• Journal of Oral Medicine and Pain
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• v.45 no.1
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• pp.1-11
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• 2020

Purpose: The purpose of this study was to assess influences of psychological factors on sleep disturbances in young adults through the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Methods: Two hundred and ninety nine college students in Gyeonggi-do completed the MMPI-2 and a questionnaire related to sleep disturbances and collected data were analyzed by logistic regression. Results: The odds of tooth grinding increased significantly with the increase of T-score of hysteria (Hy) scale. The increase of T-score of hypomania (Ma) and social introversion (Si) scale significantly contributed to the risk of insomnia. The occurrence of insomnia increased significantly as T-score of somatic complaints (RC1) and psychoticism (PSYC) scale increased. The odds of tooth grinding increased significantly as T-score of anxiety (ANX) and family problems (FAM) scale increased. The occurrence of insomnia decreased significantly with the increase of T-score of type A behavior (TPA) scale. The increase of T-score of dominance (Do) scale significantly contributed to the risk of tooth clenching. The odds of tooth grinding decreased significantly as T-score of MacAndrew alcoholism-revised (MAC-R) scale increased, whereas it increased significantly as T-score of addiction potential scale (APS) increased. No scale of MMPI-2 significantly affected the occurrence of snoring. Conclusions: T-scores of Hy, ANX, FAM, Do, MAC-R, and APS scales on MMPI-2 affected the risk of bruxism. T-scores of Ma, Si, RC1, PSYC, and TPA scales on MMPI-2 influenced the occurrence of insomnia. The psychometric instrument such as MMPI-2 is helpful in understanding and managing bruxism and insomnia.

• Sleep Medicine and Psychophysiology
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• v.11 no.2
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• pp.106-109
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• 2004

Adenotonsillar hypertrophy is the leading cause of childhood obstructive sleep apnea. Obstructive sleep apnea syndrome in childhood, however, can occur from various causes such as obesity or craniofacial abnormalities. Childhood obstructive sleep apnea syndrome can be accompanied by enuresis, parasomnias and behavior problems. For patients with the symptoms of snoring and apnea, obstructive sleep apnea should be suspected and diagnosed properly. In addition, the evaluation of complications and proper treatment are indispensable. When the cause of childhood obstructive sleep apnea is adenotonsillar hypertrophy, symptoms can be improved by surgical methods. If the cause is other than adenotonsillar hypertrophy, such as obesity, it should be treated with other therapeutic modalities, like nasal continuous positive airway pressure (nCPAP), weight reduction and modification of life style. This paper reports a case of nCPAP used to manage severe sleep apnea when it was not resolved after adenoidectomy and tonsillectomy. Differential diagnosis of narcolepsy in a case with excessive daytime sleepiness and reflections on accompanying enuresis and parasomnia were also described.

• The Journal of Pediatrics of Korean Medicine
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• v.18 no.1
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• pp.153-163
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• 2004

Objective: For last 20 years our living environment has been changed rapidly. Accordingly. there have been many changes in prevalence of diseases; In nasal disease of the pediatrics, the number of children suffering from chronic rhinorrhea and nasal obstruction has been increased. And respiratory symptoms suggesting rhinitis and sinusitis also were increased. Allergic disease is considered as an important cause of this phenomenon while importance of infection as pathogen is fading today. The aim of this study is to investigate the effect of TonggyutangGarnibang on the nasal disease of children. Methods: Children with nasal disease answer the questionnaires on their chief complaints and medical past history on their first visit to our clinic. They were treated 'With TonggyutangGarnibang for 4weeks. After treatment they answered the questionnaire on improvement of their symptoms. Results: Among treated patients, 70 were male(69%) and 32 were female(31%); sex ratio was 2.2.3:l(male:female). And children from 3-8 years old took majority of patients(64%). Major symptoms of children with nasal disease were as follows; nasal obstruction 9lchildren(62%), rhinorrhea 86children(84%), sneezing 63children(62%), cough 63children(62%), snoring 48children (47%), poor appetite 44children(43%), itching 39children(38%), headache 32children(31%), stomache 25children(25%), epistaxis 23children(23%), constipation 17children(17%), diarrhea 12children(12%). Past history and impression of the disease of the patients were as follows; allergic rhinitis(66%), atopic dermatitis(42%), sinusitis(40%), asthma(25%), urticaria(12%). Severity of symptom improved after TonggyutangGamibang treatment, it showed high treatment efficacy as follows; sneezing 70%, cough 70%, rhinorrhea 63%, nasal obstruction 59% Conclusion: This study shows TonggyutangGamibang has distinctive treatment effect on children with nasal disease.

