Journal of the korean academy of Pediatric Dentistry
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v.49
no.4
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pp.357-367
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2022
Sleep disordered breathing (SDB) is a disease characterized by repeated hypopnea and apnea during sleep due to complete or partial obstruction of upper airway. The prevalence of pediatric SDB is approximately 12 - 15%, and the most common age group is preschool children aged 3 - 5 years. Children show more varied presentations, from snoring and frequent arousals to enuresis and hyperactivity. The main cause of pediatric SDB is obstruction of the upper airway related to enlarged tonsils and adenoids. If SDB is left untreated, it can cause complications such as learning difficulties, cognitive impairment, behavioral problems, cardiovascular disease, metabolic syndrome, and poor growth. Pediatric dentists are in a special position to identify children at risk for SDB. Pediatric dentists recognize clinical features related to SDB, and they should screen for SDB by using the pediatric sleep questionnaire (PSQ), lateral cephalometry radiograph, and portable sleep monitoring test and refer to sleep specialists. As a therapeutic approach, maxillary arch expansion treatment, mandible advancement device, and lingual frenectomy can be performed. Pediatric dentists should recognize that prolonged mouth breathing, lower tongue posture, and ankyloglossia can cause abnormal facial skeletal growth patterns and sleep problems. Pediatric dentists should be able to prevent these problems through early intervention.
Kwon, Hyeok Chan;Phyo, Jung Bin;Park, Yong Gil;Lee, Hyun Ju;Tae, Ki Sik
Journal of Biomedical Engineering Research
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v.39
no.1
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pp.55-61
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2018
The purpose of this study was to investigate the effect of a pillow simulated with cranial sacral therapy (CST) on sleep induction using electroencephalography (EEG). This study included 12 voluntary participants divided into experimental group (CST group) and control group (Non-CST group) to observe EEG changes. The position of the electrode for EEG measurement consists of 8 channels electrodes (Fp1, Fp2, F3, F4, T3, T4, P3 and P4). In this study, we measured the fall asleep time, change of brain activity and sleep wave ratio using EEG wave (${\delta}$, ${\theta}$, ${\alpha}$, ${\beta}$ and ${\gamma}$). As a result, the mean fall asleep time of the experimental group was shorter than that of the control group significantly (p < 0.001). Also in comparison with the control group, both the delta (d) and theta (q) wave corresponding to the slow waves showed a larger increase and the alpha (a) wave showed a larger decrease significantly. The slow waves of experimental group showed a higher rate of significant increase than the control group (p < 0.001). Therefore this study showed that pillow based on CST had an effective in improving sleep induction and quality.
Buchanan, Allison;Cohen, Ruben;Looney, Stephen;Kalathingal, Sajitha;De Rossi, Scott
Imaging Science in Dentistry
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v.46
no.1
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pp.9-16
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2016
Purpose: To evaluate the upper airway dimensions of obstructive sleep apnea (OSA) and control subjects using a cone-beam computed tomography (CBCT) unit commonly applied in clinical practice in order to assess airway dimensions in the same fashion as that routinely employed in a clinical setting. Materials and Methods: This was a retrospective analysis utilizing existing CBCT scans to evaluate the dimensions of the upper airway in OSA and control subjects. The CBCT data of sixteen OSA and sixteen control subjects were compared. The average area, average volume, total volume, and total length of the upper airway were computed. Width and anterior-posterior (AP) measurements were obtained on the smallest axial slice. Results: OSA subjects had a significantly smaller average airway area, average airway volume, total airway volume, and mean airway width. OSA subjects had a significantly larger airway length measurement. The mean A-P distance was not significantly different between groups. Conclusion: OSA subjects have a smaller upper airway compared to controls with the exception of airway length. The lack of a significant difference in the mean A-P distance may indicate that patient position during imaging (upright vs. supine) can affect this measurement. Comparison of this study with a future prospective study design will allow for validation of these results.
