• Journal of Oral Medicine and Pain
• /
• v.22 no.2
• /
• pp.383-394
• /
• 1997

The purpose of this study was to examine the anatomic changes in the upper airway with a dental orthosis. the effectiveness and side effects of orthosis in the treatment of snoring and obstructive sleep apnea. To meet this puppose a dental orthosis, designed to increase the size of the upper airway by advancing the mandible, was used in 42 patients (30 M, 12 F), aged 29 - 69 years, to treat snoring and varying decrees of obstructive sleep apnea. Cephalometric study of anatomic featured was made with and without a dental orthosis, and the evaluation of the effectiveness and side effects of orthosis was done by questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 32 patients comp1ained the loudness of snoring as severe as be heard outside of the patient's room. 2. According to the degree of respiratory distirbance index(RDI) and aprea index(Al) from the polysomnograph in 34 patient, mild obstructive sleep apnea patients were 5, moderate 6 and severe 16. 3. Various anatomic changes in the upper airway with denta1 orthosis were as follows : (1) More superioly positioned hyoid bone ( p<0.001) (2) Enlarged oropharyngeal (superior p<0.01, middle p<0.01. inferior p<0.01) and hypopharyngeal (P<0.05) airway space. 4. According to the results of the changes of clinical syptoms after the usage of the dental orthosis acquired from questionnaires, there was significant improvement in the frequently, the loudness and the severity of snoring, cessation of breathing and awakening from the difficulty of breathing during sleep. 5. The effectiveness and side effects of dental orthosis by questionnaires were as follows ; (1) Dental orthosis satisfied almost all the patients (68±20%). (2) Snoring was improved in all the patients (73±19%). (3) Obstructive sleep aphea was improved in all the patients (61 ± 37%) (4) Sleepiness in the daytime was significantly improved (61 ±37%). (5) The sleep quality was significantly improved (61±37%). (6) The discomfort of the dental orthosis was minor (33±18%) and no serious complications were observed. 6. The dental orthosis is an effective treatment for the symptom of snoring, and it can also effectively treat varying degrees of obstructive sleep apnea.

• The Journal of the Korean dental association
• /
• v.48 no.3
• /
• pp.184-189
• /
• 2010

Snoring is a very common sleep disorder. Approximate 20~30 percent of population and 40~60 percent of middle and old age population are reported to have symptoms of snoring. Snoring patients do not frequently recognize snoring until spouse or colleague has noticed. Hence, for most people snoring has been not a serious health issue but one of bad sleeping habits. However, it recently draws social attention because most patients with diagnosed "Obstructive Sleep Apnea Syndrome" cased by obstruction of the upper airway are reported snoring. In this point, the author attempts to review the clinical aspects and treatments about snoring and "Obstructive Sleep Apnea Syndrome" in the medical and dental perspective.

• The Journal of the Korean dental association
• /
• v.57 no.5
• /
• pp.288-295
• /
• 2019

Sleep-disordered breathing (SDB) is defined as a disturbed breathing during sleep caused by repetitive upper airway collapse. Complete collapse causes a cessation of breathing, known as obstructive sleep apnea (OSA) and snoring can arise from partial collapse. Undiagnosed and untreated OSA means recurrent intermittent hypoxemia and leads to a variety of cardiovascular disorders, disturbed neurocognition, and excessive daytime sleepiness. Various behavioral modalities have been suggested for treating snoring and sleep apnea including changing the sleep position, avoiding alcohol, and weight loss. Until now continuous positive airway pressure (CPAP) therapy is one of effective treatment for patients with OSA, but its discomfort causes less tolerance and compliance. Therefore, clinical effectiveness and convenience for oral appliance have emerged and the role of dentists has become more important in the management of OSA.

• Tuberculosis and Respiratory Diseases
• /
• v.51 no.6
• /
• pp.590-596
• /
• 2001

The hallmarks of sleep apnea syndrome include daytime hypersomnolence, snoring, obesity, disturbed nocturnal sleep, and apneic episodes. Thyroid deficiency states are now a well recognized cause of sleep apnea. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A-33-yr-old man was admitted complaining of daytime hypersomnolence, snoring, sleep apnea and obesity. A polysomnogram showed obstructive pattern of sleep apnea syndrome. Physical examination and hormonal study revealed a narrowing of the upper airway and primary hypothyroidism. Dilated cardiomyopathy was diagnosed by echocardiogram. The poctients was treated for obstructive sleep apnea syndrome with nasal continuous positive airway pressure(CPAP) for 2 months and the underlying hypothyroidism with thyroid hormone therapy. This successfully controlled the snoring, sleep apnea, and other apnea-related symptoms. Here, we describe our experience of nasal CP AP and thyroid hormone therapy in a patient with primary hypothyroidism associated with obstructive sleep apnea syndrome and dilated cardiomyopathy with review of the relevant literature.

