• 대한한의학회지
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• 제33권1호
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• pp.169-176
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• 2012

Objectives: Obstructive sleep apnea (OSA) is prevalent disorder, particularly among the middle-aged. In this study, we report a new approach to improve OSA using oriental medicine and acupuncture. Methods: Three men diagnosed with OSA were enrolled in this study. They took oriental medicine 3 times a day and were given acupuncture twice a week for about 4 months. Results: We analyzed apnea-hypopnea index (AHI), oxygen desaturation index (ODI), average saturation (AS) and lowest saturation (LS) before and after treatment. AHI highly decreased in all patients and ODI also decreased in two of the three patients. Conclusions: These results indicate that oriental medicine and acupuncture therapy was effective in the improvement of OSA. Further study in a larger group with severity grades is recommended.

• 대한치과의사협회지
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• 제53권4호
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• pp.249-258
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• 2015

Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.

• 수면정신생리
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• 제11권1호
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• pp.5-9
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• 2004

Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent cessation of breathing due to complete or partial upper airway occlusion during sleep. The incompetent tone of palatal, pharngeal, and glossal muscles which fail to maintain airway patency during sleep causes narrowing of the airway dimension and increased resistance of breathing. The identification of the sites of upper airway obstruction in patients with OSA is important in understanding the pathogenesis and deciding the treatment modality of snoring and/or OSA. Various upper airway imaging modalities have been used to assess upper airway size and precise localization of the sites of upper airway obstruction during sleep. Dynamic imaging modalities enabled assessment of dimensional changes in the upper airway during respiration and sleep. This article focused on reviews of various upper airway imaging modalities, especially dynamic upper airway imaging studies providing important information on the pathogenesis of OSA.

• 수면정신생리
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• 제8권2호
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• pp.113-120
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• 2001

배 경 : 폐쇄성 수면무호흡증은 다양하고 심각한 임상 증상과 합병증을 유발하는 질환으로 국내에서도 흔히 진단되고 있다. 그러나 현재까지 수면다원기록법을 사용해 폐쇄성 수면무호흡증을 확진한 환자들의 대규모 국내 연구를 찾아 볼 수 없었다. 본 연구에서는 종래의 연구에서보다 더 큰 집단을 대상으로 수면다원기록법을 사용해 폐쇄성 수면무호흡증으로 확진된 한국인 환자의 임상적 특성과 수면 양상에 관해 조사하였다. 방 법 : 서울대학교병원 수면다원검사실에 의뢰된 환자들 중 수면다원검사 결과 폐쇄성 수면무호흡증으로 진단된 환자 801명을 대상으로 하였다. 중추성 무호흡증, 주기성 사지운동증, 기면병, 렘수면관련행동장애, 그리고 외국인 환자는 제외하였다. 연구 대상 군의 임상적 특징을 조사하였으며 수면 변인들을 연령, 성별에 따른 정상치와 비교하였다. 그리고 호흡장애지수가 수면변인에 미치는 영향을 분석하였다. 결 과 : 전체 연구대상자 801명 중 남자가 83.4%, 여자가 16.4%이었고 평균 연령은 46.6세였다. 평균 비만정도 지수는 25.8이었고 비만한 환자가 22.8%를 차지하였다. 전체 대상 중 6.2%가 벤조디아제핀계 약물을 복용 중이었다. 연구 대상군에서 정상치에 비해 입면잠복시간은 증가되었고 수면효율, 렘수면 분율, 그리고 서파수면 분율은 감소하였다. 서파수면 분율과 렘수면 분율은 각각 호흡장애지수와 음의 상관성을 보였으나 수면효율과 입면잠복시간은 모두 호흡장애지수와 유의한 상관관계가 없었다. 결 론 : 본 연구에서 다수의 폐쇄성 수면무호흡증 환자가 비만과 무관하였다. 또한 6.2%의 폐쇄성 수면무호흡증 환자가 벤조디아제핀계 약물을 복용하고 있었다. 폐쇄성 수면무호흡증의 발병은 수면효율도 낮추고 서파수면과 렘수면 분율을 감소시키나 호흡장애지수가 커져도 서파수면과 렘수면 분율이 감소할 뿐 수면효율은 별 다른 변화가 없었다. 즉, 수면효율보다는 수면 구조의 변화가 수면 중 호흡장애의 정도에 더 관련되었음을 알 수 있었다.

