• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.77-89
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• 1996

Data collected to date indicate that sleep apnea syndrome is a risk factor in the development of cardiovascular dysfunction such as systemic hypertension, cardiac arrhythmias, pulmonary hypertension, right heart failure, angina, myocardial infarction, and stroke. Several reports suggest that untreated patients with sleep apnea syndrome have a higher long-term mortality than treated patients and than normal subjects. But there are many controversies concerning the treatment of sleep apnea syndrome, and there is no universally accepted standard for effective treatment. We reviewed the current approaches and options in the medical treatment of sleep apnea syndrome.

• Sleep Medicine and Psychophysiology
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• v.11 no.2
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• pp.106-109
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• 2004

Adenotonsillar hypertrophy is the leading cause of childhood obstructive sleep apnea. Obstructive sleep apnea syndrome in childhood, however, can occur from various causes such as obesity or craniofacial abnormalities. Childhood obstructive sleep apnea syndrome can be accompanied by enuresis, parasomnias and behavior problems. For patients with the symptoms of snoring and apnea, obstructive sleep apnea should be suspected and diagnosed properly. In addition, the evaluation of complications and proper treatment are indispensable. When the cause of childhood obstructive sleep apnea is adenotonsillar hypertrophy, symptoms can be improved by surgical methods. If the cause is other than adenotonsillar hypertrophy, such as obesity, it should be treated with other therapeutic modalities, like nasal continuous positive airway pressure (nCPAP), weight reduction and modification of life style. This paper reports a case of nCPAP used to manage severe sleep apnea when it was not resolved after adenoidectomy and tonsillectomy. Differential diagnosis of narcolepsy in a case with excessive daytime sleepiness and reflections on accompanying enuresis and parasomnia were also described.

• International Journal of Internet, Broadcasting and Communication
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• v.11 no.4
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• pp.71-75
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• 2019

Sleep apnea is a disease that causes various complications, and the polysomnography is expensive and difficult to measure. The purpose of this study is to develop an unrestricted wearable monitoring system so that patients can be examined in a familiar environment. We used a method to detect sleep apnea events and to determine sleep satisfaction by non-constrained method using SpO2 measurement sensor and 3-axis acceleration sensor. Heart rate and SpO2 were measured at the finger using max30100. After acquiring the SpO2 data of the user in real time, the apnea measurement algorithm was used to transmit the number of apnea events of the user to the mobile phone using Bluetooth (HC-06) on the wrist. Using the three-axis acceleration sensor (mpu6050) attached to the upper body, the number of times of tossing and turning during sleep was measured. Based on this data, this algorithm evaluates the patient's tossing and turning during sleep and transmits the data to the mobile phone via Bluetooth. The power source used 9 volts battery to operate Arduino UNO and sensors for portability and stability, and the data received from each sensor can be used to check the various degree between sleep apnea and sleep tossing and turning on the mobile phone. Through thisstudy, we have developed a wearable sleep apnea measurement system that can be easily used at home for the problem of low sleep efficiency of sleep apnea patients.

• Sleep Medicine and Psychophysiology
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• v.19 no.1
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• pp.22-26
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• 2012

Objectives: The percentage of positional sleep apnea in obstructive sleep apnea (OSA) varies in different reports from 9% to 60%. If there is a positional dependency in patients with OSA, positional therapy alone could be successful in treating about 50% of all OSA cases. The aim of this report is to compare anthropomorphic and polysomnographic data between the positional sleep apnea group and non-positional sleep apnea group with OSA whose conditions were diagnosed in our sleep clinic. Methods: This is a retrospective study of anthropomorphic and polysomnographic data of patients with OSA who was performed a nocturnal polysomnography. Positional sleep apnea was defined as having a supine apnea-hypopnea index (AHI) of twice or more compared to the AHI in the non-supine position. The patients were divided in the positional sleep apnea group and the non-positional sleep apnea group. Results: In 101 patients with OSA, 81 were male, and the mean age was $49.2{\pm}11.9$ years. Seventy-six (75.2%) were diagnosed as the positional sleep apnea. Waist to hip ratio and body mass index (BMI) were significantly higher in non-positional sleep apnea group. The frequency of severe OSA was significantly higher in this group. In the positional sleep apnea group, nocturnal sleep quality was better preserved, and consequently these patients were less sleepy during daytime. AHI was significantly lower and minimal arterial oxygen saturation during sleep was significantly higher in this group. Conclusion: The percentage of positional sleep apnea in OSA was 75.2%. AHI, BMI, and waist to hip ratio were lower in the positional sleep apnea group. These patients have less severe breathing abnormalities than the non-positional sleep apnea group in polysomnography.

