• Sleep Medicine and Psychophysiology
• /
• v.24 no.1
• /
• pp.32-37
• /
• 2017

Objectives: A supine sleep position increases sleep apneas compared to non-supine positions in obstructive sleep apnea syndrome (OSAS). However, supine position time (SPT) is not highly associated with apnea-hypopnea index (AHI) in OSAS. We evaluated the correlation among sleep-related variables and SPT in OSAS. Methods: A total of 365 men with OSAS were enrolled in this study. We analyzed how SPT was correlated with demographic data, sleep structure-related variables, OSAS-related variables and heart rate variability (HRV). Multiple linear regression analysis was conducted to investigate the factors that affected SPT. Results: SPT had the most significant correlation with total sleep time (TST ; r = 0.443, p < 0.001), followed by sleep efficiency (SE ; r = 0.300, p < 0.001). Snoring time (r = 0.238, p < 0.001), time at < 90% SpO2 (r = 0.188, p < 0.001), apnea-hypopnea index (AHI ; r = 0.180, p = 0.001) and oxygen desaturation index (ODI ; r = 0.149, p = 0.004) were significantly correlated with SPT. Multiple regression analysis revealed that TST (t = 7.781, p < 0.001), snoring time (t = 3.794, p < 0.001), AHI (t = 3.768, p < 0.001) and NN50 count (t = 1.993, p = 0.047) were associated with SPT. Conclusion: SPT was more highly associated with sleep structure-related parameters than OSAS-related variables. SPT was correlated with TST, SE, AHI, snoring time and NN50 count. This suggests that SPT is likely to be determined by sleep structure, HRV and the severity of OSAS.

• Journal of Nutrition and Health
• /
• v.35 no.1
• /
• pp.60-68
• /
• 2002

Purpose of this study was to compare serum phospholipid fatty acid composition of obese children with that of normal weight children reside in Kangnung area. Subjects were consisted of 56(41 boys and 15 girls) moderately or severely obese elementary school children, and age and sex-matched normal weight children as a control group. Level of serum phospholipid fatty acids was measured by thin layer chromatography(TLC) followed by gas chromatography(GLC). for male subjects, serum triglyceride(121 $\pm$ 4.7mg/dl) and total cholesterol(180 $\pm$ 37.1mg/dl) concentrations were significantly(p < 0.05) higher in obese group than those for control group(81.5 $\pm$ 2.5mg/dl and 161 $\pm$ 32.0mg/dl, respectively). Obese group showed significantly higher percentage of serum phospholipid myristic acid(C14:0) than the value for control group in both male and female subjects. Obese male subjects had significantly higher percentages of palmitoleic acid(16 : 1), oleic acid(18 : 1), dihomo-${\gamma}$-linoleic acid(20 : 3, $\omega$6) and docosatetraenoic acid(22 : 4, $\omega$6), and lower percentages of eicosenoic acid(20 : 1, $\omega$6), docosapentaenoic acid(22 : 5, $\omega$6), EPA(22 : 5, $\omega$3) and DHA (22 : 6, $\omega$3) compared to values for control male subjects. For male subjects, obese group showed significantly higher ratios of 16 : 1($\omega$9)/16 : 0 and 18 : 1($\omega$9)/18 : 0, and significantly lower ratios of 22 : 5($\omega$6)/22 4($\omega$6), and 22 : 6($\omega$3)/22 : 5($\omega$3) compacted to values for the control group. But there was not significant differences in elongation and desaturation indices of serum phospholipids fatty acid metabolism between obese and control group in female subjects. Most of anthropometric measurements related to obesity were negatively correlated with the percentages of PUFA, $\omega$3 fatty acids or DHA(22 : 6, $\omega$3), and positively correlated with the percentage of myristic acid(14 : 0) or $\omega$6/$\omega$3 ratio in serum phospholipids. Serum triglyceride concentration was negatively correlated with the percentage of PUFA or $\omega$3 fatty acids, and positively correlated with $\omega$6/$\omega$3 ratio in serum phospholipids. These results indicate that obesity related changes in blood lipid levels and metabolism are more significant in male subjects than in female subjects. Also changes in serum phospholipid fatty acid composition observed in obese children appear to demonstrate the increased susceptibility of these children to cardiovascular disease and other related chronic diseases.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.33 no.10
• /
• pp.1626-1633
• /
• 2004

