• Clinical and Experimental Pediatrics
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• 제60권5호
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• pp.158-165
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• 2017

Purpose: To investigate the frequency of childhood sleep problems at pediatric clinics in Seoul and Gyeonggi provinces. Methods: Children (n=936) and their parents who visited 5 primary and 1 secondary pediatric outpatient clinics were invited to complete a Pediatric Sleep Questionnaire. Results: Among patients, 901 (96.3%) answered questionnaires in sufficient detail for evaluation. The participant's mean age was $4.35{\pm}3.02years$ (range, 0-18 years). The male to female ratio was 1:0.93 (466 boys, 435 girls). Habitual snoring (>3 day/week) was reported in 16.9% of the participants. The prevalence of habitual snoring in children <2 years and those between 2-5 years was 9% and 18%, respectively. Sleep disordered breathing was found in 15.1% (106 of 700) of children >2 years. Insomnia was reported in 13.2% of children. The prevalence of sleepwalking, night terrors, and bruxism, is 1.6%, 19%, and 21.1%, respectively. Snoring was associated with increased incidence of sleepwalking, night terrors, and bruxism. Age was associated with insomnia and habitual snoring (P<0.05). Insomnia was more prevalent in younger (21%) than in older children (6%). Snoring was more frequent in both preschool (34%) and school-aged children (33%). The frequency of sleep disordered breathing and insomnia did not vary significantly with gender. However, snoring was more prevalent in boys. Conclusion: Sleep problems are frequent among children in Korea. Children with snoring have an increased risk of sleepwalking, night terror, and bruxism. Primary clinicians should consider children's sleep habits to improve their health.

• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.267-275
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• 2008

목 적 : 신체검진 결과와 증상점수를 통하여 폐쇄성 수면무호흡증과 일차성 코골이를 감별할 수 있는가를 평가하고자 하였다. 방 법 : 56명의 코골이 환아와 20명의 무증상 대조군에게 수면다원검사를 시행하여 39명의 패쇄성 수면무호흡증후군 환아와 17명의 일차성 코골이 환아, 20명의 대조군으로 나누었다. 이들을 대상으로 편도-아데노이드의 크기를 측정하였고 수면호흡장애를 평가하는 SDBS과 OSA-18를, 그리고 행동장애를 평가하는 설문인 ADHD RS-IV을 조사하였다. 결 과 : 폐쇄성 수면무호흡증군과 일차성 코골이군의 아데노이드와 편도의 크기, SDBS ($9.4{\pm}4.6\;vs\;10.8{\pm}4.5$), OSA-18 score ($61.1{\pm}25.1\;vs\;71.2{\pm}8.4$)를 비교한 결과 통계적으로 유의한 차이를 보이지 않았으나 대조군과의 비교에서는 두군 모두 통계적으로 유의하게 높았다. ADHD RS-IV의 평균점수도 두군 모두 대조군($2.9{\pm}3.3$)보다 유의하게 높았으나 폐쇄성 수면무호흡증군($15.8{\pm}7.9$)과 일차성 코골이군($22.2{\pm}9.4$) 두군간의 비교에서는 차이를 보이지 않았다. 결 론 : 코골이 환아에서 편도 아데노이드의 크기와 증상 점수로는 폐쇄성 수면무호흡증군과 일차성 코골이군을 감별할 수 없었다. 또한 주의력 결핍 과잉행동 장애 증상 점수가 일차성 코골이 환아에서도 폐쇄성 수면무호흡증군과 같이 정상대조군에 비해 높은 결과를 보였다.

