Due to glossal and craniofacial skeletal abnormalities, children with Down syndrome (DS) are prone to obstructive sleep apnea (OSA), thus demanding an increased necessity for an earlier diagnosis and more strict control for OSA. Adenotonsillectomy (T&A op) is an effective surgical treatment method to reduce OSA in children. Nevertheless, it should be noted that T&A op in DS children might be insufficient to completely resolve OSA and that extra care is needed when performing a T&A op for airway obstruction in DS during the immediate postoperative period. The objective of the present study was to report a case of a 2-year-old male DS patient with severe OSA (apnea-hypopnea index [AHI] of 61.7/hr) which was consequently reduced to moderate OSA (AHI of 7.6/hr), followed by reduction to mild OSA (AHI of 4.8/hr) with an one-year of rapid maxillary expansion (RME) device application. With a 2-year application of the RME device, the hard palate width in the 1st and 2nd molar region was increased to 5.86 mm and 5.26 mm, respectively. This is the first case report describing that a severe OSA is reduced to moderate OSA with T&A op and further reduced to mild OSA with an RME device application.
{"title":"Obstructive Sleep Apnea in a 2-Year-Old Down Syndrome Child: Successful Management With Adenotonsillectomy Followed by Rapid Maxillary Expansion Treatment","authors":"M. J. Park, Y. Kim, Yoo-Sam Chung","doi":"10.17241/smr.2022.01319","DOIUrl":"https://doi.org/10.17241/smr.2022.01319","url":null,"abstract":"Due to glossal and craniofacial skeletal abnormalities, children with Down syndrome (DS) are prone to obstructive sleep apnea (OSA), thus demanding an increased necessity for an earlier diagnosis and more strict control for OSA. Adenotonsillectomy (T&A op) is an effective surgical treatment method to reduce OSA in children. Nevertheless, it should be noted that T&A op in DS children might be insufficient to completely resolve OSA and that extra care is needed when performing a T&A op for airway obstruction in DS during the immediate postoperative period. The objective of the present study was to report a case of a 2-year-old male DS patient with severe OSA (apnea-hypopnea index [AHI] of 61.7/hr) which was consequently reduced to moderate OSA (AHI of 7.6/hr), followed by reduction to mild OSA (AHI of 4.8/hr) with an one-year of rapid maxillary expansion (RME) device application. With a 2-year application of the RME device, the hard palate width in the 1st and 2nd molar region was increased to 5.86 mm and 5.26 mm, respectively. This is the first case report describing that a severe OSA is reduced to moderate OSA with T&A op and further reduced to mild OSA with an RME device application.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41913272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jae-Yoon Kang, Se Yeon Im, Han Wool John Sung, M. Choi, Soo-Kyoung Park, Yong Min Kim
Background and Objective Although numerous studies have reported surgical results of uvulopalatopharyngoplasty, efficacies of extended uvulopalatal flap (EUPF) surgery have only been reported in a few studies. Thus, the aim of this study was to evaluate the success rate of EUPF and investigate the advantage and practicality of this surgery.Methods Medical records of patients who underwent EUPF surgery were retrospectively analyzed. Through medical record analysis, demographic information was confirmed. Postoperative polysomnography (PSG) results were divided into a surgical ‘success’ group and a ‘failure’ group. Patients’ PSG results, questionnaires, and cephalometry were comparatively analyzed.Results All sleep parameters of PSG except rapid eye movement latency and hypopnea index were significantly improved after surgery. Ten patients were in the success group (success rate, 33.3%) and 20 patients were in the failure group. Among preoperative PSG parameters, apnea-hypopnea index, apnea index, and number of awakenings showed significant differences between the two groups. However, there were no significant differences in results of cephalometry or Friedman stage between the two groups.Conclusions The EUPF surgery can change sleep factors and improve subjective symptoms in obstructive sleep apnea patients. It could be considered as one of the treatment options for patients with surgical indications, although its success rate was only 33.3%.
