• Title/Summary/Keyword: RDI

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Relationship between Depressive Symptoms and Sleep Parameters in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 환자의 우울증상 정도에 따른 수면 양상)

  • Won, Chang-Yeon;Lee, Seung-Hee;So, Min-Ah;Lee, Jin-Sung;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.14 no.2
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    • pp.92-98
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    • 2007
  • Objectives: Obstructive sleep apnea syndrome (OSAS) is the most common form of sleep-disordered breathing and often presents with comorbid depressive symptoms. In this study, we evaluated the relationship between depressive symptoms and sleep parameters as measured by nocturnal polysomnography (NPSG) and simultaneous wrist actigraphy. Methods: Two hundred sixty-four subjects with clinically suspected cases of OSAS underwent one-night polysomnography, while simultaneously wearing a wrist actigraphy device. They also completed two questionnaires;the Epworth Sleepiness Scale-Korean version (ESS-K) and the Beck Depression Inventory (BDI). Of the cases studied, 105 subjects were proven by NSPG to have OSAS without other sleep disorders. NPSG and wrist actigraphy data from the subjects were analyzed. Pearson correlation and paired t-test were used in order to evaluate the relationship between depressive symptoms and sleep-parameters. Results: Mean age of the subjects was $46.1{\pm}13.1$ years. Means of the ESS-K score and BDI scores were $10.9{\pm}4.7$ and $12.8{\pm}8.1$, respectively. NPSG sleep parameters significantly differed from those of wrist actigraphy. There was no correlation found between subjects' respiratory disturbance index (RDI) and BDI scores. When directly comparing sleep parameters between subjects who were more depressed versus subjects who were less depressed, both total sleep time and sleep efficiency were decreased in the more depressed. A correlation between RDI and ESS-K scores was also found in the more depressed group. Conclusions: Although our findings suggest that there is no relationship between RDI and depressive symptoms, there are other significant differences in the sleep parameters between subjects who are more depressed versus those without depression. We recommend that patients with depression should also be evaluated for clinical symptoms of OSAS.

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Characteristics of Sleep Apnea Syndrome in the Elderly in a Clinical Setting (나이에 따른 수면무호흡증 임상적 특성의 변화)

  • Shin, Yoon-Kyung;Yoon, In-Young;Hong, Min-Chul;Yun, Yong-Don
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.39-44
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    • 2005
  • Objectives: Much attention has been paid to sleep apnea syndrome (SAS) in the elderly because of its high prevalence. It is expected that SAS in the elderly has both similarities and differences compared to SAS in the young or middle-aged populations. The aim of this study was to elucidate the characteristics and consequences of SAS in the elderly. Methods: In this study we included 210 young or middle-aged adults between 23 and 59 years (20 women and 190 men) and 65 older adults between 60 and 83 years of age (16 women and 49 men). Respiratory disturbance indices (RDIs) of the study subjects were more than 5 in an overnight polysomnography. They completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Informations about body mass index (BMI), neck, waist, and hip measurements, and blood pressure were obtained. Results: No difference was observed between older adults with SAS (older SAS) and adults aged under 60 with SAS (SAS aged under 60) in RDI, apnea index, % time of oxygen saturation less than 90%, and PSQI. Obstructive apnea index and oxygen desaturation index (ODI) were lower in older SAS. Compared to SAS aged under 60, lowest oxygen saturation and central apnea index were higher in older SAS, but they were statistically not significant. BMI and neck circumference were significantly lower in older SAS compared to SAS aged under 60. Diastolic blood pressure was lower in older SAS compared to SAS aged under 60 with no difference in systolic blood pressure. Older SAS showed lower scores in ESS than SAS aged under 60. Significant correlation was observed between RDI and BMI in SAS aged under 60, but not in the case of older SAS. The relationships between RDI and neck circumference, systolic and diastolic pressure, and ESS were similar. Conclusions: The elderly with SAS were not over-weight and there was no relationship between body weight and the severity of SAS. Also, the behavioral and cardiovascular effects of SAS were not marked in the elderly, which might be partly explained by decreased ODI and relatively higher lowest oxygen saturation in older SAS. The normal aging process, aside from increased body weight, might contribute to the development of SAS in the elderly with modest complications.

