• 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.

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

• Korean Journal of Clinical Laboratory Science
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• v.38 no.3
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• pp.212-217
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• 2006

Obstructive sleep apena syndrome (OSAS) is accompanied by the following symptoms: apnea caused by upper respiratory tract obstruction while sleeping, repetitive lowering of $SpO_2$, severely affected excessive daytime sleepiness (EDS), suffocation/frequent awakeness while sleeping, daytime lethargy, and lack of concentration. OSAS was investigated with sex, age, body weight, body mass index (BMI), neck circumference and snoring sound as clinical characteristics and the anticipating factors of OSAS were studied in relation with the apnea-hypopnea index (AHI). The subjects were 42 people (male 34/female 8) who visited the clinic due to snoring and had polysomnography evaluation. AHI was differenciated into normal (less than 0~5/hr), mild (5~15/hr), moderate (15~30/hr) and severe (more than 30/hr). As the apnea-hypopnea index (AHI) gets higher, the snoring sound was louder (p<0.01), neck circumference was thicker (p<0.05) and also there were relative correlations with body weight (p<0.01), body mass index (p<0.05), snoring sound (p<0.01) and neck circumference (p<0.01). Since the snoring sound and neck circumference explained 32.8% of the AHI distribution, if the patient was severely snoring or had a thick neck circumference due to obesity, the apnea-hypopnea index showed a predisposition to the obstructive sleep apnea syndrome.

• Korean Journal of Clinical Laboratory Science
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• v.44 no.4
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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.

• The Journal of Korean Medicine
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• v.33 no.1
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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.

• Sleep Medicine and Psychophysiology
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• v.18 no.2
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• pp.63-66
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• 2011

It has been controversial whether upper airway resistance syndrome (UARS) is a distinct syndrome or not since it was reported in 1993. The International Classification of Sleep Disorders classified UARS under obstructive sleep apnea syndrome (OSAS) in 2005. UARS can be diagnosed when the apnea-hypopnea index (AHI) is fewer than 5 events per hour, the simultaneously calculated respiratory disturbance index (RDI) is more than 5 events per hour due to abnormal non-apneic non-hypopneic respiratory events accompanying respiratory effort related arousals (RERAs), and oxygen saturation is greater than 92% at termination of an abnormal breathing event. Although esophageal pressure measurement remains the gold standard for detecting subtle breathing abnormality other than hypopnea and apnea, nasal pressure transducer has been most commonly used. RERAs include phase A2 of cyclical alternating patterns (CAPs) associated with EEG changes. Symptoms of OSAS can overlap with UARS, but chronic insomnia tends to be more common in UARS than in OSAS and clinical symptoms similar with functional somatic syndrome are also more common in UARS. In this journal, diagnostic and clinical differences between UARS and OSAS are reviewed.

• Sleep Medicine and Psychophysiology
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• v.20 no.1
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• pp.31-34
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• 2013

Objectives: The aim of this study was to evaluate the differences in patients with positional dependent sleep apnea according to their non-supine apnea-hypopnea index (AHI, ${\geq}5$ vs. <5). Methods: 92 patients with positional sleep apnea were evaluated. The patients were divided into two groups : group I was non-supine AHI having ${\geq}5$ ; group II was non-supine AHI having less than 5. Statistical analysis was performed to find the difference between two groups. Results: In 92 patients, the number of group I patients was 11 (12%) and the number of group II patients was 81 (88%). In the severe AHI group, percentage of group I was dominated (70%) and showing a significant difference compared with the mild and moderate AHI groups (p<.05). In the severe body mass index (BMI) group, percentage of group I was dominated (54.5%) and showing a significant difference compared with of the mild and moderate BMI groups (p<.05). The percentage of group I was significantly higher than group II (p<.05) in the AHI, supine AHI, non-supine AHI and snore time. Conclusions: In patients with positional sleep apnea, severe OSA and high BMI are more common in patients with non-supine AHI${\geq}5$ than non-supine AHI<5.

• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.67-70
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• 2008

Overlap syndrome can be defined as a coexistence of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS). The association of COPD and SAHS has been suspected because of the frequency of both diseases. Prevalence of COPD and SAHS is respectively 10 and 5% of the adult population over 40 years of age. However, a recent study has shown that the prevalence of SAHS is not higher in COPD than in the general population. The coexistence of the two diseases is only due to chance. SAHS does not affect the pathophysiology of COPD and vice versa. Prevalence of overlap syndrome is expected to occur in about 0.5% of the adult population over 40 years of age. Patients with overlap syndrome have a more profound hypoxemia, hypercapnia, and pulmonary hypertension when compared with patients with SAHS alone or usual COPD patients without SAHS. To treat the overlap syndrome, nocturnal noninvasive ventilation (NIV) or nasal continuous positive airway pressure (nCPAP) can be applied with or without nocturnal oxygen supplement.

• The korean journal of orthodontics
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• v.40 no.2
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• pp.115-126
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• 2010

This case report describes the treatment of a 66 year old adult patient with a diagnosis of severe obstructive sleep apnea who was intolerant of nasal continuous positive airway pressure (nCPAP) treatment and oral appliance therapy. An alternative treatment of snoring and obstructive sleep apnea (OSA) with 2 orthodontic microimplants anchored to the mandible providing skeletal anchorage for mandibular advancement was implemented. After a 2 week healing period, a custom designed facemask provided extraoral anchorage to which the microimplants were connected to for titratable mandibular advancement. Microimplant Mandibular Advancement (MiMA) therapy resulted in resolution of the symptoms of severe OSA with a reduction of the apnea-hypopnea index (AHI), snoring and OSA symptoms.

• Imaging Science in Dentistry
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• v.53 no.4
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• pp.283-289
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• 2023

The apnea-hypopnea index is widely regarded as a measure of the severity of obstructive sleep apnea (OSA), a condition characterized by recurrent episodes of apnea or hypopnea during sleep that induce airway collapse. OSA is a catastrophic problem due to the wide range of health issues it can cause, including cardiovascular disease and memory loss. This review was conducted to clarify the roles of various imaging modalities, particularly cone-beam computed tomography (CBCT), in the diagnosis of and preoperative planning for OSA. Unfortunately, 2-dimensional imaging techniques yield insufficient data for a comprehensive diagnosis, given the complex anatomy of the airway. Three-dimensional (3D) imaging is favored as it more accurately represents the patient's airway structure. Although computed tomography and magnetic resonance imaging can depict the actual 3D airway architecture, their use is limited by factors such as high radiation dose and noise associated with the scans. This review indicates that CBCT is a low-radiation imaging technique that can be used to incidentally identify patients with OSA, thereby facilitating early referral and ultimately enhancing the accuracy of surgical outcome predictions.