{"title":"Therapeutic Effect of Extended Uvulopalatal Flap Surgery in Patients With Obstructive Sleep Apnea","authors":"Jae-Yoon Kang, Se Yeon Im, Han Wool John Sung, M. Choi, Soo-Kyoung Park, Yong Min Kim","doi":"10.17241/smr.2022.01298","DOIUrl":"https://doi.org/10.17241/smr.2022.01298","url":null,"abstract":"Background and Objective Although numerous studies have reported surgical results of uvulopalatopharyngoplasty, efficacies of extended uvulopalatal flap (EUPF) surgery have only been reported in a few studies. Thus, the aim of this study was to evaluate the success rate of EUPF and investigate the advantage and practicality of this surgery.Methods Medical records of patients who underwent EUPF surgery were retrospectively analyzed. Through medical record analysis, demographic information was confirmed. Postoperative polysomnography (PSG) results were divided into a surgical ‘success’ group and a ‘failure’ group. Patients’ PSG results, questionnaires, and cephalometry were comparatively analyzed.Results All sleep parameters of PSG except rapid eye movement latency and hypopnea index were significantly improved after surgery. Ten patients were in the success group (success rate, 33.3%) and 20 patients were in the failure group. Among preoperative PSG parameters, apnea-hypopnea index, apnea index, and number of awakenings showed significant differences between the two groups. However, there were no significant differences in results of cephalometry or Friedman stage between the two groups.Conclusions The EUPF surgery can change sleep factors and improve subjective symptoms in obstructive sleep apnea patients. It could be considered as one of the treatment options for patients with surgical indications, although its success rate was only 33.3%.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43598902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Habibolah Khazaie, Siamand Mazhar, A. Moghadam, M. R. Ghadami, Sepideh Khazaie, A. Parvizifard
Background and Objective Weight gain and obesity could be side effects of taking atypical antipsychotic medications. They are major risk factors for obstructive sleep apnea. The purpose of this study was to investigate effects of atypical antipsychotic medications on the risk of obstructive sleep apnea in individuals with schizophrenia and control groups.Methods In this cross-sectional study, 123 patients with schizophrenia and 107 participants were selected from hospital staff and students using purposive sampling. Data were collected using structured clinical interview and Berlin questionnaires.Results Results showed that the risk of obstructive sleep apnea was significantly higher in individuals with schizophrenia. Age, body mass index, and phases of schizophrenia showed meaningful relationships with the duration of taking atypical antipsychotic medications with the risk of obstructive sleep apnea. However, the type of atypical antipsychotic medications did not have a significant relationship with the risk of obstructive sleep apnea.Conclusions Patients with schizophrenia treated with atypical antipsychotic medicationshave a higher risk of obstructive sleep apnea.
{"title":"Effect of Atypical Antipsychotic Medications on the Risk of Obstructive Sleep Apnea in Individuals With Schizophrenia","authors":"Habibolah Khazaie, Siamand Mazhar, A. Moghadam, M. R. Ghadami, Sepideh Khazaie, A. Parvizifard","doi":"10.17241/smr.2022.01326","DOIUrl":"https://doi.org/10.17241/smr.2022.01326","url":null,"abstract":"Background and Objective Weight gain and obesity could be side effects of taking atypical antipsychotic medications. They are major risk factors for obstructive sleep apnea. The purpose of this study was to investigate effects of atypical antipsychotic medications on the risk of obstructive sleep apnea in individuals with schizophrenia and control groups.Methods In this cross-sectional study, 123 patients with schizophrenia and 107 participants were selected from hospital staff and students using purposive sampling. Data were collected using structured clinical interview and Berlin questionnaires.Results Results showed that the risk of obstructive sleep apnea was significantly higher in individuals with schizophrenia. Age, body mass index, and phases of schizophrenia showed meaningful relationships with the duration of taking atypical antipsychotic medications with the risk of obstructive sleep apnea. However, the type of atypical antipsychotic medications did not have a significant relationship with the risk of obstructive sleep apnea.Conclusions Patients with schizophrenia treated with atypical antipsychotic medicationshave a higher risk of obstructive sleep apnea.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45728601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objective Many studies have indicated that obstructive sleep apnea (OSA) is linked to the development of cancer. However, there have been few studies about the link between OSA and renal cell carcinoma (RCC). This study investigated the relationship between OSA and RCC by analyzing the data from the Korea National Health Insurance Service.Methods 198574 patients (≥ 20 years of age) newly diagnosed with OSA from 2007 to 2014 were included and 992870 control groups were selected through propensity score matching according to sex and age. The average follow-up period was 4.6 years. The primary outcome was newly diagnosed RCC. The hazard ratio for RCC in patients with OSA was compared to that in the control group.Results The incidence of RCC was significantly higher among patients with OSA than among controls (hazard ratio, 1.65; 95% confidence interval, 1.41–1.93).Conclusions OSA may be a potential risk factor for RCC.
