNS-P distance in OSAS or simple snorers was significantly longer than in control. MP-H distance in OSAS was significantly longer than in simple snorers or control and MP-H distance in simple snorers was also longer than in control. NL/Pm-P angle in OSAS was lesser than in control. MP-H distance in OSAS or in the combined groups of OSAS and simple snorers was significantly correlated with apneahypopnea index(AHI). PNS-P distance in the combined groups of OSAS and simple snorers was correlated with AHI. In male of all subjects, body mass index was significantly correlated with PNS-P or MP-H distance. Conclusion: Cephalometric analysis can be useful tool in determining the craniofacial anatomic abnormalities in patients with obstructive sleep apnea syndrome. Cephalometric parameters, especially MP-H distance, can be useful for predicting frequency of narrowing or obstruction of upper airway during sleep.

• Sleep Medicine and Psychophysiology
• /
• v.24 no.1
• /
• pp.32-37
• /
• 2017

Objectives: A supine sleep position increases sleep apneas compared to non-supine positions in obstructive sleep apnea syndrome (OSAS). However, supine position time (SPT) is not highly associated with apnea-hypopnea index (AHI) in OSAS. We evaluated the correlation among sleep-related variables and SPT in OSAS. Methods: A total of 365 men with OSAS were enrolled in this study. We analyzed how SPT was correlated with demographic data, sleep structure-related variables, OSAS-related variables and heart rate variability (HRV). Multiple linear regression analysis was conducted to investigate the factors that affected SPT. Results: SPT had the most significant correlation with total sleep time (TST ; r = 0.443, p < 0.001), followed by sleep efficiency (SE ; r = 0.300, p < 0.001). Snoring time (r = 0.238, p < 0.001), time at < 90% SpO2 (r = 0.188, p < 0.001), apnea-hypopnea index (AHI ; r = 0.180, p = 0.001) and oxygen desaturation index (ODI ; r = 0.149, p = 0.004) were significantly correlated with SPT. Multiple regression analysis revealed that TST (t = 7.781, p < 0.001), snoring time (t = 3.794, p < 0.001), AHI (t = 3.768, p < 0.001) and NN50 count (t = 1.993, p = 0.047) were associated with SPT. Conclusion: SPT was more highly associated with sleep structure-related parameters than OSAS-related variables. SPT was correlated with TST, SE, AHI, snoring time and NN50 count. This suggests that SPT is likely to be determined by sleep structure, HRV and the severity of OSAS.

• The Journal of the Korean dental association
• /
• v.44 no.6 s.445
• /
• pp.350-358
• /
• 2006

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.27 no.2
• /
• pp.157-161
• /
• 2001

The purpose of this study cephalometrically evaluated changes in the posterior airway space for patients with obstructive sleep apnea syndrome(OSAS) before and after surgical advancement of the maxilla and mandible. The change in calculated airway resistance was correlated with the respiratory disturbance index(RDI). Twenty cephalometric radiographs were traced before and after surgery to determine the posterior airway area and calculate resistance. Polysomnograms of each patient were obtained before and after surgery. All patients had a decrease in calculated airflow resistance in the airway. The mean amount of resistance was 865.15 before surgery, decreasing to 192.65 after surgery (p<0.01). Eighty-five percent of the patients experienced improvement in their RDI. Reduction in the RDI appears to be due to an increase in the posterior airway space and decrease in flow resistance.

• Clinical and Experimental Pediatrics
• /
• v.53 no.10
• /
• pp.872-879
• /
• 2010

Obstructive sleep apnea (OSA) in children is a frequent disease for which optimal diagnostic methods are still being defined. Treatment of OSA in children should include providing space, improving craniofacial growth, resolving all symptoms, and preventing the development of the disease in the adult years. Adenotonsillectomy (T&A) has been the treatment of choice and thought to solve young patient's OSA problem, which is not the case for most adults. Recent reports showed success rates that vary from 27.2% to 82.9%. Children snoring regularly generally have a narrow maxilla compared to children who do not snore. The impairment of nasal breathing with increased nasal resistance has a well-documented negative impact on early childhood maxilla-mandibular development, making the upper airway smaller and might lead to adult OSA. Surgery in young children should be performed as early as possible to prevent the resulting morphologic changes and neurobehavioral, cardiovascular, endocrine, and metabolic complications. Close postoperative follow-up to monitor for residual disease is equally important. As the proportion of obese children has been increasing recently, parents should be informed about the weight gain after T&A. Multidisciplinary evaluation of the anatomic abnormalities in children with OSA leads to better overall treatment outcome.