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A Study on the Efficacy and Compliance of Oral Appliances according to the Severity of Apnea in the Treatment of Snoring and Obstructive Sleep Apnea (코골이와 폐쇄성수면무호흡증 환자에서 무호흡 심도에 따른 구강내 장치의 치료효과 및 환자의 적응도에 관한 연구)

  • 안홍균;이광호;정성창
    • Journal of Oral Medicine and Pain
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    • v.23 no.4
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    • pp.419-432
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    • 1998
  • The purpose of this Study was to examine the efficacy and compliance of a mandibular advancement device(MAD) according to the severity of sleep apnea in the snorers and obstructive sleep apnea patients. Fifty-four patients (45 males, 9 females, aged 20 - 68years ) who visited Seoul National Uiversity Dental Hospital(SNUDH) to seek for the treatment of snoring and sleep apnea were classified into four groups according to the results of the nocturnal polysomnography and they were instructed to wear MAD regularly which was designed to increase the size of the upper airway by advancing the mandible. The evaluation of the efficacy and compliance of the MAD according to the severity of apnea and the duration after the usage of MAD ( 1week, 1month, 3months, 6months, 12months) was made by using quesionnaires mad in Department of Oral Medicine and Oral diagnosis, SNUDH. The obtained results were as follows : 1. All subjects results were habitual snoreres and 43 patients(79.6%) complained the loudness of snoring that can be heard out of the room. 2. Apnea index(AI) of the total subjects was mean 29.4$\pm$26.9 and respiratory disturbance index(RDI)was mean 37.6$\pm$28.0. And there was nodifference in the efficacy and the compliances of MAD according to the severity of apnea. 3. The severityi of apnea by the questionnaires significantly corresponded with the results of nocturnal polysomnography, and this fact potentiated the diagnostic value of the questionnaire. 4. after the usage of MAD, there was significant improvement in the frequency of snoring, the loudness of snoring, frequency of apnea, daytime sleepiness nad the refreshment after sleep(p<0.001) regardless of the apnea index(AI) and respiratory distrubance index(RDI). 5. The degree of the satisfaction with MAD was mean 74.4$\pm$18.4% and that of the discomfort with the MAD was 31.4$\pm$19.6%. But there was no serious complication in occlusion and temporomandibular joint with the usage of MAD and the duration of the discomfort was mean 3.3$\pm$2.2 weeks. 6. Forty-one patients(75.9%) continued the usage of MAD but thirteen patients(24.1%) stopped the use of MAD because of the discomforts and insufficient results with it.

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A Case of REM-Dependent Obstructive Sleep Apnea Syndrome (REM 수면 의존성 폐쇄성 수면무호흡증후군 1례)

  • Lee, Ju-Young;Jeong, Do-Un
    • 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.

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Preliminary Study of The Periodic Limb Movement Disorder Following Nasal CPAP : Is It Associated With Supine-Sleeping Position? (지속적 양압술과 수면중 주기적 사지운동 장애의 관계에 대한 예비적 연구 : 앙와위가 주기적 사지운동 장애와 관련되는가?)

  • Yang, Chang-Kook;Clerk, Alex A
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.164-171
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    • 1997
  • Introduction : Periodic limb movement disorder (PLMD) is shown to common in patients with OSA and may become evident or worsened when treated with nasal continuous positive airway pressure (CPAP). Whether this is due to im proved sleep continuity. adverse nocturnal body positioning, uncovered by CPAP, or due to the CPAP stimulus is still debat-ed. We hypothesized that the increase in PLM activity following CPAP is associated with more supine-sleeping tendencies when being treated with CPAP. In the present work, we compared differences in the PLMD index (PLMI) and sleeping position of patients with sleep disordered breathing before and after CPAP treatment. Method : We studied 16 patients (mean age 46 yr, 9M, 7F) with OSA (11 patients) or UARS (5 patients) who either had PLMD on initial polysomnogram (baseline PSG) or on nasal CPAP trial (CPAP PSG). All periodic leg movements were scored on anterior tibialis EMG during sleep according to standard criteria (net duration; 0.5-5.0 seconds, intervals; 4-90 seconds. 4 consecutive movements). Paired t-tests compared PLMD index (PLMI), PLMD-related arousal index (PLMD-ArI), respiratory disturbance index (RDI), and supine sleeping position spent with baseline PSG and CPAP PSG. Results : Ten patients (63%) on baseline PSG and fifteen patients (94%) on CPAP PSG had documented PLMD ($PLMI{\ge}5$) respectively with significant increase on CPAP PSG(p<0.05). Ten patients showed the emergence (6/10 patients) or substantial worsening (4/10 patients) of PLMD during CPAP trial. Mean CPAP pressure was $7.6{\pm}1.8\;cmH_2O$. PLMI tended to increase from baseline PSG to CPAP PSG, and significantly increase when excluding 2 outlier (baseline PSG, $19.0{\pm}25.8/hr$ vs CPAP PSG, $29.9{\pm}12.5/hr$, p<0.1). PLMD-ArI showed no significant change, but a significant decrease was detected when excluding 2 outlier (p<0.1). There was no significant sleeping positional difference (supine vs non-supine) on baseline PSG, but significantly more supine position (supine vs non-supine, p<0.05) on CPAP PSG. There was no significant difference in PLMI during supine-sleeping and nonsupine-sleeping position on both of baseline PSG and CPAP PSG. There was also no significant difference in PLMI during supine-sleeping position between baseline PSG and CPAP PSG. With nasal CPAP, there was a highly significant reduction in the RDI (baseline PSG, $14.1{\pm}21.3/hr$ vs CPAP PSG, $2.7{\pm}3.9/hr$, p<0.05). Conclusion : This preliminary data confirms previous findings that CPAP is a very effective treatment for OSA, and that PLMD is developed or worsened with treatment by CPAP. This data also indicates that supine-sleeping position is more common when being treated with CPAP. However, there was no clear evidence that supine position is the causal factor of increased PLMD with CPAP. It is, however, suggested that the relative movement limitation induced by CPAP treatment could be a contributory factor of PLMD.