{"title":"The Incidence of Renal Cell Carcinoma Is Increased in Patients With Obstructive Sleep Apnea","authors":"H. Park, W. Choi, J. Cho","doi":"10.17241/smr.2022.01305","DOIUrl":"https://doi.org/10.17241/smr.2022.01305","url":null,"abstract":"Background and Objective Many studies have indicated that obstructive sleep apnea (OSA) is linked to the development of cancer. However, there have been few studies about the link between OSA and renal cell carcinoma (RCC). This study investigated the relationship between OSA and RCC by analyzing the data from the Korea National Health Insurance Service.Methods 198574 patients (≥ 20 years of age) newly diagnosed with OSA from 2007 to 2014 were included and 992870 control groups were selected through propensity score matching according to sex and age. The average follow-up period was 4.6 years. The primary outcome was newly diagnosed RCC. The hazard ratio for RCC in patients with OSA was compared to that in the control group.Results The incidence of RCC was significantly higher among patients with OSA than among controls (hazard ratio, 1.65; 95% confidence interval, 1.41–1.93).Conclusions OSA may be a potential risk factor for RCC.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46863619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Postural effects on breathing are evident in most patients with obstructive sleep apnea. However, the impact varies depending on an individual’s habitual sleeping position. Here, an age 40 obese male with typical sleep apnea symptoms is presented. He had a habit of sleeping with his back on the head of the bed in a sitting position, two or three times nightly. Polysomnography showed severe obstructive sleep apnea. However, during sitting positional sleep, the obstructive events disappeared, and sleep became stable.
{"title":"Postural Effect on Obstructive Sleep Apnea: Sitting Versus Supine","authors":"K. Ji","doi":"10.17241/smr.2022.01312","DOIUrl":"https://doi.org/10.17241/smr.2022.01312","url":null,"abstract":"Postural effects on breathing are evident in most patients with obstructive sleep apnea. However, the impact varies depending on an individual’s habitual sleeping position. Here, an age 40 obese male with typical sleep apnea symptoms is presented. He had a habit of sleeping with his back on the head of the bed in a sitting position, two or three times nightly. Polysomnography showed severe obstructive sleep apnea. However, during sitting positional sleep, the obstructive events disappeared, and sleep became stable.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46651556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kanarskii, J. Nekrasova, Pranil M. Pradhan, I. Borisov, O. Korepina, E. Kondratyeva, Angelina Nikitkina, Marina Petrova
Disturbance in circadian rhythms and the sleep-wake cycle is typical for patients in the intensive care unit, which retards rehabilitation. To assess the effect of exogenous melatonin and simultaneous mitigation of intensive care unit environmental factors on sleep duration. We studied five patients with chronic disorder of consciousness caused by anoxic brain injury. In addition, we varied the level of melatonin secretion in blood plasma to assess melatonin’s bioavailability and elimination time. We evaluated the sleep-wake cycle using continuous videoelectroencephalogram monitoring with the addition of oculographic and myographic channels for 72 hours. All the patients received melatonin tablets on the second day, wore masks and ear plugs, and had no feeding and nursing manipulations at night on the second and third days. There was no significant difference in sleep time between the first, second, and third days. Future studies of the circadian rhythm should aim at gaining a deeper analysis of the characteristics of the sleep-wake cycle in patients with severe anoxic brain injury together with further research for possible ways to influence the circadian component of sleep.
