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Influence of general anesthesia on the postoperative sleep cycle in patients undergoing surgery and dental treatment: a scoping review on the incidence of postoperative sleep disturbance

  • Terumi Ayuse;Shinji Kurata;Gaku Mishima;Mizuki Tachi;Erika Suzue;Kensuke Kiriishi;Yu Ozaki-Honda;Takao Ayuse
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.2
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    • pp.59-67
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    • 2023
  • General anesthesia may influence the postoperative sleep cycle; however, no clinical studies have fully evaluated whether anesthesia causes sleep disturbances during the postoperative period. In this scoping review, we explored the changes in postoperative sleep cycles during surgical procedures or dental treatment under general anesthesia. We compared and evaluated the influence of general anesthesia on sleep cycles and sleep disturbances during the postoperative period in adult and pediatric patients undergoing surgery and/or dental treatment. Literature was retrieved by searching eight public databases. Randomized clinical trials, observational studies, observational case-control studies, and cohort studies were included. Primary outcomes included the incidence of sleep, circadian cycle alterations, and/or sleep disturbances. The search strategy yielded six studies after duplicates were removed. Finally, six clinical trials with 1,044 patients were included. In conclusion, general anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery.

Correlation between quality of sleep and dental fear in implant surgery patients (치과 임플란트 수술 환자의 수면 질과 공포감의 관련성)

  • Jin, Mi-Young;Kim, Sun-Ok;Yu, Byeng-Chul
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.3
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    • pp.371-379
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    • 2014
  • Objectives : The purpose of this study is to investigate the correlation between quality of sleep and dental fear in implant surgery patients. Methods : A self-reported questionnaire was filled out by 153 implant patients from December 2012 to February 2013 in dental clinics and hospitals in Busan and Changwon. Data were analyzed by descriptive analysis, t-test, ANOVA and multiple regression analysis using SAS version 9.20. Results : The quality of sleep in the implant patients was $41.0{\pm}6.0$. The systemic diseases influenced on the quality of sleep and dental fear also affected the quality of sleep. Conclusions : The results of the analysis of a relationship between the fear perception of dental implant surgery patients and the quality of their sleep showed that the patients with systemic diseases, the patients with a fear by the physical stimulation relating to implant treatment showed the low quality of sleep.

Management of obstructive sleep apnea in a Treacher Collins syndrome patient using distraction osteogenesis of the mandible

  • Damlar, Ibrahim;Altan, Ahmet;Turgay, Berk;Kilic, Soydan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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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.

A Study on the relationship between work from home and sleep disturbances among workers: using the 5th working environment survey (제5차 근로환경조사를 통해 조사된 재택근무와 수면장애 간의 연관성 연구)

  • Hyun-Jung Kim;Seo-Yeon Park;Hyung Jin Kwon;Yi-Qin Fang;Lei Lee
    • Journal of Korean Academy of Dental Administration
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    • v.11 no.1
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    • pp.78-88
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    • 2023
  • This study aimed to analyze the correlation between working from home and sleep disorders among domestic workers using data from the 5th Working Environment Survey in 2017. Out of the total 30,108 wage workers, 818 employees work from home and 4,090 work in an office. A random sample of 1:5 pairs, considering gender and occupational group, was selected from these employees as the study subjects. The analysis included personal characteristics, occupational characteristics, work-from-home arrangements, and sleep disorders. Age, education, employment status, years in the workforce, weekly working hours, work-life balance, self-perceived health, depression, and anxiety were all adjusted as potential confounding variables. Conditional logistic regression analysis was conducted to examine the relationship between working from home (independent variable) and sleep disorder (dependent variable). This analysis aimed to analyze the correlation between working from home and sleep disorder. The analysis revealed that working from home was associated with sleep onset latency disorder OR=3.23 (95% CI=2.67~3.91), sleep maintenance disorder OR=3.67 (95% CI=3.02~4.45), and non-restorative sleep OR=3.01 (95% CI=2.46~3.67), which showed a statistically significant relationship with all three types of sleep disorders. Factors influencing the correlation between working from home and sleep disorders included work-life balance, social isolation, and anxiety.

An objective assessment of the impact of tendon retraction on sleep efficiency in patients with full-thickness rotator cuff tears: a prospective cohort study

  • Ashley E. MacConnell;William Davis;Rebecca Burr;Andrew Schneider;Lara R Dugas;Cara Joyce;Dane H. Salazar;Nickolas G. Garbis
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.169-174
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    • 2023
  • Background: Sleep quality, quantity, and efficiency have all been demonstrated to be adversely affected by rotator cuff pathology. Previous measures of assessing the impact of rotator cuff pathology on sleep have been largely subjective in nature. This study was undertaken to objectively analyze this relationship through the use of activity monitors. Methods: Patients with full-thickness rotator cuff tears at a single institution were prospectively enrolled between 2018 and 2020. Waist-worn accelerometers were provided for the patients to use each night for 14 days. Sleep efficiency was calculated using the ratio of the time spent sleeping to the total amount of time that was spent in bed. Retraction of the rotator cuff tear was classified using the Patte staging system. Results: This study included 36 patients: 18 with Patte stage 1 disease, 14 with Patte stage 2 disease, and 4 patients with Patte stage 3 disease. During the study, 25 participants wore the monitor on multiple nights, and ultimately their data was used for the analysis. No difference in the median sleep efficiency was appreciated amongst these groups (P>0.1), with each cohort of patients demonstrating a generally high sleep efficiency. Conclusions: The severity of retraction of the rotator cuff tear did not appear to correlate with changes in sleep efficiency for patients (P>0.1). These findings can better inform providers on how to counsel their patients who present with complaints of poor sleep in the setting of full-thickness rotator cuff tears.