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Development of Naïve-Bayes classification and multiple linear regression model to predict agricultural reservoir storage rate based on weather forecast data (기상예보자료 기반의 농업용저수지 저수율 전망을 위한 나이브 베이즈 분류 및 다중선형 회귀모형 개발)

  • Kim, Jin Uk;Jung, Chung Gil;Lee, Ji Wan;Kim, Seong Joon
    • Journal of Korea Water Resources Association
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    • v.51 no.10
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    • pp.839-852
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    • 2018
  • The purpose of this study is to predict monthly agricultural reservoir storage by developing weather data-based Multiple Linear Regression Model (MLRM) with precipitation, maximum temperature, minimum temperature, average temperature, and average wind speed. Using Naïve-Bayes classification, total 1,559 nationwide reservoirs were classified into 30 clusters based on geomorphological specification (effective storage volume, irrigation area, watershed area, latitude, longitude and frequency of drought). For each cluster, the monthly MLRM was derived using 13 years (2002~2014) meteorological data by KMA (Korea Meteorological Administration) and reservoir storage rate data by KRC (Korea Rural Community). The MLRM for reservoir storage rate showed the determination coefficient ($R^2$) of 0.76, Nash-Sutcliffe efficiency (NSE) of 0.73, and root mean square error (RMSE) of 8.33% respectively. The MLRM was evaluated for 2 years (2015~2016) using 3 months weather forecast data of GloSea5 (GS5) by KMA. The Reservoir Drought Index (RDI) that was represented by present and normal year reservoir storage rate showed that the ROC (Receiver Operating Characteristics) average hit rate was 0.80 using observed data and 0.73 using GS5 data in the MLRM. Using the results of this study, future reservoir storage rates can be predicted and used as decision-making data on stable future agricultural water supply.

CEPHALOMETRIC STUDY OF OBSTRUCTIVE SLEEP APNEA PATIENTS IN THE UPRIGHT AND SUPINE POSITIONS

  • Kim, Jong-Chul;Lowe, Alan A
    • The korean journal of orthodontics
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    • v.25 no.6 s.53
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    • pp.655-664
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    • 1995
  • Sixty male patients with polysomnographically documented OSA were included in this study. A pair of cephalograms were obtained in the upright and supine positions. In the supine position, the ANB angle, lower facial height and the cross-sectional area of soft palate increased and there was a decrease in the vertical airway length and oropharynx cross-sectional area. Positional changes did not affect the cross-sectional area of tongue, but the cross-sectional area of the oropharynx decreased in the supine position. The obese group had higher AI and RDI. Maxillary unit length, C3-H, the cross-sectional areas of tongue, soft palate and oropharynx were significantly greater in the group Obese than in non-obese group. No correlation was noted between the mandibular unit length and OSA severity, The group of small mandibular unit length showed shorter lower facial height and maxillary unit length, and smaller cross-sectional area of tongue than the long mandibular unit length group. Hyold bone positioned more inferiorly and cross-sectional area of nasopharynx decreased as the OSA severity increased.

