• Sleep Medicine and Psychophysiology
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• v.10 no.2
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• pp.88-92
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• 2003

Sleep-disordered breathing (SDB), including snoring, sleep apnea and upper airway resistance syndrome are common problems in children. The pathophysiological mechanism of SDB in children is unclear but may include hypoxemia and changes in sleep architecture. Children with SDB show reduced neurocognitive function, and memory and attentional capacity. Furthermore, these children show increased problematic behaviour and reduced school performance. Whether early recognition and treatment of SDB in children may improve neurocognitive function and school performance remains to be fully evaluated in the future.

• Journal of Oral Medicine and Pain
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• v.39 no.1
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• pp.10-14
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• 2014

Purpose: The aim of this study is to evaluate the difference between gustatory functions in a sleep disordered breathing (SDB) group and a control group. The pathogenesis of SDB has not been fully understood. Though the precise contributions of neuromuscular and anatomical factors on SDB pathogenesis are still debated, we hypothesized that the gustatory dysfunction could be predisposed to SDB. Methods: All patients were diagnosed as SDB by polysomnography (PSG). On the basis of PSG results, patients were divided into 3 groups: snoring, mixed, and obstructive sleep apnea (OSA). The control group comprised healthy volunteers who were the same age as those of the SDB group and whose breathing was verified as normal using a portable sleep monitor device. The patient group and the control group were evaluated for gustatory functions with an electrogustometry (EGM). The electrical taste thresholds were measured in the anterior, midlateral, and posterior sides of the tongue and soft palatal regions, both sides. To find out the difference in EGM scores, statistical analysis was performed using the Kruskal-wallis and Mann-Whitney U test with 95% confidence interval and p<0.05 significance level. Results: The patients with SDB had higher EGM scores than the control group at all spots tested, except for the right midlateral of the tongue, and there was a statistical significance in the comparison between the control group and the divided SDB groups, respectively. Among the divided SDB groups, the snoring group had the most significant differences in the number of the measured spots, but there was no difference among the snoring, mixed, and OSA groups. Conclusions: These results may suggest that neurologic alterations with sleep disordered breathing could be associated with gustatory dysfunction. In the future, further systemic studies will be needed to confirm this study.

• Sleep Medicine and Psychophysiology
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• v.8 no.1
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• pp.11-17
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• 2001

In 2000, the number of people aged 65 and over increased to 3.37 million, accounting for 7.1% of the total population of South Korea. The elderly population will increase up to 19.3% in 2030. Sleep disordered breathing (SDB) seems to increase with age. More than 50-60% of old people complain of SDB-related signs and symptoms including awakening headache, excessive daytime sleepiness, fatigue, cognitive dysfunction, memory loss, personality changes, and depression. The influence of a mild degree of SDB upon the elderly is unclear, but moderate to severe SDB is well known to be associated with many diseases including hypertension, arrhythmia, myocardial infarction, stroke, dementia, and sudden death. Therefore, physicians should pay attention to elderly patients who complain of SDB related symptoms and signs that may not be normal signs of aging. Physicians need to become more sensitive to treat SDB in the elderly.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.4
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• pp.357-367
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• 2022

Sleep disordered breathing (SDB) is a disease characterized by repeated hypopnea and apnea during sleep due to complete or partial obstruction of upper airway. The prevalence of pediatric SDB is approximately 12 - 15%, and the most common age group is preschool children aged 3 - 5 years. Children show more varied presentations, from snoring and frequent arousals to enuresis and hyperactivity. The main cause of pediatric SDB is obstruction of the upper airway related to enlarged tonsils and adenoids. If SDB is left untreated, it can cause complications such as learning difficulties, cognitive impairment, behavioral problems, cardiovascular disease, metabolic syndrome, and poor growth. Pediatric dentists are in a special position to identify children at risk for SDB. Pediatric dentists recognize clinical features related to SDB, and they should screen for SDB by using the pediatric sleep questionnaire (PSQ), lateral cephalometry radiograph, and portable sleep monitoring test and refer to sleep specialists. As a therapeutic approach, maxillary arch expansion treatment, mandible advancement device, and lingual frenectomy can be performed. Pediatric dentists should recognize that prolonged mouth breathing, lower tongue posture, and ankyloglossia can cause abnormal facial skeletal growth patterns and sleep problems. Pediatric dentists should be able to prevent these problems through early intervention.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.10-16
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• 2004

Sleep is associated with definite changes in respiratory function in normal human beings. During sleep, there is loss of voluntary control of breathing and a decrease in the usual ventilatory response to both low oxygen and high carbon dioxide levels. Especially, rapid eye movement (REM) sleep is a distinct neurophysiological state associated with significant changes in breathing pattern and ventilatory control as compared with both wakefulness and non-rapid eye movement (NREM) sleep. REM sleep is characterized by erratic, shallow breathing with irregularities both in amplitude and frequency owing to marked reduction in intercostal and upper airway muscle activity. These blunted ventilatory responses during sleep are clinically important. They permit marked hypoxemia that occurs during REM sleep in patients with lung or chest wall disease. In addition, sleep-disordered breathing (SDB) is more frequent and longer and hypoventilation is more pronounced during REM sleep. Although apneic episodes are most frequent and severe during REM sleep, most adults spend less than 20 to 25% of total sleep time in REM sleep. It is, therefore, possible for patients to have frequent apneas and hypopneas during REM sleep and still have a normal apnea-hypopnea index if the event-rich REM periods are diluted by event-poor periods of NREM sleep. In this review, we address respiratory physiology according to sleep stage, and the clinical implications of SDB and hypoventilation aggravated during REM sleep.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.17-22
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• 2005

