• Title/Summary/Keyword: Sleep apnea, Obstructive

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Effect of Mandibular Repositioning Device on Airway Size and Airway Collapsibility in Obstructive Sleep Apnea Syndrome : Cine CT during Sleep (수면무호흡증 환자에서 Mandibular Repositioning Device가 Airway size와 Airway Collapsibility에 미치는 효과)

  • Hong, Seung-Bong;Kyung, Seung-Hyun;Han, Hyun-Jung;Na, Dong-Kyu;Son, Young-Ik;Park, Young-Chel
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.110-115
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    • 1999
  • Objectives: To investigate the effect of mandibular repasitioning device on airway sige and airway collapsibility in patients with obstructive sleep apnea syndrome(OSAS). Methods: Cine CT with polysomnographic monitoring was performed during sleep in nine(OSAS) patients before and after manibular repositioning device(MRD) application. Axial CT images were obtained in five upper airway levels(retropalatal-high, retroalatal-low, retroglossal, epiglottis, and hypopharynx levels). In each airway level, one axial CT image was obtained during sleep apnea period and 10 serial axial CT images were scanned every 1 second during normal sleep breathing. After wearing MRD, all CT images were obtained by the same method. The cross-sectional areas of airway were measured by automatic tracing method. The changes of minimum airway size and maximum airway size after MRD were evaluated. The airway collapsibility was calculaed before and after MRD. Results: During sleep apnea, the airway of retropalatal-low level was the most frequently narrowest site. During normal sleep breahing the minimum airway size was increased significantly after MRD at retropalatal-low level(p=0.011). The mean airway collapsibility was the highest at retropalatal-low level. MRD decreased the airway collapsibility significantly at retropalatal-low level(p=0.021) and epiglottis level(p=0.038). Conclusions: The enlargement of the minimum airway size and decreased airway collapsibility may be the therapeutic mechanism of MRD in obstructive sleep apnea.

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CEPHALOMETRIC ANALYSIS OF SNORING AND OBSTRUCTIVE SLEEP APNEA SYNDROME PATIENTS (코골기 환자의 두부규격 방사선학적 분석)

  • Kim, Tae-Kyu;Yang, Dong-Kyu;Chung, In-Kyo;Kim, Jong-Ryoul;Roh, Hwan-Jung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.3
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    • pp.463-469
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    • 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.

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Sleep and Dentistry (수면과 치의학)

  • Jae-Kap Choi;Ji-Rak Kim
    • Sleep Medicine and Psychophysiology
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    • v.29 no.1
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    • pp.9-14
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    • 2022
  • Dental sleep medicine is an up-and-coming discipline of dentistry, more specifically an offshoot of oral medicine. It traditionally focuses on sleep-related breathing disorders, such as snoring and obstructive sleep apnea. However, everyday practice shows that also other sleep disorders touch on dentistry, including orofacial pain, xerostomia, and bruxism. Therefore, a new definition has been formulated for dental sleep medicine as following; 'Dental sleep medicine is the discipline concerned with the study of the oral and maxillofacial causes and consequences of sleep-related problems'. It is this article's aim to further introduce the emerging discipline of dental sleep medicine to all professionals working in sleep medicine. This article briefly describes the different dental sleep disorders with special focus on the more remarkable associations between orofacial pain and sleep.

The Compliance and Effect of CPAP in Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡 환자에서 지속적 상기도 양압술의 순응도와 효과)

  • Han, Eun-Kyoung;Yoon, In-Young;Chung, Seock-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.13 no.2
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    • pp.52-58
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    • 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.

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A Study on the Detection of Obstructive Sleep Apnea Using ECG (ECG를 이용한 수면 무호흡 검출에 관한 연구)

  • 조성필;최호선;이경중
    • Proceedings of the IEEK Conference
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    • 2003.07c
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    • pp.2879-2882
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    • 2003
  • Obstructive Sleep Apnea(OSA) is a representative symptom of sleep disorder which is caused by airway obstruction. OSA is usually diagnosed through the laboratory based Polysomnography(PSG) which is uncomfortable and expensive. In this paper, the detection method for OSA events, using ECG, has been developed. The proposed method uses the ECG data sets provided from Physionet. The features for OSA events detection are the average and standard deviation of 1 minute R-R interval, power spectrum of R-R interval and S-pulse amplitude from data sets. These features are applied to the input of Neural Network. To evaluate the method, we used the another ECG data sets. And we achieved sensitivity of 89.66%, specificity of 95.25%. So, we can know that the features proposed in this paper are important to detect OSA.