• Journal of Oral Medicine and Pain
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• 제23권1호
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• pp.75-84
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• 1998

The Purpose of this Study was to examine the anatomic differences in the upper airway according to severity of respiratory disturbance index of habitual snorers. Forty-three male habitual snorers, aged 28-68, were examined by polysomnography and divided into 4 groups according to severity determined by polysomnography. Anatomic differences in the upper airway were assessed by lateral cephalograms in upright position, and epidemiological surveys were done by using questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 35 patients (81.4%) complained the loudness of snoring as severe as be heard outside of the room. 2. According to the results of polysomnography, the number of the primary snoring patients was 7(16.3%), mild obtrusive sleep apnea 7(16.3%), moderate 7(16.3%), and severe 22(51.2%). 3. The respiratory disturbance index (RDI) of subjects was 39.5$\pm$24.4 and the body mass index(BMI) was 26.2$\pm$2. 4. More inferiorly positioned hyoid bone according to the degree of respiratory disturbace index (RDI) was observed. (p<0.001) 5. The width of superior oropharyngeal airway space was according to the degree of RDI. (p<0.001)

• Tuberculosis and Respiratory Diseases
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• 제51권6호
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• pp.590-596
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• 2001

원발성 갑상선 기능저하증은 수면무호흡증후군의 원인 중 하나이다. 수면무호흡증후군 환자의 병력과 이학적 검사를 통하여 갑상선 기능저하의 가능성에 대한 충분한 평가가 필요하며, 또한 갑상선 기능저하증 환자도 수면무호흡증후군의 증상 및 가능성에 대한 고려가 필요하다. 그리고 본 증례와 같이 심장질환이 동반되어있을 때는 갑상선 호르몬 제재 단독투여 보다는 수면무호흡증후군에 의한 심각한 합병증을 예방하기 위하여 지속적 기도양압 치료를 동시에 적용하는 것이 좋다. 저자들은 원발성 갑상선 가능저하증과 확장형 심근증이 동반된 수변무호흡증후군 환자가 갑상선 호르몬 제재를 복용하고, 지속적 기도양압 치료적용 후 완전히 호전된 증례를 경험하였기에 보고하는 바이다.

• 음성과학
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• 제8권2호
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• pp.23-37
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• 2001

The primary sound produced by the vibration of vocal folds reaches the velopharyngeal isthmus and is directed both nasally and orally. The proportions of the each component is determined by the anatomical and functional status of the soft palate. The oral sounds composed of oral vowels and consonants according to the status of vocal tract, tongue, palate and lips. The nasal sounds composed of nasal consonants and nasal vowels, and further modified according to the status of the nasal airway, so anatomical abnormalities in the nasal cavity will influence nasal sound. The measurement of nasal sounds of speech has relied on the subjective scoring by listeners. The nasal sounds are described with nasality and nasalization. Generally, nasality has been assessed perceptually in the effect of maxillofacial procedures for cleft palate, sleep apnea, snoring and nasal disorders. The nasalization is considered as an acoustic phenomenon. Snoring and sleep apnea is a typical disorders due to abundant velopharynx. The sleep apnea has been known as a cessation of breathing for at least 10 seconds during sleep. Several medical and surgical methods for treating sleep apnea have been attempted. The uvulopalatopharyngoplasty(UPPP) involves removal of 1.0 to 3.0 cm of soft palate tissue with removal of redundant oropharyngeal mucosa and lateral tissue from the anterior and sometimes posterior faucial pillars. This procedure results in a shortened soft palate and a possible risk following this surgery may be velopharyngeal malfunctioning due to the shortened palate. Few researchers have systematically studied the effects of this surgery as it relates to speech production. Some changes in the voice quality such as resonance (nasality), articulation, and phonation have been reported. In view of the conflicting reports discussed, there remains some uncertainty about the speech status in patients following the snoring and sleep apnea surgery. The study was conducted in two phases: 1) acoustic analysis of oral and nasal sounds, and 2) evaluation of nasality.