{"title":"The High-Dose of Exogenous Melatonin Did Not Alter the Sleep-Wake Cycle in Anoxic Brain Injury Patients","authors":"M. Kanarskii, J. Nekrasova, Pranil M. Pradhan, I. Borisov, O. Korepina, E. Kondratyeva, Angelina Nikitkina, Marina Petrova","doi":"10.17241/smr.2022.01361","DOIUrl":"https://doi.org/10.17241/smr.2022.01361","url":null,"abstract":"Disturbance in circadian rhythms and the sleep-wake cycle is typical for patients in the intensive care unit, which retards rehabilitation. To assess the effect of exogenous melatonin and simultaneous mitigation of intensive care unit environmental factors on sleep duration. We studied five patients with chronic disorder of consciousness caused by anoxic brain injury. In addition, we varied the level of melatonin secretion in blood plasma to assess melatonin’s bioavailability and elimination time. We evaluated the sleep-wake cycle using continuous videoelectroencephalogram monitoring with the addition of oculographic and myographic channels for 72 hours. All the patients received melatonin tablets on the second day, wore masks and ear plugs, and had no feeding and nursing manipulations at night on the second and third days. There was no significant difference in sleep time between the first, second, and third days. Future studies of the circadian rhythm should aim at gaining a deeper analysis of the characteristics of the sleep-wake cycle in patients with severe anoxic brain injury together with further research for possible ways to influence the circadian component of sleep.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45877357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objective We considered the concept of the DBST, the discrepancy between a patient’s desired time in bed (TIB) and desired total sleep time (TST). The DBST index can be used to easily assess a patient’s thoughts on their desired TST and dysfunctionally long TIB. This study aimed to explore whether the DBST index can predict the severity of insomnia.Methods A total of 374 members of the general population participated in this e-survey study. The participants answered questions regarding their bedtime, sleep onset time, wake-up time, desired TST, and desired TIB, and psychological symptoms were assessed using the Insomnia Severity Index (ISI), Patients Health Questionnaire–9 items (PHQ-9), Dysfunctional Beliefs and Attitudes about Sleep–16 items (DBAS-16), and Glasgow Sleep Effort Scale (GSES).Results The DBST index was significantly correlated with the ISI (r = 0.20, p < 0.01), PHQ-9 (r = 0.15, p < 0.01), GSES (r = 0.14, p < 0.01), DBAS-16 (r = 0.16, p < 0.01), desired TST (r = -0.62, p < 0.01), and desired TIB (r = 0.52, p < 0.01). Linear regression analysis showed that insomnia severity was predicted by persistent preoccupation with sleep (beta = 0.64, p < 0.001), dysfunctional beliefs about sleep (beta = 0.06, p < 0.001), depression (beta = 0.23, p < 0.001), and DBST (beta = 0.32, p = 0.035). The DBST directly influenced insomnia severity, and this association was shown to be mediated by dysfunctional beliefs and attitudes about sleep, preoccupation with sleep, and depression.Conclusions The DBST index could be a possible new sleep index due to its relationship with insomnia severity, depression, dysfunctional beliefs about sleep, and preoccupation with sleep. Further studies are needed to explore the consistency of the clinical sample.