• Sleep Medicine and Psychophysiology
• /
• v.12 no.1
• /
• pp.68-71
• /
• 2005

We report a case of obstructive sleep apnea syndrome, which occurred primarily during the REM sleep stage. A 55-year-old female patient who complained of chronic insomnia on the initial visit turned out to have obstructive sleep apnea syndrome of a mild degree (respiratory disturbance index (RDI) of 13.8/hour, %time spent below 90% of SaO2=5.0%) on nocturnal polysomnography. Interestingly, apnea episodes and desaturations mainly occurred during REM sleep stage. And RDI and destaturations during REM sleep stage were found to be severe enough to classify as a severe degree of obstructive sleep apnea syndrome. These findings suggest that severe obstructive sleep apnea syndrome might be masked under the symptom of chronic insomnia and that apneas can be predominantly localized within REM sleep epochs. In terms of treatment, "REM sleep-dependent" apneas may call for different methods of treatment, especially REM sleep-specific pharmacological intervention.

• The Journal of the Korean life insurance medical association
• /
• v.31 no.1
• /
• pp.29-33
• /
• 2012

Nowadays, obstructive sleep apnea is being important to life insurance industry. Many life applicants submit their attending physician's statement, diagnostic certificate, and results of polysomnography to underwriters. So It's necessary to perform evidence-based medical approach. I hope this article is helpful to insurance doctors and underwriters.

• Sleep Medicine and Psychophysiology
• /
• v.16 no.2
• /
• pp.61-64
• /
• 2009

Obstructive sleep apnea (OSA) has been definitively shown to be a risk factor for the development of cardiovascular disease and mortality. Recent reports have indicated that obstructive sleep apnea is associated with insulin resistance and impaired glucose metabolism, also have type 2 diabetes. The potential mechanisms leading to the development of type 2 diabetes in OSA patients are likely to be various. Reduced physical activity resulting from daytime somnolence, sympathetic nervous system activation, intermittent hypoxia, sleep fragmentation and sleep loss, dysregulation of the hypothalamic-pituitary axis, alteration in adipokine profiles, and activation of inflammatory pathways have been proposed. Based on the current evidence, clinicians should assess the risk of OSA in patients with type 2 diabetes and, conversely, consider that possibility of glucose intolerance in patients with OSA. Further large-scale and long-term follow-up studies in patient populations with selected by reliable but inexpensive diagnostic measures, controlled for potential confounder factor, are needed.

• Sleep Medicine and Psychophysiology
• /
• v.11 no.1
• /
• pp.50-54
• /
• 2004

The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.

• Imaging Science in Dentistry
• /
• v.54 no.2
• /
• pp.147-157
• /
• 2024

Purpose: The aim of this study was to explore the correlations of cone-beam computed tomographic findings with the apnea-hypopnea index in patients with obstructive sleep apnea. Materials and Methods: Forty patients with obstructive sleep apnea were selected from the ear-nose-throat (ENT) outpatient clinic, Faculty of Medicine, Mansoura University. Cone-beam computed tomography was performed for each patient at the end of both inspiration and expiration. Polysomnography was carried out, and the apnea-hypopnea index was obtained. Linear measurements, including cross-sectional area and the SNA and SNB angles, were obtained. Four oral and maxillofacial radiologists categorized pharyngeal and retropalatal airway morphology and calculated the airway length and volume. Continuous data were tested for normality using the Kolmogorov-Smirnov test and reported as the mean and standard deviation or as the median and range. Categorical data were presented as numbers and percentages, and the significance level was set at P<0.05. Results: The minimal value of the cross-sectional area, SNB angle, and airway morphology at the end of inspiration demonstrated a statistically significant association (P<0.05) with the apnea-hypopnea index, with excellent agreement. No statistically significant difference was found in the airway volume, other linear measurements, or retropalatal airway morphology. Conclusion: Cone-beam computed tomographic measurements in obstructive sleep apnea patients may be used as a supplement to a novel radiographic classification corresponding to the established clinical apnea-hypopnea index classification.

• The Journal of the Korean dental association
• /
• v.48 no.3
• /
• pp.190-195
• /
• 2010

Oral appliance therapy is a simple, reversible way for improving snoring and/or obstructive sleep apnea. It may be indicated for the patients who are unable to tolerate continuous positive airway pressure (CPAP) or who have potential risks for surgical intervention. Oral appliance therapy increases airway space by the providing stable anterior positioning of the mandible, pulling out tongue, lifting up soft palate, or changing the muscle activity of the genioglossus. Currently, more than 80 different types of oral appliances have been introduced for snoring and/or obstructive sleep apnea. They are classified by their characteristics such as mode of action, adjustability and material used. This article provides a detailed clinical protocol and treatment procedure for oral appliance therapy.