• Proceedings of the KOSOMBE Conference
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• v.1995 no.11
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• pp.159-163
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• 1995

• Tuberculosis and Respiratory Diseases
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• v.45 no.1
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• pp.153-168
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• 1998

Background: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. Methods: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and ECG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Control, n=25). Results: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (AI), apnea-hypopnea index (AHI), arterial oxygen saturation nadir ($SaO_2$ nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with AI, AHI, $SaO_2$ nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n==14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (${\Delta}HR$) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (${\Delta}SaO_2$) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. Conclusion : These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.126-132
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• 2016

Purpose: The aims of this study were to analyze the association between inflammatory cytokine and obstructive sleep apnea (OSA), and to evaluate treatment outcome and changes of plasma inflammatory cytokine levels after oral appliance therapy. Methods: Twenty-seven subjects who visited Department of Oral Medicine in Seoul National University Dental Hospital were performed nocturnal polysomnography and analyzed plasma C-reactive protein (CRP), interleukin (IL)-$1{\beta}$, IL-6, IL-10, and tumor necrosis factor (TNF)-${\alpha}$ levels. Each subject was evaluated with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). The subjects were classified into 12 OSA patients (apnea-hypopnea index [AHI] >5) and 15 control (AHI ${\leq}5$) groups. The OSA group was treated with mandibular advancement device (MAD) for 3 months and re-evaluated nocturnal polysomnography and plasma inflammatory cytokine levels. Results: Plasma TNF-${\alpha}$, IL-10, and IL-6 levels were significantly higher in OSA patients compared to controls. Total AHI showed significant positive correlations with plasma IL-6 and TNF-${\alpha}$ levels. Percentage time of $SpO_2$ <90 and lowest $SpO_2$ were significantly correlated with plasma TNF-${\alpha}$ level. ESS showed significant positive correlation with plasma IL-10 level. Total AHI, percentage time of $SpO_2$ <90, lowest $SpO_2$, and mean $SpO_2$ were significantly improved after the MAD therapy. Plasma TNF-${\alpha}$ level was significantly decreased after MAD therapy. Conclusions: We suggest that MAD therapy is an effective treatment modality for patients with OSA and can decrease plasma cytokine level.

• The Journal of the Korean dental association
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• v.49 no.4
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• pp.219-226
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• 2011

Snoring and obstructive sleep apnea (OSA) are common sleep disordered breathing conditions. Habitual snoring is caused by a vibration of soft tissue of upper airway while breath in sleeping, and obstructive sleep apnea is caused by the repeated obstructions of airflow for a sleeping, specially airflow of pharynx. Researchers have shown that snoring is the most important symptom connected with the obstructive sleep apnea syndrome The treatment is directed toward improving the air flow by various surgical and nonsurgical methods. The current surgical procedures used are uvulopalatopharyngoplasty(UPPP), orthognathic surgery, nasal cavity surgery. Among the nonsurgical methods there are nasal continuous positive air pressure(CPAP), pharmacologic therapy. weight loss in obese patient, oral appliance(sleep splint). Sleep splint brings the mandible forward in order to increase upper airway volume and prevents total upper airway collapse during sleep. However, the precise mechanism of action is not yet completely understood, especially aerodynamic factor. The aim of this study evaluated the effect of conservative treatment of snoring and OSAS by sleep splint through measured aerodynamic change by an aerophone II. We measured a airflow, sound pressure level, duration, mean power from overall airflow by aerophone II mask. The results indicated that on a positive correlation between a decrease in maximum airflow rate and a decrease in maximum sound pressure level, on a negative correlation between a decrease in maximum airflow rate and a increase in duration.

• Journal of Biomedical Engineering Research
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• v.36 no.2
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• pp.48-53
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• 2015

Sudden infant death syndrome(SIDS) continues to be general cause of infant death. Also, apnea is supposed to be one of the main risk factor of SIDS. Therefore, Infant's respiratory monitoring and real-time apnea detection is very important to prevent SIDS. In this study, we proposed a non-contact home monitoring system for infant's respiration using Doppler radar in order to prevent SIDS. The respiration data were acquired from a commercialized baby simulator(Simbaby$^{TM}$) using a Doppler radar. To evaluate a performance of the proposed system, the simulator was placed in a supine and prone position and the chest belt was used simultaneously as a reference signal. As a result, correlation coefficients between respiration rates of Doppler radar and the chest belt in each position were 0.95(p < 0.001) and 0.98(p < 0.001), respectively. The averages of difference were $-0.29{\pm}5.21(mean{\pm}1.96{\cdot}$ standard deviation) in supine and $-0.12{\pm}3.05$ in prone from Bland-Altman analysis. The results indicated an excellent performance in detecting apnea with a sensitivity of 100% and a positive predictive value of 100% in each posture respectively. These results demonstrated that a proposed Doppler radar system is suitable for non-contact respiratory monitoring in order to prevent SIDS of infant.