Seo, Sangwon;Hwang, Su Hwan;Yoon, Hee Nam;Jung, Da Woon;Choi, Jae Won;Lee, Yu Jin;Jeong, Do-Un;Park, Kwang Suk
Journal of Biomedical Engineering Research
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v.35
no.5
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pp.169-176
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2014
As body postures on bed affects various sleep related diseases, it is considered as important information when monitoring sleeping in daily life. Though there have already been a few approaches to monitor body postures on bed conventionally, the development for simple and unconstrained methods is still needed to realize the long-term daily monitoring. Focusing on the fact that ballistocardiogram changes depending on the body postures on bed, we developed a novel method to estimate body posturesusing extremely simple, film-type ballistocardiogram sensor which is based on polyvinylidene fluoride(PVDF) film. With 10 subjects, we performed two experiments. One was for an estimation test to show that body postures on bed can be estimated by ballistocardiogram, and the other was for a reproducibility test to present the feasibility of ballistocardiogram based body postures monitoring. To estimate body postures on bed, we made an individual template set of body postures by designating one ballistocardiogram (BCG) sample as a template in each postures. Then, we calculated Pearson's correlation coefficients between a sample and each templates and estimated the body posture of the sample by choosing a posture which corresponds to the most significant correlation coefficients. As a result, we estimated body postures on bed with 99.2% accuracy in average and found that the estimation using ballistocardiogram is reproducible.
It is not the water veins themselves that are distributed on Earth that are harmful, but the water vein waves generated from the water veins are harmful to human health. The natural frequency of the Earth is 7.83 Hz, but in order to sleep deeply, you must go down to a delta wave of 2 to 3.99 Hz, which is lower than this frequency, to achieve the deepest sleep and maintain your health. However, if you sleep in a place with dowsing waves, the dowsing waves interfere with your brain waves, making it difficult to sleep well, and you may have nightmares. Even when you wake up, your body is not refreshed and your fatigue does not go away, so you feel tired and tired easily. If this phenomenon continues, the body's resistance decreases and immunity weakens, which can eventually cause illness and cause various diseases, which can harm one's health. In other words, the safest and most effective way to deal with water veins is to avoid places with water veins and simply change your sleeping position to a place without water veins, and you can live a healthy and happy life through examples.
Lee, Dong Jun;Jang, So Ick;Shim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
Clinical and Experimental Pediatrics
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v.49
no.6
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pp.602-609
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2006
Purpose : As the prone position is thought to be an important factor in sudden infant death syndrome(SIDS), this study was conducted to contribute to reducing SIDS by analyzing sleeping positions of infants. Methods : A face-to-face questionnaire was carried out with a total of 170 parents with a baby aged less than 6 months. Results : A total of 170 infants included 95 males(55.9 percent) and 75 females(44.1 percent); their average age was 2.8 months. 45.3 percent slept in a supine position; 34.7 percent in a side or supine position; 7.1 percent in a side position; 4.7 percent in a prone position; 4.1 percent in a non-specific position. Among those in a side position, 59.7 percent were in a supine position in the morning; 19.5 percent were in the side position; 13.4 percent were in a non-specific position; and 4.1 percent were in a prone position. To the question why they slept in a specific position, 34.9 percent answered their baby slept comfortably, and particularly, 42.9 percent in the prone position group answered so. In the supine position group, 21.6 percent answered they had no reason. Both in the prone position and side position groups, 21 percent each answered they were worried about the shape of their baby's head. In the side position group, 22 percent answered that they had a fear of choking due to vomiting. In all sleeping position groups, 8.2 percent and 7.4 percent answered it was because they had a fear of suffocation and they wanted to avoid SIDS, respectively. Conclusion : Many of the parents preferred unstable positions, e.g. the side position and the prone position, which could cause SIDS. Their decision on their baby's sleeping position was not based on exact medical knowledge, but on convenience in taking care of their baby. As it was found that only 6 percent of the subjects were advised from their pediatrist about their baby's sleeping position, moreover, it is necessary to carry out more studies and activities for preventing SIDS caused by improper sleeping positions and educating patents about recommended sleeping positions for their baby.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.29