Sleep-disordered breathing (SDB) is associated with increased cardiovascular and cerebrovascular morbidity. Epidemiological and clinic-based studies have shown that SDB is related to impaired glucose tolerance and increased insulin resistance, independent of obesity. Despite of a consistent association between SDB and impaired glucose-insulin metabolism, the mechanism underlying this relationship has not been fully elucidated. It is recognized that hypoxemia and hypercapnia that occur in SDB provoke sympathetic nervous activity and catecholamine, epinephrine and norepinephrine, and cortisol are released. Sympathetic hyperactivity and increased catecholamines can impair glucose homeostasis by increasing glycogenolysis and gluconeogenesis, which can result in increased circulating insulin levels and increased risk of insulin resistance. A prospective study is needed to investigate the causal relationship between SDB and impaired glucose-insulin metabolism in a healthy population without diabetes, hypertension and obesity as etiologic risk factors.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.47.1-47.8
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• 2016

Background: The paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients. This study has its purpose in sharing a series of tonsillectomies performed at the Seoul National University Dental Hospital for the treatment and prevention of SDB in adult patients. Methods: Total of 78 patients underwent tonsillectomy at the Seoul National University Dental Hospital from 1996 to 2015, and 23 of them who were operated by a single surgeon (Prof. Jin-Young Choi) were included in the study. Through retrospective chart review, the purpose of tonsillectomy, concomitant procedures, grade of tonsillar hypertrophy, surgical outcome, and complications were evaluated. Results: Twenty-one patients diagnosed with SDB received multiple surgical procedures (uvulopalatal flap, uvulopalatopharyngoplasty, genioglossus advancement genioplasty, tongue base reduction, etc.) along with tonsillectomy. Two patients received mandibular setback orthognathic surgery with concomitant tonsillectomy in anticipation of postoperative airway compromise. All patients showed improvement in symptoms such as snoring and apneic events during sleep. Conclusions: When only throat infections were considered, tonsillectomy was a procedure rather unfamiliar to oral and maxillofacial surgeons. With a shift of primary indication from recurrent throat infections to SDB and emerging technological and procedural breakthroughs, simpler and safer tonsillectomy has become a major tool in the multidisciplinary treatment modality for SDB.

• Journal of Biomedical Engineering Research
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• v.37 no.4
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• pp.127-133
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• 2016

This study proposes the feasibility for automatic classification of sleep/wakefulness using nasal pressure in patients with sleep-disordered breathing (SDB). First, SDB events were detected using the methods developed in our previous studies. In epochs for normal breathing, we extracted the features for classifying sleep/wakefulness based on time-domain, frequency-domain and non-linear analysis. And then, we conducted the independent two-sample t-test and calculated Mahalanobis distance (MD) between the two categories. As a results, $SD_{LEN}$ (MD = 0.84, p < 0.01), $P_{HF}$ (MD = 0.81, p < 0.01), $SD_{AMP}$ (MD = 0.76, p = 0.031) and $MEAN_{AMP}$ (MD = 0.75, p = 0.027) were selected as optimal feature. We classified sleep/wakefulness based on support vector machine (SVM). The classification results showed mean of sensitivity (Sen.), specificity (Spc.) and accuracy (Acc.) of 60.5%, 89.0% and 84.8% respectively. This method showed the possibilities to automatically classify sleep/wakefulness only using nasal pressure.

• The Journal of the Korean dental association
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• v.48 no.3
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• pp.178-183
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• 2010

Obstructive Sleep Apnea(OSA) is a form of sleep disordered breathing(SDB) characterized by the occurrence of episodes of complete or partial upper airway obstruction during sleep that is often quantified as the apnea-hyponea index(AHI). It is increasingly being recognized that OSA is a public health hazard and there is increasing evidence that it is associated with an increase in morbidity. Early recognition and diagnosis of this condition may lead to earlier treatments (eg, CPAP, Oral appliances) with reduction of the risk of metabolic disease, cardiovascular diseases, such as hypertension, ischemic heart disease, arrhythmias and pulmonary hypertension.

• Journal of the korean academy of Pediatric Dentistry
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• v.49 no.2
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• pp.180-187
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• 2022

The aim of this study was to investigate the risk factors associated with sleep disordered breathing (SDB) by comparing intraoral factors, body mass index (BMI), and medical history with pediatric sleep questionnaire (PSQ) findings. Seven hundred eighty-seven subjects aged between 7 to 11 years old were included. Their caregivers were asked to complete questionnaires. Oral manifestations including Angle's classification, overjet, and Brodsky tonsil grade were examined. Children with PSQ scores of more than 0.33 points were classified into the SDB high-risk group. Among the 787 subjects, 34 (4.3%) were classified into the SDB high-risk group. Children with allergic rhinitis, atopic dermatitis, excessive overjet, or large tonsil size had a significantly higher risk for SDB versus those without. Also, there was a significant difference in SDB risk according to BMI status. Gender, gestational age, breastfeeding, and Angle's classification were not associated with SDB. Children at high risk for SDB were predisposed to tonsillar hypertrophy, allergic rhinitis, obesity, and atopic dermatitis. Children with these factors could be candidates for early intervention to prevent the progression of SDB.