• 대한치과교정학회지
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• 제40권2호
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• pp.115-126
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• 2010

이 증례보고는 심한 수면무호흡증으로 진단된 환자로, 다른 구강 내 OSA치료 장치와 nCPAP치료에 적응을 못하는 66세 남자 환자였다. 하악골에 2개의 교정용 마이크로 임프란트를 식립한 후, 식립 2주 후부터 구강외 고정원인 개조된 안면마스크에서 마이크로 임프란트에 힘을 가하여 하악골을 전진시켰다. 마이크로 임프란트를 이용한 하악골전진술(MiMA)은 심한 수면 무호흡환자의 AHI (apnea-hypopnea index), 코골이 및 심한 수면 무호흡증상을 개선할 수 있었다.

• 대한임상검사과학회지
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• 제44권4호
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• pp.205-209
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• 2012

Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep despite the effort to breathe. Apnea is closely related to clinical findings and respiratory disturbance index (RDI). The total subjects were 42 (male 26, female 16) and examined by polysomography (PSG) in terms of RDI above 5 and below 5 at Mok-Dong Hospital in Ewha Womans University from January to June, 2012. The study revealed the followings: The comparison of clinical findings and RDI above 5 showed significant increase in age, BMI, and snoring sound although lowest $SpO_2$ level decreased. The correlation coefficient analysis between clinical findings and RDI showed statistically significant correlation in age, BMI, lowest $SpO_2$ although snoring sound and average $SpO_2$ showed statistically insignificant correlation.

• 수면정신생리
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• 제12권2호
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• pp.98-104
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• 2005

Approximately 1% to 3% of all children have obstructive sleep apnea syndrome (OSAS). OSAS in children can lead to a variety of symptoms and sequalae; impairment of development and quality of life, behavioral and personality disturbance, learning problem, cor pulmonale and hypertension. Diagnosis and treatment of OASA for children are different from those for adults in many respects. Adenotonsillar hypertrophy is major cause of childhood OSAS. Overnight polysomnography in a sleep laboratory is the gold standard for diagnosing childhood OSAS. However, because full polysomnography in children may be difficult to obtain, expensive, and inconvenient, other methods to diagnose OSAS have been investigated. Adenotonsillectomy is the most common surgical treatment of childhood OSAS. But if residual symptoms remained after adenotonsillectomy, it should be considered to additional treatment such as weight control, sleep positional change, and continuous positive airway pressure (CPAP).

• 대한간호학회지
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• 제43권1호
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• pp.81-90
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• 2013

Purpose: This study was done to test structural equation modeling of health-related quality of life (QOL) of men with obstructive sleep apnea in order to identify parameters affecting QOL and provide guidelines for interventions and strategies to improve QOL in these patients. Methods: Model construction was based on 'The conceptual model of patient outcome in health-related QOL' by Wilson and Cleary, using the variables; age, physiological factors, social support, cognitive appraisal, symptoms and QOL. Participants were 201 adult male patients recruited at a tertiary university hospital in Seoul. Data were collected via questionnaires, polysomnography, and clinical records. Results: Age and symptoms directly influenced QOL. Social support and cognitive appraisal about sleep did not have a direct influence on QOL, but indirectly affected it via symptoms. QOL was lower in patients who were younger and had more severe symptoms. Symptoms were more severe for patients with lower social support and more dysfunctional cognitive appraisal. When social support was lower, cognitive appraisal was more dysfunctional. Conclusion: These results suggest it is necessary to not only manage symptoms, but also apply interventions to increase social support and cognitive appraisal about sleep in order to increase QOL in patients with obstructive sleep apnea.

• 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.

• 수면정신생리
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• 제12권2호
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• pp.105-110
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• 2005

The pathogenesis and mechanism of obstructive sleep apnea (OSA) has been under investigation for over 25 years, but its etiology and mechanism remains elusive. Skeletal (maxillary and/or mandibular hypoplasia or retrodisplacement, inferior displacement of hyoid) and soft tissue (increased volume of soft tissue, adenotonsillar hypertrophy, macroglossia, thickened lateral pharyngeal walls) factors, pharyngeal compliance (increased), pharyngeal muscle factors (impaired strength and endurance of pharyngeal dilators and fixators), sensory factors (impaired mechanoreceptor sensitivity, impaired pharyngeal dilator reflexes), respiratory control system factors (unstable respiratory control) and so on facilitate collapse upper airway. Therefore, OSA may be a heterogeneous disorder, rather than a single disease entity and various pathogenic factors contribute to the OSA varies person to person. As a result, patients may respond to different therapeutic approaches based on the predominant abnormality leading to the sleep-disordered breathing.