• 수면정신생리
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• 제2권2호
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• pp.171-179
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• 1995

Objectives : This study was carried out to determine whether the state anxiety may affect sleep on the night before surgery. Methods : The researcher examined the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day and then had semistructural interview with patients. In addition Spielberger's State Anxiety Inventory(1972), presleep questionnaire and postsleep questionnaire were administered to the patients. One hundred patients who responded to the questions were divided into three groups based on the state anxiety scores; low(n=35), middle(n=27) and high(n=38). Demographic and clinical characteristics of patients, some possible factors affecting sleep, daytime status and nighttime sleep before surgery were compared among three groups. Results : 1) There was no significant difference in demographic characteristics and some possible factors affecting sleep on the night before surgery among three groups. 2) In terms of clinical characteristics, the expectancy of surgical result was significantly different among three groups. More patients in low anxiety group than in middle and high anxiety groups, predicted surgical results as good, while more patients in middle and high anxiety groups than in low anxiety group could not predict their surgical results. 3) For daytime status, high anxiety group felt more tired compared to low anxiety group, but there was no significant difference in daytime nap among three groups. 4) For nighttime sleep before surgery, high anxiety group expected poor sleep and in fact, waked more frequently during sleep than low anxiety group. However there was no difference in bed time, sleep latency, rise time, total sleep time, sleep depth and sleep quality among three groups. 5) The need for hypnotics was higher before bedtime and also after rise in high anxiety group compared to low anxiety group. Conclusions : These results indicate that the individuals with high state anxiety before surgery have poor sleep and furthermore suggest that anxiolytics and/or hypnotics may be required to decrease anxiety and improve sleep for those with high state anxiety.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권4호
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• pp.321-328
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• 2007

If there are problems for us to sleep, we are faced with fatigue and dizziness in the day. Snoring and OSAS (obstructive sleep apnea syndrome) during sleeping are the main cause of sleep disorder. Treatments through surgical method and sleep splint can be performed to treat snoring and OSAS. Relapse of snoring and OSAS is common after treatment by surgical method. But, Recently sleep splint is frequently applied to treat snoring and OSAS with surgical treatment, because it is convenient and conservative. Sleep splint treat snoring and OSAS by ensuring airway through nose. As first step of fabrication occlusal bite is gained at a point that patient get feeling of increased nasal breathing in supined position, and next, the bite is transfered to sleep splint. This study surveyed the effect of sleep splint by questionnaire to the out-patients (the Dept. of Oral and Maxillofacial Surgery, Chonbuk National University Hospital) weared sleep splint and their partners, secondarily measured airflow through nose by aerophone II after wearing sleep splint and finally evaluated the effect of treatment of snoring and OSAS by sleep splint. The obtained result were as follows; 1. Though 'sleep splint' couldn't eliminate fundamental problems of snoring, it could improve the symptoms when patients were selected could using the 'Nakagawa's respiration method'. 2. Patients who used the sleep splint could breathe stably when patients are sleeping stably. Wearing a 'sleep splint' improved airflow by expanding the upper airway. 3. Even though sleep splint can be made with variable materials, the patients expressed the most satisfaction on the splint with '0.75mm hard shell'. 4. The 'Herbst' may allows the mandible to move the TMJ to relax. Nevertheless, some patients experienced a discomfort or irritation. 5. In Snoring and OSAS cases, it is recommended that patients should first explore non-surgical options prior to choosing a surgical treatment.

• Journal of Korean Biological Nursing Science
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• 제21권1호
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• pp.12-21
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• 2019

Purpose: The purpose of this study was to review previous literature with an aim to explore the sleep disturbance level after a patient undergoes cataract surgery using an integrative review. Methods: We used the key words, 'cataract surgery', 'sleep', and 'intraocular lens' to find peer-reviewed publications in seven databases. Among 450 searched articles, eight articles were selected after exclusion of articles that did not meet the criteria. Results: Five of the articles submitted that subjective sleep quality of the patients with blue-filtering intraocular lens (BF-IOL) implant improved as compared to that before surgery. The change of saliva melatonin concentration after BF-IOL implant did not coincide in two of the articles. Two of the articles reported an increased level of intrinsically photosensitive retinal ganglion cells response after BF-IOL implantation. Conclusion: The published studies stated that BF-IOL implant did not have any negative impact on quality of sleep among cataract patients suffering with poor sleep. Rregardless of intraocular lens type, cataract surgery may increase photoreception of intrinsically photosensitive retinal ganglion cells one year after surgery although the mechanism was not clear. It is necessary to identify various factors influencing the quality of sleep such as gender and activities among cataract patients with BF-IOL implant in the future.