• Journal of the Korea Convergence Society
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• v.11 no.1
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• pp.33-39
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• 2020

Specialists have developed pillows that take into account sleep science and ergonomics, such as comfort for lying on your side. This pillow is made of natural latex material, and improved resilience after a certain period of time. A new idea was added to the pillow, which was naturally used for sleep, but could it add additional features for health care. Here, health care targets sleep apnea, which is known to be associated with serious illness. The purpose of this paper is to design a comprehensive service that uses a pressure sensor and a voice sensor to obtain information and to identify abnormal symptoms related to diseases from this information and to refer them to a specialist. It also covers the basic design and implementation to confirm the success of this system. Based on this design, the information obtained will be converted into a DB, and a server system for consultation with a specialist will be completed to upgrade the role of assistive health devices for sleep apnea.

• Journal of Oral Medicine and Pain
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• v.41 no.4
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• pp.180-187
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• 2016

Purpose: The aims of this study were to evaluate the differences of clinical and polysomnographic features between rapid eye movement (REM)-related obstructive sleep apnea (OSA) and not-REM-related OSA, and to suggest the pathogenesis according to the REM dependency of OSA. Methods: One hundred ninety consecutive patients diagnosed with OSA were evaluated clinical features and performed full night polysomnography. The patients were divided into REM-related (REM apnea-hypopnea index [AHI] at least two times higher than their non-REM AHI) and not-REM-related (a REM AHI less than two times higher than their non-REM AHI) OSA groups and evaluated the differences in age, body mass index (BMI), neck circumference, Ep-worth Sleepiness Scale score, and parameters of polysomnography. Results: REM-related patients were younger and showed higher sleep efficacy, low percentage of light sleep stage (stage 1 sleep), and low rate of positional OSA. Age was significantly associated with REM dependency of OSA and REM AHI were significant correlated with BMI, neck circumference, percentage of sleep in supine position, and percentage time of snoring. Conclusions: Our results showed that REM-related OSA patients showed less severe polysomnographic parameters than not-REM-related patients. However, significant risk factors were differed depending on the REM dependency and OSA severity, and the clinical features correlated with REM AHI and non-REM AHI were also showed differently. We suggest that the occurrence of OSA according to the REM dependency can be based on different mechanisms.

• Sleep Medicine and Psychophysiology
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• v.1 no.2
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• pp.172-181
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• 1994

Obstructive sleep apnea syndrome(OSAS) is most frequently diagnosed in the sleep laboratories and its severity is objectively estimated. In terms of treatment, the most prevalent method is the continuous positive airway pressure(CPAP) application as of now. However, in Korea, CPAP is still not sufficiently known and it is attributable to the fact that sleep study facilities have not been popularized. In this article, the authors present their own experience with CPAP in nine subjects with OSAS. In this study, CPAP was found to decrease stage 1 sleep and to increase stage 2 sleep, with increasing mean oxygen saturation and decreasing lowest oxygen saturation during nocturnal sleep. Also, it tended to increase sleep continuity and generally to improve sleep architecture. Rebound slow wave and/or REM sleep stages during CPAP were also noted in 8 out of 9 cases. The authors suggest that CPAP should be considered as the primary mode of treatment for patients with obstructive sleep apnea syndrome and related educational programs for physicians should be developed and provided by sleep specialists.

• Anxiety and mood
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• v.4 no.2
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• pp.157-159
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• 2008

Continuous positive airway pressure (CPAP) has been known as a safe and effective therapy for the patients with obstructive sleep apnea (OSA). Previous studies on CPAP treatment have often reported significant improvement in mood state in those patients. However, there are very few reports on its potential to induce manic or hypomanic episode in the patients with OSA. We report a case of 34-year-old patient with OSA who developed manic and hypomanic episodes consecutively after CPAP treatment with facial mask. We suggest that CPAP treatment could induce a manic or hypomanic episode in patients with obstructive sleep apnea.

• Journal of Biomedical Engineering Research
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• v.35 no.4
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• pp.95-98
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• 2014

The baroreflex is one kind of homeostatic mechanisms to regulate acute blood pressure (BP) changes by controlling heartbeat interval (HBI). To quantify the effect of baroreflex, we suggested a new approach of analyzing Granger causality between systolic BP (SBP) and HBI. The index defined as baroreflex effectiveness (BRE) was generated by the hypothesis that more effectual baroreflex would be related to more effective Granger causal influence of SBP on HBI. Six obstructive sleep apnea (OSA) patients (apnea-hypopnea index, AHI ${\geq}5$ events/hr) and six normal subjects participated in the study. Their SBP and HBI during nocturnal sleep were obtained from a non-invasive continuous BP measurement device. While the BRE ($mean{\pm}SD$) of normal subjects was $47.0{\pm}4.0%$, OSA patients exhibited the BRE of $34.0{\pm}3.8%$. The impaired baroreflex function of OSA patients can be explained by the physiological mechanism associated with recurrent hypoxic episodes during sleep. Thus, the significantly lower BRE in OSA patients verified the availability of Granger causality analysis to evaluate baroreflex during sleep. Furthermore, the range of BRE obtained from normal subjects was not overlapped with that obtained from OSA patients. It suggests the potential of BRE as a new helpful tool for diagnosing OSA.