• Journal of the Korea Society of Computer and Information
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• v.22 no.11
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• pp.17-23
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• 2017

In this paper, we implemented a respiration measurement system consisting of piezoelectric sensor, respiration signal processing device, and a viewer on a notebook. We tried an experiment for measuring respiration and detecting sleep apnea syndrome when a subject lay on a bed. We applied the respiration measurement algorithm to sensor data obtained from four subjects. In order to get a good graph shape, data manipulation methods such as moving averages and maximum values were applied. The window size for moving average was chosen as N=70, and the threshold value for each subject was customized. In this case, the proposed system showed 96.0% accuracy. When the maximum value among 90 data was applied instead of moving average, our system achieved 95.1% accuracy. In an experiment for detecting sleep apnea syndrome, the system showed that sleep apnea occurred correctly and calculated the average interval of sleep apnea. While infants or the elderly as well as patients with sleep apnea syndrome are lying down on a bed, our results are also expected to be able to cope with some accidental emergency situation by observing their respiration and detecting sleep apnea.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.11
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• pp.464-467
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• 1997

In this study, ECG was recorded during sleep patients with obstructive sleep apnea. We detecte(heart rate variability) signal from the ECG wa QRS detection algorithm. And we observed HRV by the power spectrum density using autoregr modeling. The experimental results were analysis sleep stage 1, sleep stage 2, sleep stage 3, sleep s sleep stage REM. In experimental result, the PSD with obstructive sleep apnea patients was distributed low frequency band except sleep step 4. These effect means that the sympathetic nervous system affected the sleep stage 1, 2, REM and the parasympathetic nervous system affected the sleep stage 3, 4 with obstructive sleep apnea patients.

• Korean Journal of Clinical Laboratory Science
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• v.43 no.4
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• pp.188-193
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• 2011

Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. Since it is closely related to sleep parameter and body indices, the study was focused on the relationship with them. The results of polysomnography (PSG) in obstructive sleep apnea was done at ENT department of Ewha women university Mokdong hospital from March to September 2010 with 52 subjects (male 35, female 17). The leads were placed to measure electroencephalogram (EEG), electrooculogram (EOG), mandibular and anterior tibialis electromyogram (EMG), airflow in nasal and oral cavity, chest and abdominal breathing pattern, snoring sound and arterial oxygen saturation ($SpO_2$) level. From sleep parameter and body indices of adult obstructive sleep apnea compared to normal adult revealed that age (p<0.01) and snoring sound (p<0.05) were increased, stage 1 sleep (p<0.01) was increased, the deeper stages (3&4) of sleep (p<0.05) were reduced. Respiratory disturbance index (RDI) (p<0.01), mean $SpO_2$ (p<0.05) and lowest $SpO_2$ (p<0.01) were also decreased. The correlation analysis from sleep parameter and body indices of OSA showed the positive correlation with age (r=0.463, p<0.001), snoring sound (r=0.278, p<0.05), stage 1 sleep (r=0.391, p<0.01) and RDI (r=0.409, p<0.01), but showed the negative correlation with the deeper stages (3&4) of sleep (r=-0.307, p<0.05), mean $SpO_2$=(r=-0.274, p<0.05) and lowest $SpO_2$ (r=-0.392, p<0.01). This study proves that obstructive sleep apnea and indices have closed related.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.19-23
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• 2017

Obstructive sleep apnea is a common disorder in which respiratory flow decreases or disappears despite respiratory effort due to occlusion of the upper respiratory tract during sleep. Oxidative stress and systemic inflammatory reaction induced by the obstruction cause complications such as hypertension, coronary artery disease, and diabetes and increase cancer incidence. Furthermore, in patients with interstitial lung disease, obstructive sleep apnea has a very high prevalence and is thought to have a close pathophysiological and clinical correlation. In other words, obstructive sleep apnea could be the cause or a complication of interstitial lung disease ; when these two afflictions coexist, the prognosis of the patient is worse. In patients with interstitial lung disease with obstructive sleep apnea, CPAP treatment significantly improved sleep and quality of life, as well as improved morbidity and mortality in a recent study. Therefore, early diagnosis and treatment of obstructive sleep apnea in patients with interstitial lung disease are very important, and additional studies designed to include patients with idiopathic pulmonary fibrosis as well as patients with advanced interstitial lung disease should be performed.