In recent, the roles of oleic acid, most abundant fatty acid in myelin, were investigated in relation to the brain functions. This study examined the effects of diets either with desirable ratios of $\omega$6/ $\omega$9 and P/M/S (mixed oil-fed group: MO) or with defficient in $\omega$3 series fatty acids (safflower oil-fed group: SO) on the oleic acid composition in RBC and brain synaptosomal, mitochondrial & microsomal phospholipids. The desirable fatty acid composition was computer-searched with different fats and oils to meet right ratios of both $\omega$6/ $\omega$3 and P/M/S. Diets were fed 3 weeks before conception and new-born pups were fed maternal milk from the same mothers and same diets until 9 wks of age. At 3 wks of age, the compositions of oleic acid in brain subcellular fractions and red blood cells were constantly remained whatever the composition of dietary fatty acids. But at 9 wks of age, the composition of oleic acid in synaptosome and mitochondria were significantly higher in MO group than SO group. The composition of oleic acid in milk was significantly higher in MO group than SO group, but in case of SO group, that of oleic acid was increased by 48%, in comparison with dietary fatty acid compositions. -9 desaturase index (18:0\longrightarrow8:1) of brain synaptosome was significantly higher in MO group than SO group at 3 and 9 weeks of ages, but that of brain microsome was higher in SO group than MO group at 9 wks of age. Taken together, the presences of oleic acid in the diet was important to maintain brain functions. The origins of oleic acid in brain may suggests two hypotheses; first, the central nervous system has priority for the uptake of oleic acid, and second the nervous system can synthesize all the oleic acid it needs, independently of its presence in the diet.

• Journal of the korean academy of Pediatric Dentistry
• /
• v.47 no.4
• /
• pp.377-388
• /
• 2020

The aim of this study was to evaluate the association between various predicting tools and Apnea-Hypopnea Index (AHI) to identify children with sleep disordered breathing (SDB). From 5 to 10 years old who came for orthodontic counseling, 61 children, whom had lateral cephalograms, pediatric sleep questionnaire (PSQ) records, and portable sleep monitoring results, were included in this study. A total of 17 measurements (11 distances and 6 angles) were made on lateral cephalograms. The measurements of lateral cephalograms, PSQ scales and portable sleep monitoring results were statistically analyzed. 49 of 61 (80%) patients showed AHI > 1, which suspected to have SDB and their mean AHI was 2.75. In this study, adenoid size (A/N ratio), position of the hyoid bone from mandibular plane, gonial angle, and PSQ scale were related to a higher risk of pediatric SDB. Also, oxygen desaturation index (ODI) and snoring time from sleep monitoring results were statistically significant in children with SDB using Mann-Whitney test (p < 0.05). In conclusion, evaluation of hyoid bone position, adenoidal hypertrophy, gonial angle in lateral cephalogram, and PSQ scale was important to screen out potential SDB, especially in children with frequent snoring.

• Korean Journal of Clinical Laboratory Science
• /
• v.45 no.2
• /
• pp.73-76
• /
• 2013