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Clinical and Physical Characteristics That Affect Apnea-Hypopnea Index in Suspected Obstructive Sleep Apnea Patients : The Preliminary Study (폐쇄성수면무호흡증 의심환자에서 무호흡저호흡지수에 영향을 주는 임상적 신체적 요인 : 예비연구)

  • Kang, Seung-Gul;Shin, Seung-Heon;Lee, Yu Jin;Jung, Joo Hyun;Kang, Il Gyu;Park, Insook;Kim, Peter Chanwoo;Ye, Mi Kyung;Hwang, Hee Young;Kim, Seon Tae;Park, Kee Hyung;Kim, Ji-Eun
    • Korean Journal of Biological Psychiatry
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    • v.20 no.2
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    • pp.54-60
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    • 2013
  • Objectives The purpose of this study is to find the influential clinical and physical characteristics which affect apnea-hypopnea index (AHI) in suspected obstructive sleep apnea (OSA) patients. Methods We evaluated the comprehensive factors including sleep related symptoms, clinical scales, medical history, substance use, and anthropometric data of the 119 participants who complained of the symptoms of OSA. All the participants underwent attended-full night laboratory polysomnography. The correlation and multiple regression analysis were conducted to find the influential and predictive factors of AHI. Results A multiple linear regression model 1 showed that higher AHI was associated with higher body mass index (BMI)(p < 0.001) and higher frequency of observed apnea (p = 0.002). In multiple linear regression model 2, AHI was associated with higher BMI (p < 0.001) and loudness of snoring (p = 0.018). Conclusions The present preliminary results suggest that BMI and observed apnea are most influential factors that affect AHI in suspected OSA patients. In the future study we will design the prediction formula for the OSA and AHI, which is useful in the clinical medical field.

Correlational Analysis of Supine Position Time and Sleep-related Variables in Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡 증후군에서 앙와위 자세시간과 수면관련변인 간 상관관계 분석)

  • Kim, Si Young;Park, Doo-Heum;Yu, Jaehak;Ryu, Seung-Ho;Ha, Ji-Hyeon
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.32-37
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    • 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.

A Literature Survey of Machine Learning Based Obstructive Sleep Apnea Diagnosis Research

  • Kim, Seo-Young;Suh, Young-Kyoon
    • Journal of the Korea Society of Computer and Information
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    • v.25 no.7
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    • pp.113-123
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    • 2020
  • Obstructive sleep apnea (OSA) among sleep disorders is one of relatively common diseases. Patients can be checked for the disease through sleep polysomnography. However, as far as he diagnosis of OSA using polysomnography (PSG) is concerned, many practical problems such as an increasing number of patients, expensive testing cost, discomfort during examination, and the limited number of people for testing have been pointed out. Accordingly, for the purpose of substituting PSG researchers have been actively conducting studies on OSA diagnosis based on machine learning using bio signals. In this regard, we review a rich body of existing OSA diagnosis studies applying machine learning techniques based on bio-signal data. As a result, this paper presents a novel taxonomy of the reviewed studies and provides their comprehensive comparative analysis results. Also, we reveal various limitations of the studies using the bio signals and suggest several improvements about utilization of the used machine learning methods. Finally, this paper presents future research topics related to the application of machine learning techniques using bio signals.

The Usefulness of the Berlin Questionnaire as a Screening for Obstructive Sleep Apnea in a Sleep Clinic Population (수면 클리닉을 내원한 환자에서 폐쇄성수면무호흡의 선별을 위한 베를린 설문의 유용성)

  • Kang, Hyeon-Hui;Kang, Ji-Young;Lee, Sang-Haak;Moon, Hwa-Sik
    • Sleep Medicine and Psychophysiology
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    • v.18 no.2
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    • pp.82-86
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    • 2011
  • Objectives: The Berlin Questionnaire (BQ) has been used to help identify patients at high risk of having sleep apnea in primary care. But it has not been validated in a sleep clinic for Korean patients. The aim of this study is to evaluate the usefulness of the BQ as a screening tool for obstructive sleep apnea (OSA) for Korean patients in a sleep clinic. Methods: The BQ was prospectively applied to 121 subjects with OSA suspicion who visited to our sleep clinic. All subjects performed overnight polysomnography. OSA was defined as an apnea-hypopnea index (AHI) ${\geq}5$. We investigated the sensitivity, specificity, positive and negative predictive values of the BQ according to severity by AHI. Results: In 121 subjects, 73.6% were males, with a mean age of $48.8{\pm}13.0$ years. Twenty-five (20.6%) patients did not have OSA (AHI<5), 30 (25%) patients had mild OSA ($AHI{\geq}5$ and <15), 26 (21.4%) had moderate ($AHI{\geq}15$ and <30), and 40 (33%) had severe OSA ($AHI{\geq}30$). The BQ identified 69.4% of the patients as being at high risk for having OSA. The sensitivity and specificity of the BQ were 71.9% and 40%, for $AHI{\geq}5$, 75.8% and 38.2% for $AHI{\geq}15$, 77.5% and 34.6% for $AHI{\geq}30$, respectively. The positive and negative predictive values of the BQ were 82.1% and 27.0% for $AHI{\geq}5$, respectively. Positive and negative likelihood ratios were 1.2 and 0.7, and the overall diagnostic accuracy of the BQ was 65.3%, using an AHI cut-off of 5. Conclusion: Due to modest sensitivity and low specificity, the BQ does not seem to be an appropriate tool for identifying patients with obstructive sleep apnea in a sleep clinic population.