背景与目的我们考虑了DBST的概念，即患者期望的卧床时间(TIB)和期望的总睡眠时间(TST)之间的差异。DBST指数可以用来很容易地评估患者对他们期望的TST和功能失调的长TIB的想法。本研究旨在探讨DBST指数是否可以预测失眠的严重程度。方法对374名普通人群进行电子问卷调查。参与者回答有关就床时间、睡眠开始时间、起床时间、期望TST和期望TIB的问题，并使用失眠严重程度指数(ISI)、患者健康问卷-9项(PHQ-9)、睡眠功能失调信念和态度-16项(bas -16)和格拉斯哥睡眠努力量表(GSES)评估心理症状。结果DBST指数与ISI (r = 0.20, p < 0.01)、PHQ-9 (r = 0.15, p < 0.01)、GSES (r = 0.14, p < 0.01)、DBAS-16 (r = 0.16, p < 0.01)、理想TST (r = -0.62, p < 0.01)、理想TIB (r = 0.52, p < 0.01)显著相关。线性回归分析显示，持续关注睡眠(β = 0.64, p < 0.001)、对睡眠的功能失调信念(β = 0.06, p < 0.001)、抑郁(β = 0.23, p < 0.001)和DBST (β = 0.32, p = 0.035)可以预测失眠严重程度。DBST直接影响失眠的严重程度，这种关联被证明是由对睡眠的功能失调的信念和态度、对睡眠的关注和抑郁介导的。结论DBST指数与失眠严重程度、抑郁程度、睡眠信念功能障碍和睡眠关注相关，可能成为一种新的睡眠指数。临床样本的一致性有待进一步研究。
{"title":"The DBST Index, the Discrepancy Between Desired Time in Bed and Desired Total Sleep Time: The Possible New Sleep Index Predicting Severity of Insomnia","authors":"Seockhoon Chung","doi":"10.17241/smr.2022.01368","DOIUrl":"https://doi.org/10.17241/smr.2022.01368","url":null,"abstract":"Background and Objective We considered the concept of the DBST, the discrepancy between a patient’s desired time in bed (TIB) and desired total sleep time (TST). The DBST index can be used to easily assess a patient’s thoughts on their desired TST and dysfunctionally long TIB. This study aimed to explore whether the DBST index can predict the severity of insomnia.Methods A total of 374 members of the general population participated in this e-survey study. The participants answered questions regarding their bedtime, sleep onset time, wake-up time, desired TST, and desired TIB, and psychological symptoms were assessed using the Insomnia Severity Index (ISI), Patients Health Questionnaire–9 items (PHQ-9), Dysfunctional Beliefs and Attitudes about Sleep–16 items (DBAS-16), and Glasgow Sleep Effort Scale (GSES).Results The DBST index was significantly correlated with the ISI (r = 0.20, p < 0.01), PHQ-9 (r = 0.15, p < 0.01), GSES (r = 0.14, p < 0.01), DBAS-16 (r = 0.16, p < 0.01), desired TST (r = -0.62, p < 0.01), and desired TIB (r = 0.52, p < 0.01). Linear regression analysis showed that insomnia severity was predicted by persistent preoccupation with sleep (beta = 0.64, p < 0.001), dysfunctional beliefs about sleep (beta = 0.06, p < 0.001), depression (beta = 0.23, p < 0.001), and DBST (beta = 0.32, p = 0.035). The DBST directly influenced insomnia severity, and this association was shown to be mediated by dysfunctional beliefs and attitudes about sleep, preoccupation with sleep, and depression.Conclusions The DBST index could be a possible new sleep index due to its relationship with insomnia severity, depression, dysfunctional beliefs about sleep, and preoccupation with sleep. Further studies are needed to explore the consistency of the clinical sample.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45269919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obstructive sleep apnea (OSA) is a common chronic sleep disorder that causes oxygen desaturations, sympathetic hyperactivation, and sleep fragmentation. The gold standard for OSA treatment in adults is positive airway pressure (PAP) therapy, which is effective when used during sleep. However, about half of patients with OSA refuse or are non-adherent to PAP, and some patients have anatomical problems that can be alleviated surgically. Surgery can be considered for patients who are very likely to have successful surgical results, but who are intolerant to PAP or oral appliances because of anatomical abnormalities. There are various surgical modifications of the upper airway for OSA, including nasal surgeries (e.g., septoplasty, turbinoplasty, and endoscopic sinus surgery), nasopharyngeal surgeries, oral and oropharyngeal surgeries (e.g., uvulopalatopharyngoplasty and variations, tonsillectomy, and palatal implants), hypopharyngeal surgeries (e.g., tongue ablation, tongue-base resection, and genioglossus advancement), and multi-level surgeries. Much clinical research has reported the outcomes of various surgical procedures for OSA internationally based on the traditional surgical success rate (defined as ≥ 50% reduction in the postoperative apnea-hypopnea index [AHI], postoperative AHI < 20), and AHI reduction ratio (defined as between the preoperative and postoperative AHI). In addition, many studies investigating the results of various OSA surgeries have been reported in Korea. In this article, we review the characteristics of various upper airway surgical procedures for OSA, global surgical results for OSA, and current surgical outcomes for OSA in Korea.
