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

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• v.61 no.11
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• pp.593-599
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• 2018

Background and Objectives Respiratory scoring guidelines for children and adults have been used for evaluating adolescents both in the 2007 and 2012 American Academy of Sleep Medicine (AASM) scoring manuals. We compared the scoring methods of polysomnography used in these scoring manuals, where pediatric and adult scoring rules were adopted for the diagnosis of sleep apnea in adolescents. Subjects and Method 106 Korean subjects aged between 13 and 18 years were enrolled. All subjects underwent overnight polysomnography in a sleep laboratory. Data were scored according to both pediatric and adult guidelines in the 2007 and 2012 AASM scoring manuals. Results Both pediatric and adult apnea hypopnea index (AHI) using the 2012 method were significantly higher than those using the 2007 method. The difference in AHI compared between pediatric and adult scores with the 2012 AASM scoring system was markedly decreased from that with the 2007 method. There was a significant discordance in sleep apnea diagnosis between pediatric and adult scoring rules in the 2012 method. Conclusion Both pediatric and adult rules were used for the diagnosis of adolescent sleep apnea in the 2012 method. However, there was significant discordance in the diagnosis between pediatric and adult scoring guidelines in the 2012 AASM manual, probably due to different cut-off values of AHI for the diagnosis of sleep apnea in pediatric (${\geq}1$) and adult (${\geq}5$) patients. Further studies are needed to determine a more reasonable cut-off value for the diagnosis of sleep apnea in adolescents.

• The Journal of the Institute of Internet, Broadcasting and Communication
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• v.23 no.2
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• pp.119-129
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• 2023

Sleep apnea causes various secondary disease such as hypertension, stroke, myocardial infarction, depression and cognitive impairment. Early detection and continuous management of sleep apnea are urgently needed since it causes cardio-cerebrovascular diseases. In this study, wearable device for monitoring respiration during sleep using PVDF film was developed to detect vibration through trachea caused by breathing, which determines normal breathing and sleep apnea. Variables such as respiration rate and apnea were extracted based on the detected breathing sound data, and a noise reduction algorithm was established to minimize the effect even when there is a noise signal. In addition, it was confirmed that irregular breathing patterns can be analyzed by establishing a moving threshold algorithm. The results show that the accuracy of the respiratory rate from the developed device was 98.7% comparing with the polysomnogrphy result. Accuracy of detection for sleep apnea event was 92.6% and that of the sleep apnea duration was 94.0%. The results of this study will be of great help to the management of sleep disorders and confirmation of treatment by commercialization of wearable devices that can monitor sleep information easily and accurately at home during daily life and confirm the progress of treatment.

• Sleep Medicine and Psychophysiology
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• v.24 no.2
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• pp.86-96
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• 2017

Objectives: This study aimed to analyze causality among sleep apnea, depression and cognitive function in patients with obstructive sleep apnea. Methods: We reviewed the medical records of 105 patients with sleep apnea and snoring who underwent overnight polysomnography (PSG). We analyzed various biological data, sleep variables (sleep duration and percentage) and respiratory variables [arousal index (AI), periodic leg movement index (PLM index), snoring Index (SI), mean SpO2, minimum SpO2, apnea-hypopnea index (AHI), and respiratory disturbance index (RDI)]. We also analyzed various data by sleep, cognition, and mood related scales: Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), snoring index by scale (SIS), Montreal Cognitive Assessment-Korean (Moca-K), Mini-mental State Examination-Korean (MMSE-K), clinical dementia rating (CDR), and Beck Depression Inventory (BDI). We analyzed causation among sleep, and respiratory, mood, and cognition related scales in obstructive sleep apnea patients. We analyzed the mediating effects of depression on sleep apnea patient cognition. Results: As Duration N1 increased and Total sleep time (TST) decreased, MOCA-K showed negative causality (p < 0.01). As BDI and supine RDI increased, causality was negatively related to MOCA-K (p < 0.01). As PSQI (p < 0.001) and SIS (p < 0.01) increased and as MMSE-K (p < 0.01) decreased, causality was positively related to BDI. BDI was found to mediate the effect of age on MOCA-K in patients with obstructive sleep apnea. Conclusion: Duration N1, total sleep time, BDI, and supine RDI were associated with cognitive function in obstructive sleep apnea patients. Depression measured by BDI partially mediated cognitive decline in obstructive sleep apnea patients.