• Journal of Oral Medicine and Pain
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• 제37권4호
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• pp.213-219
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• 2012

구강내 장치 요법은 가벼운 혹은 중간 정도의 폐쇄성 수면 무호흡증의 일차 치료법이며 심한 폐쇄성 수면 무호흡증의 경우에도 CPAP 또는 수술요법에서 효과가 없을 때 좋은 대안적 치료법이 될 수 있다. 하지만 다양한 구강내 장치들마다 치료 효과가 다르며 또한 모든 환자들에서 효과를 기대하기 어려운 것도 사실이다. 본 연구는 목젖입천장인두절제술(uvulopalatopharyngoplasty, UPPP) 을 받았으나 증상의 개선이 없는 심한 폐쇄성 수면 무호흡증 (obstructive sleep apnea, OSA) 환자에서 단국대 치대 구강내과에서 개발한 구강내 조절성 하악전방이동형 코골이 방지장치 (Adjustable Anterior Positioner, AAP)를 사용하여 치료한 증례를 보고하고 그에 대한 고찰을 한다.

• Tuberculosis and Respiratory Diseases
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• 제42권2호
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• pp.238-243
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• 1995

갑상선 기능저하증은 수면 무호흡 증후군의 한 원인이 될 수 있다. 수면 무호흡 증후군 환자에서 병력과 이학적 검사상 갑상선 기능저하의 가능성에 대한 충분한 평가가 필요하며 갑상선 기능저하증 환자에서도 수면 무호흡 증후군의 증상 및 가능성에 대한 고려가 필요하다. 저자들은 갑상성 기능저하증이 동반된 수면 무호흡 증후군 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권2호
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• pp.162-166
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• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.47.1-47.8
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• 2016

Background: The paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients. This study has its purpose in sharing a series of tonsillectomies performed at the Seoul National University Dental Hospital for the treatment and prevention of SDB in adult patients. Methods: Total of 78 patients underwent tonsillectomy at the Seoul National University Dental Hospital from 1996 to 2015, and 23 of them who were operated by a single surgeon (Prof. Jin-Young Choi) were included in the study. Through retrospective chart review, the purpose of tonsillectomy, concomitant procedures, grade of tonsillar hypertrophy, surgical outcome, and complications were evaluated. Results: Twenty-one patients diagnosed with SDB received multiple surgical procedures (uvulopalatal flap, uvulopalatopharyngoplasty, genioglossus advancement genioplasty, tongue base reduction, etc.) along with tonsillectomy. Two patients received mandibular setback orthognathic surgery with concomitant tonsillectomy in anticipation of postoperative airway compromise. All patients showed improvement in symptoms such as snoring and apneic events during sleep. Conclusions: When only throat infections were considered, tonsillectomy was a procedure rather unfamiliar to oral and maxillofacial surgeons. With a shift of primary indication from recurrent throat infections to SDB and emerging technological and procedural breakthroughs, simpler and safer tonsillectomy has become a major tool in the multidisciplinary treatment modality for SDB.

• 한방재활의학과학회지
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• 제34권3호
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• pp.65-74
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• 2024

Objectives This study aims to establish a protocol for a systematic review to evaluate the effectiveness and safety of manual therapy (MT) for obstructive sleep apnea (OSA). Methods We will conduct a search for relevant randomized controlled trials using seven databases, including MEDLINE/PubMed, Embase, and the Cochrane Central Register of Controlled Trials. The study includes patients with OSA treated with MT. Comparators include all other treatments excluding MT. The primary outcome is the apnea-hypopnea index; secondary outcomes include mean peripheral oxygen saturation, snoring index, quality of sleep, quality of life, peak nasal inspiratory flow, and adverse events. Results Two independent researchers will select studies based on inclusion criteria and extract necessary data. Risk of bias (RoB) will be assessed using the Cochrane RoB 2.0 tool. Meta-analysis will be conducted if there are two or more studies with the same outcome measure; otherwise, a qualitative analysis will be performed. Subgroup analysis will be conducted based on the type of MT, and evidence certainty will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Conclusions This study will evaluate the effect of MT on OSA. By systematically reviewing various MTs, it aims to refine application methods in clinical practice and provide a foundation for future research.