• Imaging Science in Dentistry
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• v.46 no.3
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• pp.167-171
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• 2016

Purpose: Obstructive sleep apnea (OSA) is a common medical disorder with serious complications if untreated. Dentists play a vital role in the early diagnosis of this condition, thereby improving patients' prognoses. The purpose of this study was to identify patients with a high risk of OSA using simple cephalometric measurements in patients receiving routine dental care. Materials and Methods: The present study was conducted on 206 patients divided into a high-risk group and a control group after answering the Berlin questionnaire. Cephalometric analysis of a digital cephalogram was performed to measure the upper airway diameter (UAD) and mandibular-to-hyoid bone distance (MP-H) by 2 observers at 2 different times. Results: Among 206 patients, 93 (45%) were included in the high-risk group and 113 (55%) were in the control group. No significant difference was present between the groups with regard to gender, and the patients ranged in age from 18 to 65 years. The UAD measurements in the high-risk group were significantly lower than in the control group, and the MP-H measurements were significantly higher in the high-risk group than in the control group. The UAD was lower in middle-aged patients in both groups. Conclusion: Our study found that the UAD was lower in individuals with a high risk of OSA. Also, we found that middle-aged individuals of both genders were more likely to develop OSA. Dentists play a vital role in diagnosing patients at a high risk for OSA via thorough clinical examinations, risk factor analyses, and simple cephalometric analyses.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.71-76
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• 2017

Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made. When inducing deep sedation in a patient with OSA, airway obstruction may increase, causing oxygen saturation to drop; airway interventions are necessary in such cases. Effective DISE and MMA surgery can be performed by administering propofol through target-controlled infusion while monitoring the bispectral index (BIS).

• Journal of Oral Medicine and Pain
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• v.41 no.4
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• pp.180-187
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• 2016

Purpose: The aims of this study were to evaluate the differences of clinical and polysomnographic features between rapid eye movement (REM)-related obstructive sleep apnea (OSA) and not-REM-related OSA, and to suggest the pathogenesis according to the REM dependency of OSA. Methods: One hundred ninety consecutive patients diagnosed with OSA were evaluated clinical features and performed full night polysomnography. The patients were divided into REM-related (REM apnea-hypopnea index [AHI] at least two times higher than their non-REM AHI) and not-REM-related (a REM AHI less than two times higher than their non-REM AHI) OSA groups and evaluated the differences in age, body mass index (BMI), neck circumference, Ep-worth Sleepiness Scale score, and parameters of polysomnography. Results: REM-related patients were younger and showed higher sleep efficacy, low percentage of light sleep stage (stage 1 sleep), and low rate of positional OSA. Age was significantly associated with REM dependency of OSA and REM AHI were significant correlated with BMI, neck circumference, percentage of sleep in supine position, and percentage time of snoring. Conclusions: Our results showed that REM-related OSA patients showed less severe polysomnographic parameters than not-REM-related patients. However, significant risk factors were differed depending on the REM dependency and OSA severity, and the clinical features correlated with REM AHI and non-REM AHI were also showed differently. We suggest that the occurrence of OSA according to the REM dependency can be based on different mechanisms.

• The Journal of Korean Medicine
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• v.35 no.2
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• pp.12-18
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• 2014

Objectives: This was a retrospective case series about the clinical effect of integrated approach with behavior therapy for obstructive sleep apnea (OSA). Methods: Medical records of twelve patients with OSA who were treated with behavior modification including nasal breathing with oral appliances and sleep in lateral position, oral administration of herbal medicines and acupuncture treatment between January and September of 2013 were reviewed. Apnea-hypopnea index (AHI), day time sleepiness, apneas and hypopneas counts during sleep, risk indicator (RI), oxygen desaturation index, average saturation during sleep, lowest desaturation, lowest saturation, snoring events ratio and number of desaturations (%) were assessed before and after treatments with the ApneaLink device, which is a portable diagnostic apparatus for monitoring airflows of the patient's breath at home. Results: After an average 62.67 (SD 37.16) days of treatment, AHI (from 17.67, 12.79 to 8.75, 8.25, p=0.007), RI (from 22.00, 13.26 to 12.09, 8.03, p=0.004), oxygen desaturation index (from 17.33, 12.17 to 8.17, 7.86, p=0.005), and number of desaturations (from 7.00 times, 9.79 to 0.92 times, 1.39, p=0.044) showed significant improvement. Daytime sleepiness improved from 6.5 (3.2) to 3.8 (1.8) but there was no significant difference after treatment (p=0.17). No adverse events related to treatment were observed during participation in the treatment. Conclusion: From this case series, we found that behavior modification with herbal medication and acupuncture may be effective for improving sleep apnea without serious adverse events. Future randomized controlled trials with larger sample size will be necessary for concrete evidence on the benefit of this integrated treatment for OSA.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.5 no.1
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• pp.5-11
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• 2009