• 수면정신생리
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• 제25권2호
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• pp.92-95
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• 2018

Catathrenia가 환자에게 어떠한 신체적 문제를 유발하며 장기간 지속되는 경우에는 어떠한 합병증을 유발하는지, 자연 경과는 어떻게 되는지 등 예후 관련해서도 아직까지 구체적으로 확인된 바는 없다. 이와 같은 많은 의학적 궁금증들이 해소되기 위해서는 매우 드문 질환이긴 하지만 향후 지속적인 문헌 수집을 통한 질환 분석과 함께 전향적 연구가 필요할 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.7.1-7.8
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• 2020

Maxillomandibular advancement (MMA) is effective for the treatment of obstructive sleep apnea (OSA). In previous studies, the airway was increased in the anteroposterior and transverse dimensions after MMA. However, the effect of the opposite of mandibular movement (mandibular setback) on the airway is still controversial. Mandibular setback surgery has been suggested to be one of the risk factors in the development of sleep apnea. Previous studies have found that mandibular setback surgery could reduce the total airway volume and posterior airway space significantly in both the one-jaw and two-jaw surgery groups. However, a direct cause-and-effect relationship between the mandibular setback and development of sleep apnea has not been clearly established. Moreover, there are only a few reported cases of postoperative OSA development after mandibular setback surgery. These findings may be attributed to a fundamental difference in demographic variables such as age, sex, and body mass index (BMI) between patients with mandibular prognathism and patients with OSA. Another possibility is that the site of obstruction or pattern of obstruction may be different between the awake and sleep status in patients with OSA and mandibular prognathism. In a case-controlled study, information including the BMI and other presurgical conditions potentially related to OSA should be considered when evaluating the airway. In conclusion, the preoperative evaluation and management of co-morbid conditions would be essential for the prevention of OSA after mandibular setback surgery despite its low incidence.

• 대한치과의사협회지
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• 제53권12호
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• pp.926-934
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• 2015

Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences. Untreated OSA may cause, or be associated with, several adverse outcomes, including daytime sleepiness, increased risk for motor vehicle accidents, cardiovascular disease, and depression. Various treatments are available, including non-surgical treatment such as medication or modification of life style, continuous positive airway pressure (CPAP) and oral appliance (OA). Skeletal surgery for obstructive sleep apnea (OSA) aims to provide more space for the soft tissue in the oropharynx to prevent airway collapse during sleep. Conventional surgical techniques include uvopalatopharyngoplasty(UPPP), genioglossus advancement (GA), and maxillomandibular advancement (MMA). Surgical techniques, efficacy and complications of skeletal surgery are introduced in this review.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.34.1-34.5
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• 2019

Background: To systematically review the literature for methods to localize the genial tubercle as a means for performing an advancement of the genioglossus muscle. Methods: PubMed, Google Scholar, CRISP, EMBASE, CINAHL, and Scopus were searched from inception through June 16, 2015. Results: One hundred fifty-two articles were screened, and the full text versions of 12 articles were reviewed in their entirety and 7 publications reporting their methodology for localizing the genial tubercle. Based upon these measurements and the results published from radiographic imaging and cadaveric dissections of all the papers included in this study, we identified the genial tubercle as being positioned within the mandible at a point 10 mm from the incisor apex and 10 mm from the lower mandibular border. Conclusion: Based upon the results of this review, the genial tubercles were positioned within the mandible at a point 10 mm from the incisor apex and 10 mm from the lower mandible border. It may serve as an additional reference for localizing the genial tubercle and the attachment of the genioglossus muscle to the mandible, although the preoperative radiological evaluation and the palpation of the GT are recommended to accurately isolate.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.267-275
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• 2005

Obstructive sleep apnea syndrome (OSAS) is characterized by sleep-induced obstruction of the upper airway that results in cessation of airflow. Obstruction can occur at a number of points in the airway, but frequently in the oropharynx. A diagnostic evaluation includes cephalometry, computed tomography, magnetic resonance imaging, acoustic reflection technique, polysomnography and fibroptic endoscopy. Cephalometric measurements of the patients with obstructive sleep apnea have revealed that posterior airway anatomy has strong relations with the symptoms of them. A lateral cephalogram is routinely obtained in the radiologic evaluation of sleep apnea patients. The purpose of this study is to provide a the lateral cephalometric korean norms for the diagnosis and treatment of the patients with obstructive sleep apnea by analyzing the abnormal occlusion of Korean adults.

• 대한치과의사협회지
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• 제57권5호
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• pp.279-287
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• 2019

Obstructive sleep apnea syndrome (OSAS) is characterized by obstructive events of the upper airway (UAW) during sleep, which can be associated with clinical signs and symptoms such as snoring, excessive daytime sleepiness, impaired memory, and fatigue. It is associated with many problems like psychosocial problems, physiologic alterations in the cardiovascular and respiratory systems as a result of hypoxia and repeated awakenings during sleep. Conservative treatments such as weight loss, sleep positioning, improvement of sleep hygiene, CPAP and MAD can be performed for the obstructive sleep apnea. However, their effect for the OSA is limited and differs by patient's individual properties. Accordingly, surgical reconstructions of the upper airway must be carried out for the treatment of OSA.

• 수면정신생리
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• 제23권2호
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• pp.93-96
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• 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.