• Journal of Oriental Neuropsychiatry
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• v.31 no.4
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• pp.329-336
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• 2020

Objectives: This case report intended to examine how herbal medicine treatment for breathingrelated sleep disorders applied with polysomnography affected the structure of sleep. Methods: From January to November 2019, we retrospectively reviewed the progress records and polysomnography reports of patients who visited Korean medical hospitals in Daejeon and Cheonan. Results: In case 1, the patient complained of daytime sleepiness and snoring and was diagnosed with obstructive sleep apnea disorder and treated with Ukgan-san-gami. There were significant changes in the polysomnographic parameters, such as sleep efficiency, waking after sleep onset, sleep latency, the total arousal index, and the apnea-hypopnea index after herbal treatment. In case 2, the patient complained of frequent waking after sleep onset, daytime sleepiness, and snoring, and was diagnosed with obstructive sleep apnea disorder and treated with Yeoldahanso-tang-gami. There were significant changes in the polysomnographic parameters, such as the total arousal index and the apnea-hypopnea index after herbal treatment. In case 3, the patient complained of daytime sleepiness and was diagnosed with obstructive sleep apnea disorder and treated with Bangpungtongsung-san. There was no significant change in the polysomnographic parameters after herbal treatment. Conclusions: It is meaningful to note that objectively identifying the outcome of treatment for breathing-related sleep disorders is necessary in the clinical practice of Korean medicine.

• Journal of TMJ Balancing Medicine
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• v.7 no.1
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• pp.1-10
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• 2017

In order to establish a relationship between sleep related breathing disorder (SBD) and temporomandibular disorders (TMDs), a literature review was performed. A researching was performed based on PubMed, including english languages. Any clinical study identified relationship between SBD and TMD were selected in this review. 13 studies were analyzed in this review. According to SBD diagnosis, articles were grouped as follows: polysomnographic diagnosis (n=7), clinical diagnosis (n=2) and survey/self-report (n=4). 12 articles established a positive relation between SBD and TMD and 1 did not. SBD would be associated with protrusion/retrusion degree, myofascial pain, muscular and joint pathology, and other orofacial findings. It was analyzed that the retrusion of the mandible had the significant influence on the severity of the SBD.

• Sleep Medicine and Psychophysiology
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• v.27 no.1
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• pp.8-15
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• 2020

Sleep disorder in chronic obstructive pulmonary disease (COPD) is common and typically is associated with oxygen desaturation. The mechanisms of desaturation include hypoventilation and ventilation to perfusion mismatch. Despite the importance of sleep in patients with COPD, this topic is under-assessed in clinical practice. Impaired sleep quality is associated with more severe COPD and may contribute to worse clinical outcomes. Recent data have indicated that specific respiratory management of patients with COPD and sleep disordered breathing improves clinical outcomes. Clinicians managing patients with COPD should pay attention to and actively manage symptoms of comorbid sleep disorders. Management of sleep-related problems in COPD should particularly focus on minimizing sleep disturbance.

• Journal of mucopolysaccharidosis and rare diseases
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• v.1 no.2
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• pp.35-39
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• 2015

Sleep problems occur frequently among patients with Prader-Willi syndrome (PWS). The most common problem is excessive daytime sleepiness (EDS) that are closely related to of sleep-related breathing disorder (SRBD) such as obstructive sleep apnea (OSA) and congenital hypoventilation syndrome. Obesity, craniofacial dysmorphism and muscular hypotonia of patients with PWS may increase the risk of SRBD. Sleep apneas can interrupt the continuity of sleep, and these disruptions result in a decrease in both the quality and quantity of sleep. In addition to SRBD, other sleep disorders have been reported, such as hypersomnia, a primary abnormality of the rapid eye movement (REM) sleep and narcolepsy traits at sleep onset REM sleep. Patients with PWS have intrinsic abnormalities of sleep-wake cycles due to hypothalamic dysfunction. The treatment of EDS and other sleep disorders in PWS are similar to standard treatments. Correction of sleep hygiene such as sufficient amount of sleep, maintenance of regular sleep-wake rhythm, and planned naps are important. After comprehensive evaluation of sleep disturbances, CPAP or surgery should be recommended for treatment of SRBD. Remaining EDS or narcolepsy-like syndrome are controlled by stimulant medication. Bright light therapy might be beneficial for disturbed circadian sleep-wake rhythm caused by hypothalamic dysfunction.

• Sleep Medicine and Psychophysiology
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• v.8 no.1
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• pp.11-17
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• 2001

In 2000, the number of people aged 65 and over increased to 3.37 million, accounting for 7.1% of the total population of South Korea. The elderly population will increase up to 19.3% in 2030. Sleep disordered breathing (SDB) seems to increase with age. More than 50-60% of old people complain of SDB-related signs and symptoms including awakening headache, excessive daytime sleepiness, fatigue, cognitive dysfunction, memory loss, personality changes, and depression. The influence of a mild degree of SDB upon the elderly is unclear, but moderate to severe SDB is well known to be associated with many diseases including hypertension, arrhythmia, myocardial infarction, stroke, dementia, and sudden death. Therefore, physicians should pay attention to elderly patients who complain of SDB related symptoms and signs that may not be normal signs of aging. Physicians need to become more sensitive to treat SDB in the elderly.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.10-16
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• 2004