The objective of this study was to assess oral health status such as prevalence of dental caries, gingivitis and other combined disorder, orofacial dysfunction in patients with cerebral palsy(CP), as well as the state of tooth brushing, possibility of dental treatment. Sixty-six subjects with CP aged 9 to 37 years were included in the study. Clinical caries status(DMFT index) and other data were evaluated and statistically analyzed using SPSS program (SPSS 17.0). The results were as follows: The DMFT index and prevalence of gingivitis of study subjects were 2.82(male), 3.33(female) and 89%, respectively. DMFT index classified into four groups according to age as follows: DMFT index were 1.14(ages 6-11), 1.40(ages 12-14), 2.16(ages 15-24), 4.15(ages 25-37). In addition to the physical disorder, speech difficulty(86%), epilepsy(35%) and visual impairment(14%) were associated and the epilepsy medication was the most common medication. And orofacial dysfunction such as the eating difficulties(79%), drooling(36%), swallowing disorder(30%), breathing difficulty(15%), bruxism(30%) and snoring(33%) was shown. Most people with cerebral palsy can't brush alone and didn't use oral care adjunctive supplies. Moreover, Fifty-nine percent of them were noncooperative to dental treatment.

• Journal of Korean Academy of Nursing
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• v.29 no.1
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• pp.61-71
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• 1999

Sleep is a necessity for survival. Disruption of sleep leads to numerous adverse physiological and psychological consequences. These could be particularly undesirable for older patients, who are subject to many additional factors. But there is limited research related to hospitalized elderly in Korea. The purpose of the study is to explore sleep patterns and disturbing factors of before and after hospitalization, in order to present basic information regarding elderly sleep to develop nursing intervention. The sample consisted of 32 elderly men and women between the ages of n and 87 years. Data collection was done from September to November 1997. Measures of sleep patterns and related factors were obtained from self-reported sleep questionnaires. Analysis of data was done by use of t-test, paired t-test, ANOVA, and Pearson Correlation Coefficient. The results of this study were summarized as follows : 1. In comparision between before and after admission of their sleep pattern, “sleep onset” tends to be delayed and nocturnal sleep time was significantly reduced. So, hospitalized elderly reported less total sleep time than before admission. 2. Regarding the sleep disturbing factors, medication(hypnotics ; 37.5%), physiological factor (snoring ; 59.4%) environmental factor (pillow ; 78.1%), emotional factor(anxiety related to disease ; 37.5%), and illness factor(fatigue ; 34.7%) were reported. 3. Significant differences in gender were found. Men had more disturbances in sleep than women owing to difficulty in falling a sleep and lack of nocturnal sleep. Women consumed more sleep inducing drugs. Significant increase was reported in napping during the day with increasing age. 4. Significant differences between good sleepers and poor sleepers were found for the following variables : nocturnal sleep time, total sleep time, bed time, sleep onset latency time, sleep latency time after nocturnal awakening, time spent in bed upon arousal, environmental factors, and emotional factors. In conclusion, it was found that the quantity and quality of sleep were significantly altered in hospitalized elderly, but adequate strategies for better sleep were not practiced. Further research is needed to develop Intervention strategies to promote sleep and to prevent sleep problems.

• Journal of Oral Medicine and Pain
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• v.41 no.1
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• pp.7-15
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• 2016

Purpose: Mandibular advancement device (MAD) is widely recognized as an important treatment option for obstructive sleep apnea (OSA) and is readily accepted than any other treatment options owing to its simplicity and ambulatory nature. At this time, there are a multitude of MAD designs and their efficacies may be influenced by adjustment and retention mechanism. The MAD with the anterior connector (anteriorly adjustable mandibular advancement device, AAMAD) was newly developed in the Department of Oral Medicine, Dankook University Dental Hospital (Cheonan, Korea) and was prescribed for the OSA patients including snoring patients. Thus, this study was aimed to objectively investigate the effectiveness of the AAMAD on the OSA patients using the self-applied portable device (ApneaLink), and evaluate the treatment outcomes among patients with various severity of OSA level. Methods: Results of the treatment of fourteen patients (13 male, 1 female) with the AAMAD were retrospectively analyzed. Each patient underwent home sleep test before treatment and were divided into two groups, i.e., those with mild (apnea-hypopnea index [AHI] ${\geq}5$ and <15) to moderate OSA (AHI ${\geq}15$ and <30) and severe OSA (AHI ${\geq}30$). After treatment, home sleep test was conducted again and treatment outcomes were compared between mild to moderate and severe OSA patients. Results: Of all patients, 78.6% showed more than 50% AHI reduction. We found a significant reduction (85.3%) of AHI in the severe OSA patients. Patients with mild to moderate OSA showed the reduced AHI (56.1%). Conclusions: We concluded that AAMAD is an effective oral appliance for the majority of OSA patients.