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신혜림,김혜경,김지현 대한수면연구학회 2023 Journal of sleep medicine Vol.20 No.2
Sleep bruxism (SB) is a common disorder that presents as repetitive jaw muscle activity with clenching or grinding of teeth and/or bracing or thrusting of the mandible. Several studies have suggested that SB is associated with obstructive sleep apnea (OSA). However, the effect of treatment with continuous positive airway pressure (CPAP) on SB concomitant with OSA has not been well recognized, except in a few reported cases. Herein, we present three cases of SB with various OSA severities that were successfully treated with CPAP, as indicated by the improvement in their clinical symptoms and bruxism index on polysomnography. Our results suggest that clinicians should raise suspicion of OSA in patients with SB and be aware that patients with SB and concomitant moderate-to-severe OSA can be successfully treated with CPAP.
비강압력신호를 이용한 수면호흡장애 환자의 수면/각성 분류
박종욱,정필수,강규민,이경중,Park, Jong-Uk,Jeoung, Pil-Soo,Kang, Kyu-Min,Lee, Kyoung-Joung 대한의용생체공학회 2016 의공학회지 Vol.37 No.4
This study proposes the feasibility for automatic classification of sleep/wakefulness using nasal pressure in patients with sleep-disordered breathing (SDB). First, SDB events were detected using the methods developed in our previous studies. In epochs for normal breathing, we extracted the features for classifying sleep/wakefulness based on time-domain, frequency-domain and non-linear analysis. And then, we conducted the independent two-sample t-test and calculated Mahalanobis distance (MD) between the two categories. As a results, $SD_{LEN}$ (MD = 0.84, p < 0.01), $P_{HF}$ (MD = 0.81, p < 0.01), $SD_{AMP}$ (MD = 0.76, p = 0.031) and $MEAN_{AMP}$ (MD = 0.75, p = 0.027) were selected as optimal feature. We classified sleep/wakefulness based on support vector machine (SVM). The classification results showed mean of sensitivity (Sen.), specificity (Spc.) and accuracy (Acc.) of 60.5%, 89.0% and 84.8% respectively. This method showed the possibilities to automatically classify sleep/wakefulness only using nasal pressure.
김규남,고경석,정승은,하승희,박미경 대한두개안면성형외과학회 2010 Archives of Craniofacial Surgery Vol.11 No.2
Purpose: There are several surgical methods for correcting a velopharyngeal insufficiency (VPI) but in some cases, it is not possible to achieve complete recovery of the velopharyngeal function. This paper introduces a new therapy for treating hypernasality without further surgery using continuous positive airway pressure (CPAP). Methods: CPAP therapy was applied to seven VPI patients for eight weeks from April of 2007 to September of 2009. All patients underwent palatoplasty for the cleft palate and six patients underwent palatal lengthening for VPI before CPAP therapy. A speech pathologist performed an auditory perceptual evaluation to evaluate the improvement in hypernasality after 8-week CPAP therapy. Results: Six patients showed an improvement in hypernasality after CPAP therapy according to the auditory perceptual evaluation. One patient with severe hypernasality responded to the early part of therapy but the hypernasality did not improve after therapy. Conclusion: CPAP therapy might be effective in reducing the hypernasality in patients with VPI by providing resistance training to strengthen the velopharyngeal closure muscles. In particular, CPAP therapy could be more effective for patients who show mild to moderate hypernasality after surgery. (J Korean Cleft Palate Craniofac Assoc 11: 73, 2010)
Whoon Jong Kil,Tabitha Pham,Sabbir Hossain,Juan Casaigne,Kellie Jones.,Mohammad Khalil 대한방사선종양학회 2018 Radiation Oncology Journal Vol.36 No.1
Deep inspiration breathing hold (DIBH) compared to free-breathing (FB) during radiotherapy (RT) has significantly decreased radiation dose to heart and has been one of the techniques adopted for patients with breast cancer. However, patients who are unable to make suitable deep inspiration breath may not be eligible for DIBH, yet still need to spare the heart and lung during breast cancer RT (left-sided RT in particular). Continuous positive airway pressure (CPAP) is a positive airway pressure ventilator, which keeps the airways continuously open and subsequently inflates the thorax resembling thoracic changes from DIBH. In this report, authors applied CPAP instead of FB during left-sided breast cancer RT including internal mammary node in a patient who was unable to tolerate DIBH, and substantially decreased radiation dose the heart and lung with CPAP compared to FB.
