• 대한치과의사협회지
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• 제53권4호
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• pp.259-265
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• 2015

Recently, oral appliances for treating snoring and obstructive sleep apnea are widely used. Among various appliances, mandibular advancement devices are most effective without serious side effects. Advancement of mandible keep airway open and decrease snoring and/or obstructive apnea events. They can be used as stand-alone therapy or an adjunct to continuous positive air pressure for lowering air pressure. Oral appliances should be applied by dentists who have knowledges and experiences on occlusion and temporomandibular disorders and manage of side effects.

• 수면정신생리
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• 제1권2호
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• pp.163-171
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• 1994

연구목적 : 수면 무호흡의 증상은 크게 불면증, 낮의 과다한 졸리움, 기억력과 집중력 등의 인지기능장애, 우울 등의 감정장애 등이 주 증상을 이루고 있다. 그런데 이러한 증상들이 수면 및 수면 무호홉의 여러 변수들과 어떤 상관관계를 가지며 어떤 과정을 통해서 구체적으로 발생되는 지에 대한 연구는 그렇게 많지 않다. 연구방법 : 본 연구는 수면 무호흡증 환자 60 명을 대상으로 수면다원검사를 실시함과 동시에 낮 졸리움 척도, 불면증 척도, 인지기능 척도 및 감정장애 척도를 통해 수면 무호홉의 증상을 평가하였다. 그리고 수면다원 검사상의 여러 수면변수, 무호흡의 횟수, $O_2$ desaturation, 코골기 정도 등과 무호흡 증상의 4 가지 척도와 상관관계를 조사하였다. 연구결과 : 유의한 상관관계를 보인 결과는 다음과 같다. 무호흡 환자 중 불면증호소가 적고 비교적 잠을 잘 자는 경우는 호흡장애가 많은 경우와 중심성 무호흡이 많은 경우였다. 그리고 제 3 단계 서파수면에서 코골기가 많거나 경등도의 산소저하가 많은 경우였다. 대신 낮에 졸리움증이 많은 경우는 제 1 단계에서 코골기가 많은 경우였다. 그러나 무호흡의 정도나 산소와는 직접 상관관계가 나타나지는 않았다. 우울 등의 감정장애는 수면 중 산소저하가 중등도이상으로 심한 경우 많이 나타났으며 제 4 단계 서파수면이 적은 경우 이러한 우울 감정이 더 심하게 나타났다. 집중과 기억 등의 인지기능은 REM 수면이 많고 호흡장애의 횟수가 적을수록 더욱 감소되는 현상을 보였다. 결론 : 무호흡의 증상은 서로 다른 원인과 기전을 통해 발생될 수 있으며 이러한 증상을 좀 더 객관적 평가할 수 있다면 환자의 수면 및 무호흡의 정도와 상태를 예측하는데 더욱 많은 도움을 줄 수 있을 것으로 기대된다.

• Tuberculosis and Respiratory Diseases
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• 제51권6호
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• pp.590-596
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• 2001

원발성 갑상선 기능저하증은 수면무호흡증후군의 원인 중 하나이다. 수면무호흡증후군 환자의 병력과 이학적 검사를 통하여 갑상선 기능저하의 가능성에 대한 충분한 평가가 필요하며, 또한 갑상선 기능저하증 환자도 수면무호흡증후군의 증상 및 가능성에 대한 고려가 필요하다. 그리고 본 증례와 같이 심장질환이 동반되어있을 때는 갑상선 호르몬 제재 단독투여 보다는 수면무호흡증후군에 의한 심각한 합병증을 예방하기 위하여 지속적 기도양압 치료를 동시에 적용하는 것이 좋다. 저자들은 원발성 갑상선 가능저하증과 확장형 심근증이 동반된 수변무호흡증후군 환자가 갑상선 호르몬 제재를 복용하고, 지속적 기도양압 치료적용 후 완전히 호전된 증례를 경험하였기에 보고하는 바이다.

• 한국산업정보학회논문지
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• 제22권1호
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• pp.41-51
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• 2017

This Paper Describes a Method for the Evaluation of Sleep Apnea, Namely, the Peak Signal-to-noise ratio (PSNR) of Wavelet Transformed Electroencephalography (EEG) Data. The Purpose of this Study was to Investigate EEG Properties with Regard to Differences between Sleep Spindles and K-complexes and to Characterize Obstructive Sleep Apnea According to Sleep Stage. We Examined Non-REM and REM Sleep in 20 Patients with OSA and Established a New Approach for Detecting Sleep Apnea Base on EEG Frequency Changes According to Sleep Stage During Sleep Apnea Events. For Frequency Bands Corresponding to A3 Decomposition with a Sampling Applied to the KC and the Sleep Spindle Signal. In this Paper, the KC and Sleep Spindle are Ccalculated using MSE and PSNR for 4 Types of Mother Wavelets. Wavelet Transform Coefficients Were Obtained Around Sleep Spindles in Order to Identify the Frequency Information that Changed During Obstructive Sleep Apnea. We also Investigated Whether Quantification Analysis of EEG During Sleep Apnea is Valuable for Analyzing Sleep Spindles and The K-complexes in Patients. First, Decomposition of the EEG Signal from Feature Data was Carried out using 4 Different Types of Wavelets, Namely, Daubechies 3, Symlet 4, Biorthogonal 2.8, and Coiflet 3. We Compared the PSNR Accuracy for Each Wavelet Function and Found that Mother Wavelets Daubechies 3 and Biorthogonal 2.8 Surpassed the other Wavelet Functions in Performance. We have Attempted to Improve the Computing Efficiency as it Selects the most Suitable Wavelet Function that can be used for Sleep Spindle, K-complex Signal Processing Efficiently and Accurate Decision with Lesser Computational Time.