Sleep is associated with definite changes in respiratory function in normal human beings. During sleep, there is loss of voluntary control of breathing and a decrease in the usual ventilatory response to both low oxygen and high carbon dioxide levels. Especially, rapid eye movement (REM) sleep is a distinct neurophysiological state associated with significant changes in breathing pattern and ventilatory control as compared with both wakefulness and non-rapid eye movement (NREM) sleep. REM sleep is characterized by erratic, shallow breathing with irregularities both in amplitude and frequency owing to marked reduction in intercostal and upper airway muscle activity. These blunted ventilatory responses during sleep are clinically important. They permit marked hypoxemia that occurs during REM sleep in patients with lung or chest wall disease. In addition, sleep-disordered breathing (SDB) is more frequent and longer and hypoventilation is more pronounced during REM sleep. Although apneic episodes are most frequent and severe during REM sleep, most adults spend less than 20 to 25% of total sleep time in REM sleep. It is, therefore, possible for patients to have frequent apneas and hypopneas during REM sleep and still have a normal apnea-hypopnea index if the event-rich REM periods are diluted by event-poor periods of NREM sleep. In this review, we address respiratory physiology according to sleep stage, and the clinical implications of SDB and hypoventilation aggravated during REM sleep.

• The Journal of the Korean dental association
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• v.53 no.4
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• pp.238-248
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• 2015

Sleep related breathing disorders(SRBDs) are a group of diseases accompanied by difficulties in respiration and ventilation during sleep. Central sleep apnea, obstructive sleep apnea(OSA), sleep-related hypoventilation, and hypoxemia disorder are included in this disease entity. OSA is known to be the most common SRBDs and studies show its significant correlation with general health problems including hypertension, arrhythmia, diabetes, and metabolic syndrome. The diagnostic process of OSA is composed of physical examinations of the head and neck area and also the oral cavity. Radiologic studies including cephalography, CT, MRI, and fluoroscopy assist in identifying the site of obstruction. However, polysomnography(PSG) is still considered the gold standard for the diagnosis of OSA since it offers both qualitative and quantitative recording of the events during a whole night's sleep. The dentist who is trained in sleep medicine can easily identify patients with the risk of OSA starting from simple questions and screening questionnaires. Diagnosis is the first step to treatment and considering the high rate of under-diagnosis for OSA the dentist may play a substantial role in the diagnosis and treatment of OSA which will eventually lead to the well-being of the patient as a whole person. So the objective of this article is to assist dental professionals in gaining knowledge and insight of the diagnostic measures for OSA including PSG.

• Sleep Medicine and Psychophysiology
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• v.24 no.1
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• pp.5-11
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• 2017

The use of alcohol is associated with the development and worsening of sleep disorder. Alcohol is generally known to have a sedative effect, but it has an arousal or sedative effect depending on the timing and drinking dose and directly affects REM sleep physiology. Alcohol acts on the central nervous system (CNS) to interfere with the sleep-wake cycle and to affect sleep-related hormone secretion. In addition, the ingestion of alcohol pre-sleep is associated with deterioration and development of sleep related breathing disorders (SBD). The increase in resistance of the upper respiratory tract and the decrease in sensitivity of the CNS respiratory center and the respiratory muscles are major mechanisms of alcohol-induced SBD, and result in snoring or apnea in healthy men or aggravating apnea in patients with OSA. Sleep-related restless leg syndrome and circadian rhythm disorders are common in alcohol use disorder patients. This review provides an assessment of scientific studies that investigated on the impact of alcohol ingestion on nocturnal sleep physiology and sleep disorders.

• Sleep Medicine and Psychophysiology
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• v.25 no.2
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• pp.92-95
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• 2018

Catathrenia is a rare sleep disease characterized by monotonous groaning sounds that appear to be related with prolonged expiration, commonly experienced during rapid eye movement (REM) sleep. Catathrenia is also known as nocturnal groaning or sleep-related groaning and is currently categorized as a sleep-related breathing disorder. We present a rare case of a 19-year-old male with nocturnal groaning during non-REM sleep. We suggest that if catathrenia is suspected, polysomnography should be utilized to differentiate it from various sleep disorders such as snoring, central sleep apnea, sleep talking, parasomnia, and sleep-related movement disorders.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.5-8
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• 2002

Stroke is a leading cause of death in most developed countries and some developing countries including South Korea. It is well known that stroke has is related in some way with several sleep disorders. At first, the onset time of stroke varies according to circadian rhythm. Early morning is the most prevalent time and late evening the least. The changes of blood pressure, catecholamine level, plasminogen activity and aggregation of platelet during sleep have been suggested as possible mechanisms. Sleep apnea (SA), a representative disorder in the field of sleep medicine, is found in more than 70% of acute stroke patients compared to 2-5% of the general population. Various sleep related breathing disorders occur after stroke and snoring is a distinct risk factor for stroke. So the relationship between stroke and SA is obvious, but the cause and effect are still not clearly known. Also, stroke may cause many sleep related problems such as insomnia, hypersomnia, parasomnia and changes in sleep architecture. Patients, family members and even medical personnel often ignore stroke-related sleep problems, being concerned only about the stroke itself. The clinical impacts of sleep problems in stroke patients may be significant not only in terms of quality of life but also as a risk factor or prognostic factor for stroke. More attention should be paid to the sleep problems of stroke patients.