수술 후 지속되는 과다비성 환자에서 지속성 기도양압 치료의 장기적 유효성: 증례보고
권주용,박미경,백롱민 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.6
Purpose: In some patients with velopharyngeal insufficiency (VPI), Hypernasality can persist after surgical management. Continuous Positive Airway Pressure (CPAP)is applied to these patients for treating hypernasality. The purpose of this study is to report follow-up results of postoperative CPAP therapy. Methods: After performing palatal lengthening, CPAP therapy was applied to three patients for eight weeks from July of 2008 to November of 2009. Perceptual evaluation,nasometry, and nasopharyngeal endoscopy were performed to evaluate hypernasality, nasalance and size of the gap at velopharyngeal port. Each evaluation was made before surgery, right after CPAP therapy and during followup of more than a year after CPAP therapy. Results: All of the patients showed improvement in hypernasality right after CPAP therapy according to the auditory perceptual evaluation, nasometry and nasopharyngeal endoscopy. But the improvement in hypernasality in these patients did not last during follow-up. Conclusion: In this study, our results suggest that CPAP therapy is effective in reducing hypernasality for postoperative VPI patients immediately after the therapy,but hypernasality may be worsen in some patients during follow-up. Therefore we recommend follow-ups after CPAP therapy to see if the efficacy of CPAP therapy lasts.
Kil, Whoon Jong,Pham, Tabitha,Hossain, Sabbir,Casaigne, Juan,Jones, Kellie,Khalil, Mohammad The Korean Society for Radiation Oncology 2018 Radiation Oncology Journal Vol.36 No.1
Deep inspiration breathing hold (DIBH) compared to free-breathing (FB) during radiotherapy (RT) has significantly decreased radiation dose to heart and has been one of the techniques adopted for patients with breast cancer. However, patients who are unable to make suitable deep inspiration breath may not be eligible for DIBH, yet still need to spare the heart and lung during breast cancer RT (left-sided RT in particular). Continuous positive airway pressure (CPAP) is a positive airway pressure ventilator, which keeps the airways continuously open and subsequently inflates the thorax resembling thoracic changes from DIBH. In this report, authors applied CPAP instead of FB during left-sided breast cancer RT including internal mammary node in a patient who was unable to tolerate DIBH, and substantially decreased radiation dose the heart and lung with CPAP compared to FB.
주은연 대한수면연구학회 2008 Journal of sleep medicine Vol.5 No.2
Positive airway pressure (PAP) is the treatment of choice for patients with moderate-to-severe obstructive sleep apnea (OSA). PAP can effectively reduce the apnea-hypopnea index and improve subjective and objective sleepiness. Also it can gives benefits in sleep quality and quality of life for both the patient and bed partner. Since continuous PAP (CPAP) treatment of OSA was described, additional modes of pressure delivery have been developed (bilevel PAP, autoadjusting PAP, flexible PAP). While none of the variants of PAP improves adherence in unselected patients compared to CPAP, individual patients may respond to a change in pressure mode. Although attended PAP titration remains the standard of practice for selecting a treatment pressure, use of autotitrating PAP devices in the unattended setting can provide an effective titration alternative with careful patient selection and review of titration results. However, despite the increase in PAP treatment options, lack of acceptance and inadequate adherence to PAP therapy remain the major causes of treatment failure. Heated humidification can improve PAP adherence, especially in patients with nasal congestion or dryness.
CPAP(Continuous Positive Airway Pressure) 치료 프로그램이 취학 전 구순․구개열 아동의 과대비성 개선에 미치는 효과
조성미(Sung-Mi Jo),정옥란(Ok-ran Jeong),한기환(Ki-Hwan Han) 한국음성학회 2007 음성과학 Vol.14 No.4
The purpose of this study was to determine the effectiveness of CPAP (Continuous Positive Airway Pressure) therapy on the treatment of hypernasality in patients with cleft lips and palates. 7 preschool children with severe hypernasality participated in the study. Acoustic measurements of nasality were done by using the NasalView (version 1.31). Results showed that the nasalance values were reduced linearly in both vowels according to the treatment period. The sharp treatment effect was observed at the beginning stage. The nasality values of the vowel /i/ showed a sharp decrease at the Evaluation Phase 1 and 2 and a small increase at the Phase 4 followed by a drop in the end. Further studies would be desirable for various patients with different disorder types.
코골이와 폐쇄성 수면무호흡증의 진단 및 치료의 중요성과 치과의사의 역할
김현철(Hyeon Cheol Kim) 대한치과의사협회 2010 대한치과의사협회지 Vol.48 No.3
Obstructive Sleep Apnea(OSA) is a form of sleep disordered breathing(SDB) characterized by the occurrence of episodes of complete or partial upper airway obstruction during sleep that is often quantified as the apnea-hyponea index(AHI). It is increasingly being recognized that OSA is a public health hazard and there is increasing evidence that it is associated with an increase in morbidity. Early recognition and diagnosis of this condition may lead to earlier treatments (eg, CPAP, Oral appliances) with reduction of the risk of metabolic disease, cardiovascular diseases, such as hypertension, ischemic heart disease, arrhythmias and pulmonary hypertension.