no.5
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pp.338-345
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2003
Purpose : This study was intended to perform cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram was also investigated. Patient and Method : Twenty four patients who visited Sleep Disorder Clinic in Dongsan Medical Center, Keimyung University and evaluated with polysomnograph(PSG) and cephalogram were included in the study. The patients had apnea-hypopnea episode(AHI) over 10 times per hour was diagnosed as OSA after overnight PSG. To evaluate hard and soft tissue profile, cephalometric radiogram were taken at maximal intercuspation(P1) and mandibular protruding position(P2). The diffefence between the OSA and normal group were evaluated statistically and the stepwise regression analysis was applied to analyse the cephalometric influencing factors to OSA. Result : The OSA Group(n=14) had significantly higher Body Mass Index(BMI) than control group(n=10). Lower facial height(ANSGn) was longer in OSA group. However statistically significant difference was not detected in other anteroposterior craniofacial measurements. The soft palate lenth (PNS-P), hyoid position (MP-Hyoid) had positive correlation between AHI (r=0.496, r=0.413, respectively, p<0.05). However, the measurements of oropharyngeal airway was not different between the two groups. The hypothesis, the antero-posteriorly narrow oropharyngeal airway might aggravate the airway resistance and can give rise to higher AHI, was not accepted in the study. This can be attributed by inclusion of the patients performed uvulopalatopharyngoplasty because of the tonsilar or soft palate hypertrophy in the present study. The results of regression analysis revealed that PNS-P, upper airway width(Nph1), upper facial heght(N-ANS), and lower facial height(ANS-Gn) could influence the degree of AHI (F value < 0.0001, $R^2$ = 0.829). Conclusion : We suggest lateral cephalogram may utilized as a useful method to evaluate OSA. The patient with long soft palate, narrow upper airway width, long upper & lower facial height can be expected to have high risk of OSA. However, it should be emphasized the comphrehensive intraoral inspection including soft palate and tonsilar hypertrophy because lateral cepahlogram cannot visualize oropharyngeal status completely.
Seo, Eun-Woo;Lee, Ho-Kyung;Han, Min-Woo;Seo, Mi-Hyun;Kim, Hyun-Jun;Song, Seung-Il
Maxillofacial Plastic and Reconstructive Surgery
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v.35
no.3
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pp.161-166
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2013
Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.
In order to measure ECG in daily life, a new ECG measurement method on bed was developed. The provided method does not require any direct conductive contact between the instrument and bare skin, so that it does not cause the uncomfortable feel of touch and the possible skin trouble which are typical shortcomings of the conventional conductive contact ECG measurement. The provided method utilized an array of high-input-impedance active electrodes fixed on the mattress and an indirect-skin-contact ground made of a large conductive textile sheet and laid on lower area of the mattress. A thin cotton bedcover covered the mattress, the electrodes, and the conductive textile and subjects lay on the mattress over the bedcover. ECG was obtained successfully. However its signal quality is lower and the motion artifact is larger than direct-contact measurement. Careful measurement setup was needed to reduce the motion artifact originated from variation in static electricity. From the ECG obtained by the provided method, R-peak could be discriminated easily and the information about the position and the posture of the subject could be obtained.
The Purpose of this Study was to examine the anatomic differences in the upper airway according to severity of respiratory disturbance index of habitual snorers. Forty-three male habitual snorers, aged 28-68, were examined by polysomnography and divided into 4 groups according to severity determined by polysomnography. Anatomic differences in the upper airway were assessed by lateral cephalograms in upright position, and epidemiological surveys were done by using questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 35 patients (81.4%) complained the loudness of snoring as severe as be heard outside of the room. 2. According to the results of polysomnography, the number of the primary snoring patients was 7(16.3%), mild obtrusive sleep apnea 7(16.3%), moderate 7(16.3%), and severe 22(51.2%). 3. The respiratory disturbance index (RDI) of subjects was 39.5$\pm$24.4 and the body mass index(BMI) was 26.2$\pm$2. 4. More inferiorly positioned hyoid bone according to the degree of respiratory disturbace index (RDI) was observed. (p<0.001) 5. The width of superior oropharyngeal airway space was according to the degree of RDI. (p<0.001)
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