• Sleep Medicine and Psychophysiology
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• v.17 no.1
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• pp.11-15
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• 2010

Obstructive sleep apnea is a common sleep disorder that predominantly affects adult men than women. However, the prevalence in women increases with menopause dramatically. Menopause has long been described as a risk factor for obstructive sleep apnea. Recent large well-designed population studies support that menopause increases the risk for sleep-disordered breathing. The mechanism of that hypothesis is not yet clear. But, the decline in progesterone has been thought to influence the development of obstructive sleep apnea because progesterone is a respiratory stimulant and plays a protective role against sleep apnea. Increased visceral obesity and hypertension as major symptoms of metabolic syndrome are also associated with menopause and place women at increased risk for obstructive sleep apnea and other serious health problem. Hormone replacement therapy has been associated with a lower prevalence of sleep apnea. But, relative risk and benefits of hormone replacement therapy compared with other treatment options will require thorough consideration for each individual woman. Finally, attention should be drawn to the need for obstructive sleep apnea evaluation in perimenopausal and postmenopausal women.

• Journal of the Korean Institute of Electrical and Electronic Material Engineers
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• v.24 no.7
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• pp.605-608
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• 2011

In this study, OSA (the obstructive sleep apnea) periods were detected in patients with OSA during sleep because of the treatment was different according to the frequency and symptoms of obstructive sleep apnea. ANS (autonomic nervous activity) was changed by obstructive sleep apnea periods so we intended to detect the periods to care the obstructive sleep apnea patients. RR intervals, SDNN (standard deviation of normal to normal) and RMSSD (root mean square standard deviation) were calculated in time domain analysis and LF (low frequency), HF (high frequency), NHF (normalized high frequency), NLF (normalized low frequency) were calculated in frequency domain analysis of HRV (heart rate variability) with obstructive sleep apnea patients. In this paper, SDNN (standard deviation of normal to normal) of time domain analysis were decreased in the obstructive sleep apnea periods. And NLF and LF/HF ratio were increased and NHF (normalized high frequency) was decreased in the frequency domain analysis. The parameters can be used to treat obstructive sleep apnea patients by detecting the obstructive sleep apnea periods such as CPAP (continuous positive airway pressure).

• Sleep Medicine and Psychophysiology
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• v.17 no.2
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• pp.69-74
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• 2010

Obstructive sleep apnea syndrome is associated with significant cardiovascular morbidity and increased mortality. However, it was controversial whether obstructive sleep apnea syndrome could cause pulmonary hypertension. The controversy was resolved by several studies that have shown pulmonary hypertension in 20% to 40% of patients with obstructive sleep apnea syndrome without underlying other cardiopulmonary diseases and reductions in pulmonary arterial pressure in patients with obstructive sleep apnea syndrome after treatment with nocturnal continuous positive airway pressure. Recent studies provide strong evidence for endothelial dysfunction in obstructive sleep apnea syndrome and pulmonary hypertension. Endothelin-1 is a 21 amino acid peptide with diverse biologic activity such as highly potent vasoconstrictor and mitogen regulator that may play a key role in obstructive sleep ap-nea syndrome and pulmonary hypertension. Continuous positive airway pressure therapy is moderately effective in reducing pulmonary arterial pressure. Further researches are needed to assess the therapeutic efficacy of pharmacologic therapy with agents that inhibit the action of endothelin-1 in obstructive sleep apnea syndrome patients with pulmonary hypertension.

• Korean Journal of Clinical Laboratory Science
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• v.39 no.3
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• pp.264-270
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• 2007

Obstructive sleep apnea syndrome (OSAS) is defined by sleep apnea with decreased oxygen saturation, excessive snoring with daytime sleepiness, and frequent awakening during the night time sleep. The present study was performed to investigate how apnea-hypopnea, that possibly causes breathing disturbance during sleep, can affect sleep pattern in patients with OSAS. We included 115 patients (92 men, 23 women) who underwent a polysomnography from January 2006 to May 2007. As the frequency of sleep apnea-hypopnea increases, the proportion of non-rapid eye movement (REM) sleep (p<0.001), and stage I sleep (p<0.001) increased, while that of stage II sleep (p<0.001), stage III and IV sleep (p<0.01), and REM sleep (p<0.05) decreased. Furthermore, sleep apnea-hypopnea was closely correlated with REM sleep (r=0.314, p<0.001), stage I sleep (r=0.719, p<0.001), stage II sleep (p=-0.342, p<0.05), stage III and IV sleep (r=-0.414, p<0.001), and REM sleep (r=-0.342, p<0.05). Stage I sleep could account for the 51% of the variance of apnea-hyponea. Our study shows sleep apnea-hypopnea affects sleep pattern in pattern with OSAS significantly, and the change of stage I sleep is the most important factor in estimating the disturbance of sleep pattern.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.38-46
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• 1996

The purpose of this study is to investigate the neurocognitive dysfunction and the degree of severity according to the oxygen desaturation in obstructive sleep apnea patients. We performed nocturnal polysomnographic recording and administered 3 Vienna Test System subtest of Reaction unit, Continuous attention and Cognitrone to 11 obstructive sleep patients and 13 controls. The result were as follows: 1) On Continous attentin and Cognitrone, patients with obstructive sleep apnea showed significant lower score on correct answer, higher score on missed answer and prolonged reaction time than control. But, there was no significant difference on Reaction unit between two groups. 2) Among 3 groups divided by degree of oxygen desaturation, there were no significant differences on Reaction unit. As the oxygen saturation decreased however, the obstructive sleep apnea group revealed significantly poor performance score on continuous attention and cognitrone. We suggested that obstructive sleep apnea patients showed disturbed neurocognitive function with complex cognitive process and the severity of neurocognitive dysfunction was also correlated with oxygen desaturation.

• 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.

• 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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.6
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• pp.388-392
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• 2016

In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors. After distraction osteogenesis, the patient's respiratory problems resolved, and she was able to sleep comfortably. Distraction osteogenesis was an effective method of advancing the mandible, increasing the upper airway space and ultimately preventing obstructive sleep apnea syndrome in patients with Treacher Collins syndrome.

• 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.

• 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.