• Tuberculosis and Respiratory Diseases
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• 제42권2호
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• pp.238-243
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• 1995

갑상선 기능저하증은 수면 무호흡 증후군의 한 원인이 될 수 있다. 수면 무호흡 증후군 환자에서 병력과 이학적 검사상 갑상선 기능저하의 가능성에 대한 충분한 평가가 필요하며 갑상선 기능저하증 환자에서도 수면 무호흡 증후군의 증상 및 가능성에 대한 고려가 필요하다. 저자들은 갑상성 기능저하증이 동반된 수면 무호흡 증후군 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 대한임상검사과학회지
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• 제38권3호
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• pp.212-217
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• 2006

Obstructive sleep apena syndrome (OSAS) is accompanied by the following symptoms: apnea caused by upper respiratory tract obstruction while sleeping, repetitive lowering of $SpO_2$, severely affected excessive daytime sleepiness (EDS), suffocation/frequent awakeness while sleeping, daytime lethargy, and lack of concentration. OSAS was investigated with sex, age, body weight, body mass index (BMI), neck circumference and snoring sound as clinical characteristics and the anticipating factors of OSAS were studied in relation with the apnea-hypopnea index (AHI). The subjects were 42 people (male 34/female 8) who visited the clinic due to snoring and had polysomnography evaluation. AHI was differenciated into normal (less than 0~5/hr), mild (5~15/hr), moderate (15~30/hr) and severe (more than 30/hr). As the apnea-hypopnea index (AHI) gets higher, the snoring sound was louder (p<0.01), neck circumference was thicker (p<0.05) and also there were relative correlations with body weight (p<0.01), body mass index (p<0.05), snoring sound (p<0.01) and neck circumference (p<0.01). Since the snoring sound and neck circumference explained 32.8% of the AHI distribution, if the patient was severely snoring or had a thick neck circumference due to obesity, the apnea-hypopnea index showed a predisposition to the obstructive sleep apnea syndrome.

• Neonatal Medicine
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• 제28권1호
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• pp.14-21
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• 2021

Purpose: Premature infants have immature respiratory control and cerebral autoregulation. We aimed to investigate changes in cerebral oxygenation during apnea with and without peripheral oxygen desaturation in premature infants. Methods: This prospective observational study was conducted at Inha University Hospital. Near-infrared spectroscopy (NIRS)-monitored regional cerebral oxygen saturation (rScO₂) and pulse oximeter-monitored peripheral oxygen saturation (SpO₂) were assessed during the first week of life in 16 stable, spontaneously breathing preterm infants. Apneic episodes that lasted for ≥20 seconds or were accompanied by desaturation or bradycardia were included for analysis. The average rScO₂ value during the 5-minute prior to apnea (baseline), the lowest rScO₂ value following apnea (nadir), the time to recover to baseline (recovery time), the area under the curve (AUC), and the overshoot above the baseline after recovery were analyzed. Results: The median gestational age and birth weight of the infants were 29.2 weeks (interquartile range [IQR], 28.5 to 30.5) and 1,130 g (IQR, 985 to 1,245), respectively. A total of 73 apneic episodes were recorded at a median postnatal age of 2 days (IQR, 1 to 4). The rScO₂ decreased significantly following apneic episodes regardless accompanied desaturation. There were no differences in baseline, nadir, or overshoot rScO₂ between the two groups. However, the rScO₂ AUC for apnea with desaturation was significantly higher than that for apnea without desaturation. Conclusion: Cerebral oxygenation can significantly decrease during apnea, especially when accompanied by reduced SpO₂. These results add the evidence for the clinical utility of NIRS in monitoring premature infants.

• 수면정신생리
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• 제7권2호
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• pp.79-83
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• 2000

Sleep disturbances are frequently associated with neurological disorders. Sleep disorders interfere with rehabilitation of patients with neurological disorders such as stroke and may increase the severity of their symptoms and recurrence rate of stroke. The treatment of sleep apnea syndrome is particularly important in managing patients with cerebral infarction of whom 50-80% have moderate to severe sleep apnea. Sleep apnea produces not only poor quality sleep but also excessive daytime sleepiness, fatigue and lack of energy. Sleep problems frequently found in patients with dementia are sleep-wake cycle abnormality, fragmentation of sleep, nocturnal insomnia, decreased slow wave sleep and REM sleep, and sleep disordered breathing. The management of sleep disturbances is very important for controlling symptoms such as nocturnal wandering and sundowning syndrome in patients with dementia. Parkinson's disease and epilepsy are other neurological disorders that may have sleep disturbances.

• 대한한의학회지
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• 제33권1호
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• pp.169-176
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• 2012

Objectives: Obstructive sleep apnea (OSA) is prevalent disorder, particularly among the middle-aged. In this study, we report a new approach to improve OSA using oriental medicine and acupuncture. Methods: Three men diagnosed with OSA were enrolled in this study. They took oriental medicine 3 times a day and were given acupuncture twice a week for about 4 months. Results: We analyzed apnea-hypopnea index (AHI), oxygen desaturation index (ODI), average saturation (AS) and lowest saturation (LS) before and after treatment. AHI highly decreased in all patients and ODI also decreased in two of the three patients. Conclusions: These results indicate that oriental medicine and acupuncture therapy was effective in the improvement of OSA. Further study in a larger group with severity grades is recommended.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권6호
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• pp.388-392
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• 2016

In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors. After distraction osteogenesis, the patient's respiratory problems resolved, and she was able to sleep comfortably. Distraction osteogenesis was an effective method of advancing the mandible, increasing the upper airway space and ultimately preventing obstructive sleep apnea syndrome in patients with Treacher Collins syndrome.