Maxillomandibular advancement surgery after long-term use of a mandibular advancement device in a post-adolescent patient with obstructive sleep apnea

  • Lee, Keun-Ha;Kim, Kyung-A;Kwon, Yong-Dae;Kim, Sung-Wan;Kim, Su-Jung
    • The korean journal of orthodontics
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    • v.49 no.4
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    • pp.265-276
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    • 2019
  • Patients with obstructive sleep apnea (OSA) whose phenotype belongs to a craniofacial vulnerability are referred from sleep doctors to orthodontists. In adults, for osseo-pharyngeal reconstruction (OPR) treatment, permanent maxillomandibular advancement (MMA) surgery and use of a temporary mandibular advancement device (MAD) are applied. This case report demonstrates successful treatment of OSA through application of phased MAD and MMA in a 16-year-old male with craniofacial deformity and residual growth potential. This patient showed skeletal and dentoalveolar changes after 7-year MAD use throughout post-adolescence, which affected the design and timing of subsequent MMA surgery, as well as post-surgical orthodontic strategy. This case report suggests that OPR treatment can be useful for treatment of OSA in post-adolescent patients, from an orthodontic point of view, in close collaboration with sleep doctors for interdisciplinary diagnosis and treatment.

GENIAL ADVANCEMENT, INFRAHYOID MYOTOMY AND SUSPENSION IN TREATMENT OF OBSTRUCTIVE SLEEP APNEA SYNDROME (이부전방이동술, 하설골근절개술 및 설골현수법을 이용한 폐쇄성 수면 무호흡증 환자의 치료:증례보고)

  • Kim, Jae-Jin;Kim, Eun-Seok;Kim, Tae-Sup
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.2
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    • pp.162-166
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    • 2001
  • Obstructive sleep apnea syndrome(OSAS) is a complex sleep disorder characterized by intermittent apnea secondary to sleep-induced obstruction of the upper airway. It occurs because of an airway obstruction anywhere between the trachea and the oronasal apparatus. The hallmark of OSAS is snoring, which is caused by vibration of the tissues of the pharynx as the airway narrows. The consequences of OSAS have focused on excessive daytime sleepiness resulting from sleep fragmentation and the cardiovascular derangements producing hypertension and arrhythmias. The primary method of controlling OSAS has been surgery. The current surgical procedures used for OSAS are tracheostomy, tonsillectomy, nasal septoplasty, uvulopalatopharyngoplasty, anterior mandibular osteotomy with hyoid myotomy and suspension, and maxillary, mandibular and hyoid advancement. We report a case of OSAS that was improved by genial advancement with infrahyoid myotomy and suspension. The patient was objectively documented by polysomnography, cephalometric analysis, and physical examination before the surgical procedure. The patient underwent genial advancement with infrahyoid myotomy and suspension. Patient had a good response from surgery.

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Comparison of the Effects of Hand Massage Provided with Different Intervals and Periods on Pain and Sleep Disturbance after Orthopedic Surgery

  • Cho, You-Na;Kim, Inja
    • The Korean Journal of Rehabilitation Nursing
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    • v.18 no.2
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    • pp.128-134
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    • 2015
  • Purpose: The purpose of this study was to compare the effects of hand massage provided with different intervals and periods on pain and sleep disturbance after orthopedic surgery. Methods: A non-equivalent control group pretest- posttest design was used. The subjects were admitted in an orthopedic hospital to get a surgery. They were divided into three groups. Group I (n=30) had hand massage every day. Group II (n=30) had hand massage every other day. Control group (n=31) had usual care. Data of all three groups were collected on the day before operation, POD (postoperative day) 6 and POD12. Hand massage was given for 2 and half minutes per hand. Results: Pain on POD6 of experimental group II was reduced more than those of control group. Pains on POD12 of both experimental groups were reduced more than those of control group. On POD6, only perceived sleep disturbance (PSD) was significantly different among groups. On POD12, PSD, total sleeping time, and sleep efficiency were more improved in the experimental groups. Conclusion: Hand massage was effective on the reduction of pain and sleep disturbance after orthopedic surgery. Applying hand massage on alternate day was effective enough. Also the effects were more obvious after 12 days.

An Aerodynamic study used aerophone II for snoring patients (코콜이 환자의 sleep splint 착용 전후의 음향학적 및 공기역학적 연구)

  • Jung, Se-Jin;Kim, Hyun-Gi;Shin, Hyo-Keun
    • 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.

A Case of Nasal Surgery for a Positive Airway Pressure-Intolerant OSAS Patient Due to Nasal Obstruction (코막힘으로 인해 양압기에 적응하지 못한 폐쇄성수면무호흡증 환자에서 시행된 코수술 1례)

  • Jung, Jae Hyun;Seon, Sang Woo;Hong, Seung-No;Choi, Ji Ho
    • Sleep Medicine and Psychophysiology
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    • v.23 no.2
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    • pp.97-99
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    • 2016
  • Positive airway pressure (PAP) is currently recommended as a primary treatment for obstructive sleep apnea syndrome (OSAS) and positively affects various subjective and objective parameters related to OSAS, such as the apnea-hypopnea index, excessive daytime sleepiness, and blood pressure. However, PAP also exhibits various adverse effects, including skin breakdown, pressure intolerance, claustrophobia, unintentional mask removal, mouth leaks, and dryness. Especially, unintentional mask removal due to nasal obstruction may result in poor PAP compliance. A 47-year-old male patient with severe OSAS who had low PAP compliance due to nasal obstruction underwent nasal surgery. After the surgery, nasal obstruction was corrected and the patient experienced improved PAP compliance (from 30.4% to 86.7%). This case demonstrates that nasal surgery may be useful for improving PAP compliance in OSAS patients with nasal obstruction.