Uvulopalatopharyngoplasty (UPPP) is one possibility for the treatment of Obstructive Sleep Apnea (OSA). The aim of this study was study the analysis of polysomnography of pre-UPPP and post-UPPP. All patients were evaluated by means of a physical examination, the epworth sleepiness scale (ESS), the beck depression inventory (BDI) and the nocturnal polysomnography (PSG) before surgery, and 6~12 months after surgery. A total of 15 patients were investigated. All underwent UPPP. The patients were between 26 and 62 years old ($mean{\pm}SD$; $39.7{\pm}10.9$) with a lean body mass index (BMI) of $mean{\pm}SD$; $26.2{\pm}3.0kg/m^2$. The comparison of sleep questionnaires showed that after UPPP, the patients had a significantly lower BMI ($26.2{\pm}3.0kg/m^2$ vs $26.0{\pm}3.4kg/m^2$, p=0.241), ESS ($10.0{\pm}5.4$ vs $6.9{\pm}3.2$, p=0.022), BDI ($9.2{\pm}8.2$ vs $4.2{\pm}4.3$, p=0.343) and higher blood pressure ($127.5{\pm}12.1$ vs $123.7{\pm}12.0$, p=0.272) compared to before UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly lower stage N1 ($108.8{\pm}53.1$ vs $82.2{\pm}48.9$, p=0.016), lower sleep latency ($4.9{\pm}4.4$ vs $2.0{\pm}1.7$, p=0.083), a lower total arousal number ($210.6{\pm}90.3$ vs $147.1{\pm}87.3$, p=0.019), lower oxygen desaturation index (ODI) ($30.2{\pm}20.9$ vs $10.2{\pm}15.1$, p=0.006), lower apnea-hypopnea index (AHI) ($31.6{\pm}22.4$ vs $10.9{\pm}15.4$, p=0.005), and a lower respiratory disturbance index (RDI) ($37.4{\pm}21.3$ vs $18.5{\pm}16.5$, p=0.008) compared to after UPPP. The comparison of sleep parameters showed that after UPPP, patients had a significantly higher stage N2 ($154.0{\pm}39.9$ vs $180.5{\pm}49.5$, p=0.017), higher REM ($58.5{\pm}29.7$ vs $72.6{\pm}34.0$, p=0.249), higher $meanSaO_2$ ($94.3{\pm}2.0$ vs $95.9{\pm}0.9$, p=0.043), and higher $meanSaO_2$ ($79.3{\pm}8.5$ vs $83.1{\pm}7.9$, p=0.116) than before UPPP. After UPPP, 6 patients were cured, 2 showed marked improvement, and 7 did not improve. After surgery, the success of the treatment was at 53%. The subjective patient satisfaction was higher than before the surgery.

• Sleep Medicine and Psychophysiology
• /
• v.15 no.2
• /
• pp.71-76
• /
• 2008

Introduction: In this study, we compared sleep structure, EEG characteristic of pediatric obstructive sleep apnea (OSA) and normal controls which were matched in sex and age. Methods: Fifteen children (male：female=4：11) who complained snoring and were suspected to have sleep apnea and their age and sex matched normal controls (male：female=5：10) have been done nocturnal polysomnography (NPSG). Sleep parameters, sleep apnea variables and relative spectral components of EEG from NPSG have been compared between both groups. Results: Pediatric OSA group were distinguished from normal controls in terms of apnea index, respiratory disturbance index and nadir of oxyhemoglobulin desaturation. Pediatric OSA group showed increased percent of sleep stage 1, decreased rapid eye movement sleep percent and increased delta power in O1 EEG channel. However other sleep parameters and spectral powers were not different between two groups. Conclusion: In pediatric OSA group, sleep structure parameter disruption may be not prominent as the previous studies for adult OSA group because of including mild OSA data in diagnostic criteria. In addition, EEG changes might not be distinct due to low arousal index compared to adult OSA patients. We can observe general characteristics and particularity of pediatric OSA through this study.

• Korean Journal of Clinical Laboratory Science
• /
• v.39 no.2
• /
• pp.141-146
• /
• 2007

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a disorder characterized by the repetitive collapse of the pharyngeal airway during sleep, which leads to oxygen desaturation, sleep fragmentation, daytime sleepiness, and increased risk for hypertension and stroke. We investigated the clinical factors related to the severity of OSAHS. Polysomnography was performed in three hundred and ninety five consecutive adult patients with clinical symptoms of obstructive sleep apnea syndrome. All patients completed the sleep questionnaire and the Epworth Sleepiness Scale before polysomnography. Patients were classified into four groups based on the severity of their polysomnographic data: Non-OSA group, characterized by Apnea-Hypopnea Index (AHI) < 5; mild OSA group, by AHI 5-15; moderate OSA group, by AHI 16-30; and severe OSA group, by AHI > 30. Neck circumference was also measured at the cricothyroid level. A total of 395 patients (336 men and 59 women) were studied. In the non-OSA group, there were 55 patients; their mean neck circumference was $39.63{\pm}4.24cm$ and mean BMI was $24.48{\pm}3.53$. In the mild group, there were 101 patients; their mean neck circumference was $41.93{\pm}3.75cm$ and mean BMI was $25.33{\pm}2.94$. In the moderated group, there were 93 patients; their mean neck circumference was $43.27{\pm}3.50cm$ and BMI was $25.90{\pm}2.88$. In the severe group, there were 146 patients; their mean neck circumference was $44.94{\pm}3.93cm$ and mean BMI was $26.81{\pm}3.76$. Men had significantly larger neck circumference than women ($Mean{\pm}SD$, $43.72{\pm}3.83$ vs $39.17{\pm}4.30$, p < 0.001), and higher AHI than women ($29.12{\pm}22.65$ vs $14.63{\pm}14.11$, p < 0.001). Multiple regression analysis revealed that neck circumference was the most significant predictor of AHI. Neck circumference and BMI were positively correlated with the severity of OSAHS. The severity of OSAHS was greater in men than in women.