• Annals of Clinical Neurophysiology
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• v.17 no.2
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• pp.61-67
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• 2015

Background: The aim of this study was to investigate the predictive value of snoring frequency in the diagnosis and severity of obstructive sleep apnea. Methods: Patients who underwent polysomnography with one or more of the following characteristics were included: 1) sleepiness, non-restorative sleep, fatigue, or insomnia symptoms; 2) arousal due to cessation of breathing or the occurrence of gasping or choking when waking up; and 3) habitual snoring, breathing interruptions, or both, noted by a bed partner or other observer. We analyzed the differences in clinical and polysomnographic variables between patients with and without obstructive sleep apnea and investigated the associations of those variables with obstructive sleep apnea severity. Results: One hundred ninety-three patients met the inclusion criteria, and 145 of the 193 patients were diagnosed with obstructive sleep apnea. Multiple logistic regression analysis showed that large neck circumference (p = 0.0054) and high snoring index (p = 0.0119) were independent predictors for obstructive sleep apnea. Moreover, between the obstructive sleep apnea severity groups, there was a strong tendency of difference in body mass index (p = 0.0441) and neck circumference (p = 0.0846). However, there was no significant difference in snoring frequency according to obstructive sleep apnea severity (p = 0.4914). Conclusions: We confirmed that snoring frequency is a predictor of obstructive sleep apnea. In addition, we showed for the first time that snoring frequency is not associated with obstructive sleep apnea severity, thus it is not a valuable marker for predicting obstructive sleep apnea severity.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.404-415
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• 1998

Background: Sleep apnea syndrome, which occurs in 1~4 % of the adult population, frequently has different cardiovascular complications such as hypertension, ischemic heart disease, cardiac arrythmia as well as sleep-wake disorder such as excessive daytime hypersomnolence or insomnia. Mortality and vascular morbidity are reported to be significantly higher in sleep apnea syndrome patients than in normal population. According to the recent studies, autonomic dysfunction as well as hypoxemia, hypercapneic acidosis, and increased respiratory effort, may playa role in the high prevalence of cardiovascular complications in patients with sleep apnea syndrome. However the cause and mechanism of autonomic neuropathy in patients with sleep apnea syndrome are not well understood. We studied the existence of autonomic neuropathy in patients with sleep apnea syndrome and factors which influence the pathogenesis of autonomic neuropathy. Method: We used the cardiovascular autonomic neuropathy(CAN) test as a method for evaluation of autonomic neuropathy. The subjects of this study were 20 patients who diagnosed sleep apnea syndrome by polysomnography and 15 persons who were normal by polysomnography. Results: Body mass index and resting systolic blood pressure were higher in sleep apnea group than control group. Apnea index(Al), respiratory disturbance index(RDI) and snoring time percentage were significantly higher in sleep apnea group compared with control group. But there were no significant differences in saturation of oxygen and sleep efficiency in two groups. In the cardiac autonomic neuropathy test, the valsalva ratio was significantly low in sleep apnea group compared with control group but other tests had no differences between two groups. The CAN scores and corrected QT(QTc) interval were calculated significantly higher in sleep apnea group, but there were no significant correlations between CAN scores and QTc interval. There were no significant data of polysomnography to correlate to the CAN score. It meant that the autonomic neuropathy in patients with sleep apnea was affected by other multiple factors. Conclusion: The cardiovascular autonomic neuropathy test was a useful method for the evaluation of autonomic neuropathy in patients with sleep apnea syndrome and abnormalities of cardiovascular autonomic neuropathy were observed in patients with sleep apnea syndrome. However, we failed to define the factors that influence the pathogenesis of autonomic neuropathy of sleep apnea syndrome. This study warrants futher investigations in order to define the pathogenesis of autonomic neuropathy in patients with sleep apnea syndrome.