• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.32-42
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• 1996

Objectives : Upper airway resistance syndrome(UARS) is a sleep-related breathing disorder characterized by abnormal negative intrathoracic pressure during sleep. Abnormally increased negative intrathoracic pressure results in microarousal and sleep fragmentation which underlay UARS-associated complaints of daytime fatigue and sleepiness. Although daytime dysfunction in patients with UARS is comparable to that of sleep apnea syndrome, UARS has been relatively unnoticed in clinical setting. That is why UARS is apt to be excluded in diagnosing of sleep-related breathing disorders since its respiratory disturbance index and arterial oxygen saturation are within normal limits. The current study presents a summary of clinical and polysomnographic characteristics found in patients with UARS. The present study aims (1) to explore characteristics of patients diagnosed with UARS, (2) to characterize the polysomnographic findings of UARS patients, and (3) to enhance the understanding of UARS through those clinical and laboratory characteristics. Methods : This was a retrospective study of 20 UARS patients (male 15, female 5) and 30 obstructive sleep apnea (OSA) patients (male 21, female 9) at the Stanford Sleep Disorders Clinic. We diagnosed patients as having UARS when they met critenia, RDI < 5 characteristic findings of an elevated esophageal pressure($<-10\;cmH_2O$), frequent arousals secondary to an elevated esophageal pressure, and symptoms of daytime fatigue and sleepiness. We used polysomnographic value, which is standardized by Williams et al(1974), as normal control. Statiotical test were done with student t-tests. Results : (1) Mean age of UARS was $41.0\;{\pm}\;14.8$ years and OSA was $50.9\;{\pm}\;12.0$ years. UARS subject was significantly younger than OSA subject (p<0.05). (2) The total score of Epworth Sleepiness Scale (ESS) was UARS $9.7\;{\pm}\;6.3$ and OSAS $11.2\;{\pm}\;6.3$. There was no significant difference between two groups. (3) The mean body mass index was UARS $28.1\;{\pm}\;5.7\;kg/m^2$ and OSAS $32.9\;{\pm}\;7.0\;kg/m^2$. UARS had significantly lower meen body man index than OSAS subjects (p<0.05). (4) The polysomnographic parameters of UARS were not significantly different from those of OSA except RDI(p<0.001), $SaO_2$ (p<0.001) and slow wave sleep latency (p<0.05). (5) Compared with normal control, Total sleep time in UARS subjects was significantly shorter (p<0.001), sleep efficiency index was significantly lower (p<0.001), total awakening percentage was significantly higher (p<0.001), and sleep stage 1 (p<0.001) were significantly higher. (6) OSA patients showed poor sleep quality and distinct abnormal sleep architectures compared with normal control. Conclusions : Conclusions from the above results are as follows : (1) UARS patients were younger and had lower body mass index when umpared with OSA patients. (2) The quality of sleep and sleep architectures of the UARS and OSA patients are significantly different from those of normal control. (3) ESS scores and awakening frequencies of UARS are similar with those of OSA, suggesting that daytime dysfunction of UARS patients may be comparable to those of OSA patients. (4) The RDI and the $SaO_2$ which are important indicators in diagnosing sleep-related breathing disorders, of UARS subjects are close to normal value. (5) According to the the above results, we unclude that despite the absence of $SaO_2$ drops and the absence of an elevated number of apnea and hypopnea, subjects developed clinical complaints which were associated with laborious breathing, elevated Pes nadir, and frequently snoring. (6) Accordingly, we suggest including LIARS in the differential diagnosis list when sleep related breathing disorder is suspected clinically and overnight polysomnographic findings except snoring and frequent microarousal are within normal limits.

• Journal of Korean Home Economics Education Association
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• v.28 no.3
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• pp.47-63
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• 2016

The purpose of this study is to suggest the basic information for diverse and balanced research and development in this field with understanding research trends related to safety education in home economics. In order to so, this study makes population and sampling by targeting cases which refer to 'safety' on 15 papers of academic journals related to home economics registered in the National Research Foundation from 2001 to 2015, 244 papers related to safety education area and 179 master doctorate thesis by searching keyword as 'safety'. Analysis contents are research trends of papers related to safety education by year and by subject and research trends of safety education by area and by research method. As a result of the study, first, the number of research papers related to safety education by year on home economics curriculum repeated increase and decrease and there have been consistent studies conducted on safety education with 14-52 papers per every year and yearly average 28.2 papers. On the other hand, the most number of studies conducted in 2015 with 52 papers which are twice as much of 26 papers in 2014. This seems to be affected by the announcement of safety comprehensive countermeasures from government and the emphasis of safety subject on 2015 curriculum revision of the Ministry of Education. Second, with regards to research trends by topic, 137 papers are related to safety education (29%), 336 papers are related to safety actual condition (71%). Accidents and recognition had a greater percentage in a paper before 2009 (74.4%) and studies are increased after 2009 (from 21 papers to 53 papers) in terms of development or evaluation of safety education program, development of education materials, development of education method etc. Subject area dealt with the most on the research of safety actual condition is regarding safety accidents or effective variables (23.2%). Subject regarding the variables are researches related to factors influencing family violence, internet addiction, spouse violence, willingness to purchase unsafe food, age harassment, or suicidal attempt etc. Next, researches related to safety recognition (13.9%), safety knowledge and attitude (7.4%), safety behaviors (6.3%), safety consciousness (2.3%) show in sequence. Subject area dealt with the most on the researches regarding safety education is development and evaluation of safety education program (11%) and this appears the most in 2015 by year (21.5%). Third, with regards to eight areas of safety education, there are 143 papers regarding public safety (33.8%), 106 papers regarding violence and personal safety (25.1%), 93 papers regarding general subject on safety or whole safety area (22%) and 58 papers regarding drug and internet addiction (13.7%) in sequence. And there is no paper related to first aid and 1 paper is related to occupational safety (0.2%). Occupational safety area is less researched nevertheless its included in home economic curriculum as relative chapter. First aid does not directly correlate with home economics curriculum but should be studied in preparation for accident which could happen in practical class. Forth, with regards to research trends by research method, quantitative research (89.1%) is mostly used and both research study (70.4%) and experimental research (18.7%) are used the most frequently. In particular, researches on the actual condition of safety education and experimental studies for effectiveness verification take most of research method. As qualitative studies, there are phenomenological study (3.1%) and case study (3.1%) related to actual conditions of safety accidents. 10 papers (2.4%) are mixture of quantitative and qualitative research and some research conducted research study and experimental research at the same time (0.9%). With regards to subject of study, human environments (87.5%) are more than physical environments (12.5) and students (48.4%) are more than teachers and school parents (20.6%). As the subject of physical environments, school (6.5%) is the most but home environment is none. As a result of the study, research for the development of evaluation tool for evaluating safety education, occupational safety and lifelong education should be conducted from this time forward. In addition, the object of study shall be expanded to both human environments in terms of entire life and physical environments for home. An in-depth qualitative research should be needed by observing and meeting with each student.