• Journal of Oral Medicine and Pain
• /
• v.37 no.4
• /
• pp.213-219
• /
• 2012

Oral appliances are a primary treatment option for snoring and mild to moderate obstructive sleep apnea (OSA) and are considered as an alternative for patients with severe OSA who have failed continuous positive airway pressure (CPAP) or upper airway surgery. But it is true that OAs have varying degrees of effectiveness depending on different oral appliances and the efficacy of OAs are established in some but not all patients. New oral appliance, which is one of Adjustable Anterior Positioners, was developed by Dept of Oral Medicine, Dental School, Dankook University. This is a report for treating severe OSA patient with a failure of previous uvulopalatopharyngoplasty using a new Adjustable Anterior Positioner, followed by significant success of controlling OSA.

• Clinical and Experimental Pediatrics
• /
• v.53 no.10
• /
• pp.872-879
• /
• 2010

Obstructive sleep apnea (OSA) in children is a frequent disease for which optimal diagnostic methods are still being defined. Treatment of OSA in children should include providing space, improving craniofacial growth, resolving all symptoms, and preventing the development of the disease in the adult years. Adenotonsillectomy (T&A) has been the treatment of choice and thought to solve young patient's OSA problem, which is not the case for most adults. Recent reports showed success rates that vary from 27.2% to 82.9%. Children snoring regularly generally have a narrow maxilla compared to children who do not snore. The impairment of nasal breathing with increased nasal resistance has a well-documented negative impact on early childhood maxilla-mandibular development, making the upper airway smaller and might lead to adult OSA. Surgery in young children should be performed as early as possible to prevent the resulting morphologic changes and neurobehavioral, cardiovascular, endocrine, and metabolic complications. Close postoperative follow-up to monitor for residual disease is equally important. As the proportion of obese children has been increasing recently, parents should be informed about the weight gain after T&A. Multidisciplinary evaluation of the anatomic abnormalities in children with OSA leads to better overall treatment outcome.

• Journal of Korean Biological Nursing Science
• /
• v.18 no.3
• /
• pp.135-143
• /
• 2016

Purpose: This study was conducted to identify the factors associated with obstructive sleep apnea (OSA) risk in patients with metabolic syndrome (MS). Methods: Patients with MS between 30 and 74 years of age were recruited in an outpatient clinic of a cardiovascular center in Seoul, South Korea. MS and the risk of OSA were evaluated by Berlin questionnaire survey, the medical records of the participants were reviewed and a comprehensive lifestyle survey was performed. SPSS WIN 21.0 was used for statistical analysis. Results: BMI (OR: 1.31, CI: 1.14-1.51, p<.001) and lifestyle score (OR: 0.96, CI: 0.93-0.99, p=.028) were associated with the risk of OSA. Physical activity, weight control and diet were specifically associated with the risk of OSA after controlling for age, gender and BMI. Conclusion: This study demonstrated that lifestyle was an important factor associated with OSA risk in patients with MS.

• The korean journal of orthodontics
• /
• v.27 no.6 s.65
• /
• pp.865-870
• /
• 1997

The submental region in patients with Obstructive Sleep Apnea (OSA) is Perceived to be larger than normal. Therefore, neck thickness has become a variable routinely measured during clinical screening of OSA subjects. In general, OSA Patients are believed to have a large tongue and a narrow airway. To test if OSA patients have a larger face and tongue than non-apneics, eighty pairs of upright and supine cephalograms were obtained from four groups of subjects subclassified in accordance with severity. The sum of distances between pairs of landmarks was calculated for each subjects and employed as a pure size variable for the face and tongue. Only tongue size becomes larger in accordance with apnea severity in both body positions (P<.01). Tongue size reflects apnea severity, yet it Provides only a small fraction of the explanation with regard to apnea severity. We conclude that size may be one factor of many which are significantly related to OSA severity.