• Proceedings of the KSLP Conference
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• 2012.03a
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• pp.13-13
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• 2012

• Annals of Clinical Neurophysiology
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• v.16 no.2
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• pp.95-97
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• 2014

• Sleep Medicine and Psychophysiology
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• v.11 no.2
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• pp.84-88
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• 2004

Objectives: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. Methods: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI)：control (n=24), and patients with sleep apnea (n=70). Results: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p<0.05) Conclusion: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method.

• Sleep Medicine and Psychophysiology
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• v.24 no.2
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• pp.118-123
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• 2017

Central sleep apnea (CSA) is a highly prevalent comorbidity in patients with heart failure and may present in 25 to 40 percent of heart failure patients. Continuous positive airway pressure (CPAP) is the primary therapeutic option and effective in treatment of obstructive sleep apnea (OSA). In heart failure patients with CSA, several trials of CPAP showed a number of positive effects in heart failure treatment. A 58-year-old male visited the hospital because of dyspnea and he was diagnosed as heart failure with ischemic heart disease. He underwent coronary angiography and received percutaneous coronary intervention due to stenosis at the middle of left anterior descending coronary artery. However, dyspnea was not completely improved after treatment with percutaneous coronary intervention. The patient also experienced snoring and sleep apnea which worsened with symptom of dyspnea in the recent year. We suspected CSA and the patient underwent polysomnography to confirm whether sleep apnea was present. During the polysomnography, CSA with Cheyne-Stokes respiration (CSR) was observed and apnea-hypopnea index was 45.9/hr. The patient was treated with CPAP. After CPAP treatment, hypoxemia and CSA were resolved and dyspnea was improved with reducing NYHA class. We report a case successfully treated with clinical improvement by presuming CSA in a patient with heart failure.

• Science of Emotion and Sensibility
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• v.22 no.1
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• pp.89-100
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• 2019

Sleep apnea, a medical condition associated with a variety of complications, is generally monitored by standard sleep polysomnography, which is expensive and uncomfortable. To overcome these limitations, this study proposes an unconstrained wearable monitoring system with stretch-fiber sensors that integrate with the wearer's clothing. The system allows patients to undergo examinations in a familiar environment while minimizing the occurrence of skin allergies caused by adhesive tools. As smart clothing for adult males with sleep apnea, long-sleeved T-shirts embedding fibrous sensors were developed, enabling real-time monitoring of the patients' breathing rate, oxygen saturation, and airflow as sleep apnea diagnostic indicators. The gauge factor was measured as 20.3 in sample 4. The maximum breathing intake, measured during three large breaths, was 2048 ml. the oxygen saturation was measured before and during breath-holding. The oxygen saturation change was 69.45%, showing a minimum measurable oxygen saturation of 70%. After washing the garment, the gauge factor reduced only to 18.0, confirming the durability of the proposed system. The wearable sleep apnea monitoring smart clothes are readily available in the home and can measure three indicators of sleep apnea: respiration rate, breathing flow and oxygen saturation.

• Clinical and Experimental Pediatrics
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• v.55 no.6
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• pp.212-214
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• 2012

Rubinstein-Taybi syndrome (RTS) is characterized by peculiar facies, mental retardation, broad thumbs, and great toes. Approximately one-third of the affected individuals have a variety of congenital heart diseases. They can also have upper airway obstruction during sleep, due to hypotonia and the anatomy of the oropharynx and airway, which make these patients susceptible to obstructive sleep apnea (OSA). In our case, pulmonary hypertension was caused, successively, by congenital heart defects (a large patent ductus arteriosus and arch hypoplasia) and obstructive sleep apnea during early infancy. The congenital heart defects were surgically corrected, but persistent pulmonary hypertension was identified 2 months after the operation. This pulmonary hypertension was due to OSA, and it was relieved by nasal continuous positive airway pressure. This case is the first report of pulmonary hypertension from OSA in a young infant with RTS.