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Development of Web-GIS Based Agricultural Drought Information System for Agricultural Water Management (농촌용수관리를 위한 Web 및 GIS 기반 농업가뭄정보시스템 개발)

  • Nam, Won-Ho;Choi, Jin-Yong;Yoo, Seung-Hwan;Jang, Min-Won;Ko, Kwang-Don
    • Proceedings of the Korea Water Resources Association Conference
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    • 2009.05a
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    • pp.236-239
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    • 2009
  • 우리나라는 계절적으로 편중된 강우특성 때문에 가용 수자원이 충분하지 않고 최근엔 빈번하게 발생하는 이상기후현상과 국지성기후로 인해 가뭄의 빈도 및 강도가 증대되고 있어 기후변화에 적응할 수 있는 농촌용수 물관리 대책과 가뭄대응능력 개선의 필요성이 요구되고 있다. 이러한 가뭄의 관리를 위해서는 시간적인 가뭄의 발생과 공간적인 가뭄의 분포를 파악하여 적절한 가뭄평가 수단을 통한 가뭄대책 수립기준을 설정하고 이에 대한 대책방안을 마련하여 각 지역별 특성에 맞는 가뭄대책을 수립해야 한다. 따라서 본 연구에서는 농업가뭄을 극복하고 농촌수자원의 안정적 확보와 효율적인 이용을 위해서 농업가뭄 상황을 분석하고 평가할 수 있으며 농업가뭄대책의 수립과 시행을 뒷받침할 수 있는 Web 및 GIS 기반농업가뭄관리시스템을 제안하고자 한다. 기존의 개발된 토양수분지수(Soil Moisture Index, SMI)와 저수지가뭄지수(Reservoir Drought Index, RDI)를 통합한 통합농업가뭄지수(Integrated Agricultural Drought Index, IADI)을 이용하여 다양한 시나리오를 통해 가뭄의 여러 가지 패턴에 따른 지역별 농업가뭄의 위험과 예측 피해를 설명하고, 가뭄관리에 필요한 정보를 단계적으로 제공함으로써 실제 물 관리 및 가뭄대책 업무에 반영하고 적절한 대응책을 수립하는데 기초자료가 될 것으로 판단된다.

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Induction of Non-Diapause Eggs and Manifestation of Quantitative Characters by Low Temperature Incubation of Eggs in the Silkworm, Bombyx mori L.

  • Singh, Ravindra;Jayaswal, K.P.;Rao, D.Raghavedra;Kariappa, B.K.;Premalatha, V.
    • International Journal of Industrial Entomology and Biomaterials
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    • v.4 no.2
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    • pp.149-153
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    • 2002
  • Induction of non-diapause eggs and manifestation of quantitative characters were studied in different seasons by low temperature incubation of eggs of a low yielding diapause with coloured cocoons silkworm breed, RDI of Bombyx mori. Hundred percent of nandiapause eggs were induced when the egg incubation was carried out at 15$^{\circ}C$ followed by incubation initially at $25^{\circ}C$ and then at $15^{\circ}C$. The diapause-nondia-pause relation was found to be reversible. Analysis of variance study demonstrated significant variation in all the quantitative characters whereas significant variation due to different incubation treatments was observed for larval span, fifth instar larval span, cocoon yield/10,000 larvae by weight, cocoon weight, cocoon shell weight, and cocoon shell ratio. study on hybrid vigour skewed significant heterosis over mid parent value for four economic characters viz., cocoon weight, cocoon shell weight, cocoon shell ratio and filament length in a Fl hybrid between RD1 with diapause eggs and Japanese type bivoltine $NB_{4} D_{2}$.

A Case Report on Treatment of Obstructive Sleep Apnea Patient Using Intraoral Removable Appliance (구강내 장치를 이용한 수면 무호흡 환자의 치료 증례)

  • Kang, Kook-Jin;Oh, Kang-Seob;Lee, Si-Hyung
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.210-215
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    • 1998
  • OSA(Obstructive Sleep Apnea) is a condition with repeated obstruction of the upper airway while sleeping. This obstruction of the upper airway may result if sleep-induced physiologic change in muscle activity is superimposed on various structural defects of the upper airway. Macroglossia, micrognathia, retrognathia, and decreased airway lumen have all been implicated in OSA. There are a variety of surgical and nonsurgical treatment modalities currently available for OSA. Recently the uvulopalatopharyngoplasty has achieved widespread use, but success rates vary and long-term effects are still unknown. Current nonsurgical treatment methods can be cumbersome and uncomfortable with variable responses. For this case. we diagnosed as OSA by using polysomnographic analysis and cephalometric analysis, and delivered intraoral removable appliance which is more conservative, reversible and easy to use for patient. And we got results that Apnea Index(AI) decreased from 14.4 to 3.1, Total Respiratory Disturbance Index(Total RDI) decreased from 18.1 to 7.0 and removal of chronic headache in daytime.

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