• Archives of Plastic Surgery
• /
• v.43 no.6
• /
• pp.506-511
• /
• 2016

Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5-70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of $19.2{\pm}5.3events/hour$, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.

• Journal of Nutrition and Health
• /
• v.33 no.7
• /
• pp.745-754
• /
• 2000

Effects of oral taurine supplementation (6g/day)for 2-4 weeks on activities of red blood cell(RBC)total superoxide dismutase (SOD) and plasma glutathione peroxidase(GSH-Px) and the level of malondialdehyde(MDA) were evaluated in healthy female adults (23.6$\pm$0.3 years old). Compared to the value for 0 week plasma GSH-Px activity of the subjects was significantly lower after 2 weeks of taurine supplementation(p<0.05) and recovered to the value similar to 0 week after 4 weeks of taurine supplementation. RBC total SOD activity tended to be decreased after 2 weeks of taurine supplmentation compared to the values for 0 week although the difference between the means of the two group was not statistically significant. Plasma MDA level was not significantly decreased by taurine supplementation most probably due to the fact that the subjects participated in the present study were healthy and their antioxidant defense system had been in the 'normal' range. Plasma MDA concentration was negatively correlated with plasma taurine concentration(r=-0.2003m p<0.05) but tended to be positively correlated with plasma cholesterol concentration(r=0.2465, p=0.0645) as expected Plasma GSH-Px activity was positively associated with the percentage of 22:0 (r=0.2892, p<0.05) or 20:4w6(r=0.2939, p<0.05). On the other hand plasma MDA concentration was positively correlated with the percentage of 20:5w3 in plasma total lipids(r=0.2635 p<0.05) and negatively correlated with $\Delta$5 desaturation index of w6 fatty acids(20:3w6⇒20:4w6) in plamsa total lipids(r=-0.2714, p<0.05) as well as in phospholipids(r=-0.2864, p<0.05). From these results protective effect of taurine supplementation against lipid peroxidation and antioxidant defense system in humans appears to be minimal when the subjects are in a relatively healthy state. Further studies concerning the antioxidant efficacy of taurine should be conducted in human subjects under various disease states related to oxidative stress such as diabetes and artheroxclerosis.

• Tuberculosis and Respiratory Diseases
• /
• v.82 no.4
• /
• pp.335-340
• /
• 2019

Background: Snoring is the cardinal symptom of obstructive sleep apnea (OSA). Snoring and upper airway obstruction associated with major oxygen desaturation may occur in populations undergoing flexible bronchoscopy. Methods: To evaluate the prevalence of patients at a high risk of having OSA among patients undergoing bronchoscopy with sedation and to investigate whether snoring during the procedure predicts patients who are at risk of OSA, we prospectively enrolled 517 consecutive patients who underwent the procedure with moderate sedation. Patients exhibiting audible snoring for any duration during the procedure were considered snorers. The STOP-Bang (Snoring, Tiredness, Observed apnea, high blood Pressure-Body mass index, Age, Neck circumference and Gender) questionnaire was used to identify patients at high (score ${\geq}3$ out of 8) or low risk (score <3) of OSA. Results: Of the 517 patients, 165 (31.9%) snored during bronchoscopy under sedation. The prevalence of a STOP-Bang score ${\geq}3$ was 61.9% (320/517), whereas 200 of the 352 nonsnorers (56.8%) and 120 of the 165 snorers (72.7%) had a STOP-Bang score ${\geq}3$ (p=0.001). In multivariable analysis, snoring during bronchoscopy was significantly associated with a STOP-Bang score ${\geq}3$ after adjustment for the presence of diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and stroke (adjusted odds ratio, 1.91; 95% confidence interval, 1.26-2.89; p=0.002). Conclusion: Two-thirds of patients undergoing bronchoscopy with moderate sedation were at risk of OSA based on the screening questionnaire. Snoring during bronchoscopy was highly predictive of patients at high risk of OSA.