• Sleep Medicine and Psychophysiology
• /
• v.23 no.2
• /
• pp.93-96
• /
• 2016

Obstructive sleep apnea syndrome (OSAS) has negative effects on health, including increased mortality, risk of cardiovascular disease, and neurocognitive difficulties. OSAS is common in obese patients and obesity is an important risk factor of OSAS. A 41-year-old female OSAS patient with severe obesity (body mass index [BMI] ${\geq}35$) who failed dietary weight loss underwent bariatric surgery. After surgery, there were improvements in BMI (from 36.9 to $31.7kg/m^2$) and polysomnographic data, including the apnea-hypopnea index (from 25.1 to 11.2 events/hr) and minimum SaO2 (from 69 to 82%). This case demonstrates that bariatric surgery may be an effective therapeutic option to reduce sleep-disordered breathing in severely obese patients with moderate OSAS. Bariatric surgery as a treatment option for OSAS should be considered in OSAS patients with severe obesity who failed dietary weight loss.

• 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.

• Sleep Medicine and Psychophysiology
• /
• v.27 no.2
• /
• pp.77-81
• /
• 2020

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder in which narrowing and obstruction of the upper airway lead to frequent arousal and decreased arterial oxygenation during sleep. OSA is more common in children with genetic disorders like achondroplasia compared to children without genetic disorders. Achondroplasia is genetic disorder characterized by hypoplasia of the facial bone and skull base with foramen magnum stenosis, resulting in exceedingly high frequency of OSA. The authors present a case of a patient with achondroplasia diagnosed with severe OSA through polysomnography after adenectomy showed little therapeutic effect and who was treated with continuous positive airway pressure.

• International journal of advanced smart convergence
• /
• v.12 no.3
• /
• pp.89-103
• /
• 2023

Obstructive sleep apnea (OSA) is one of the most prevalent sleep disorders that can lead to serious consequences, including hypertension and/or cardiovascular diseases, if not treated promptly. Continuous positive airway pressure (CPAP) is widely recognized as the most effective treatment for OSA, which needs the proper titration of airway pressure to achieve the most effective treatment results. However, the process of CPAP titration can be time-consuming and cumbersome. There is a growing importance in predicting personalized CPAP pressure before CPAP treatment. The primary objective of this study was to optimize the CPAP titration process for obstructive sleep apnea patients through EEG feature engineering with machine learning techniques. We aimed to identify and utilize the most critical EEG features to forecast key OSA predictive indicators, ultimately facilitating more precise and personalized CPAP treatment strategies. Here, we analyzed 126 OSA patients' PSG datasets before and after the CPAP treatment. We extracted 29 EEG features to predict the features that have high importance on the OSA prediction index which are AHI and SpO2 by applying the Shapley Additive exPlanation (SHAP) method. Through extracted EEG features, we confirmed the six EEG features that had high importance in predicting AHI and SpO2 using XGBoost, Support Vector Machine regression, and Random Forest Regression. By utilizing the predictive capabilities of EEG-derived features for AHI and SpO2, we can better understand and evaluate the condition of patients undergoing CPAP treatment. The ability to predict these key indicators accurately provides more immediate insight into the patient's sleep quality and potential disturbances. This not only ensures the efficiency of the diagnostic process but also provides more tailored and effective treatment approach. Consequently, the integration of EEG analysis into the sleep study protocol has the potential to revolutionize sleep diagnostics, offering a time-saving, and ultimately more effective evaluation for patients with sleep-related disorders.

• 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.

• Transactions of the Korean Society of Mechanical Engineers B
• /
• v.39 no.5
• /
• pp.443-448
• /
• 2015

Obstructive sleep apnea (OSA) is a syndrome characterized by the repetitive episodic collapse of the upper airway. Maxillomandibular advancement surgery is one of the most effective surgical treatment methods in treating obstructive sleep apnea. The advancement of both maxill and mandible can enlarge the cross-sectional areas and volumes of the postero-superior airway. The purpose of this study is to analyze flow patterns in the upper airway before and after maxillomandibular advancement surgery. Here, we analyzed flow phenomena of inspiration and expiration to prevent obstructive sleep apnea patient from happening side effect. Modeling of the upper airway carried out from clinical CT scanned images. We used time-dependent values for boundary condition. CFD analyses were performed and evaluated section of minimum area (SMA), compared with patient inside upper airway before and after maxillomandibular advancement surgery in SMA, and negative pressure effects. The study showed the greatest enlargment of the section of minimum cross-sectional area. Moreover, the velocity and the negative airway pressure were decreased. According to the result of this study, the maxillomandibular advancement surgery stabilizes the airflow in the postero-superior airway of OSA patients.