{"title":"Surgical Outcomes for Obstructive Sleep Apnea in Korea","authors":"Minkyeong Lee, Jae Yong Lee, J. Choi","doi":"10.17241/smr.2022.01424","DOIUrl":"https://doi.org/10.17241/smr.2022.01424","url":null,"abstract":"Obstructive sleep apnea (OSA) is a common chronic sleep disorder that causes oxygen desaturations, sympathetic hyperactivation, and sleep fragmentation. The gold standard for OSA treatment in adults is positive airway pressure (PAP) therapy, which is effective when used during sleep. However, about half of patients with OSA refuse or are non-adherent to PAP, and some patients have anatomical problems that can be alleviated surgically. Surgery can be considered for patients who are very likely to have successful surgical results, but who are intolerant to PAP or oral appliances because of anatomical abnormalities. There are various surgical modifications of the upper airway for OSA, including nasal surgeries (e.g., septoplasty, turbinoplasty, and endoscopic sinus surgery), nasopharyngeal surgeries, oral and oropharyngeal surgeries (e.g., uvulopalatopharyngoplasty and variations, tonsillectomy, and palatal implants), hypopharyngeal surgeries (e.g., tongue ablation, tongue-base resection, and genioglossus advancement), and multi-level surgeries. Much clinical research has reported the outcomes of various surgical procedures for OSA internationally based on the traditional surgical success rate (defined as ≥ 50% reduction in the postoperative apnea-hypopnea index [AHI], postoperative AHI < 20), and AHI reduction ratio (defined as between the preoperative and postoperative AHI). In addition, many studies investigating the results of various OSA surgeries have been reported in Korea. In this article, we review the characteristics of various upper airway surgical procedures for OSA, global surgical results for OSA, and current surgical outcomes for OSA in Korea.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48413279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tayebeh Palimi, M. Zilaee, Elham Rajaei, M. Karandish
Background and Objective In rheumatoid arthritis (RA) patients sleep disturbance is one of serious and prevalent problems. Considering the known effects of melatonin on sleep quality and inflammation, this study aimed to investigate melatonin supplementation effect on quality of sleep and disease activity in patients with RA.Methods In this randomized, placebo-controlled trial (double-blind), 64 RA patients were selected and divided into experimental and placebo groups randomly; experimental group received 3 mg/d of melatonin and another group consumed placebo for 60 days. Before and after the investigation, assessment of the quality of sleep determined using the Pittsburgh Sleep Quality Index (PSQI). Disease Activity Score-28 (DAS28) and the Visual Analogue Scale (VAS) questionnaires were used for evaluation of disease activity and pain intensity, respectively.Results Melatonin significantly reduced PSQI, DAS28 and VAS scores, when values compared with baseline. In contrast to placebo group, good sleep quality within the melatonin group increased significantly compared to baseline and this improvement in sleep quality was significant when compared between groups. The scores of DAS28 and pain VAS at the end of trial were significantly reduced compared to the baseline in both groups. However, reduction in the DAS28 and VAS scores of the melatonin group were stronger than reductions in the placebo receiving group.Conclusions This study results revealed that melatonin was safe and effective in improving sleep quality and reducing DAS28 and pain VAS scores in RA patients.
{"title":"Effects of Melatonin on Sleep Quality and Disease Activity in Patients With Rheumatoid Arthritis","authors":"Tayebeh Palimi, M. Zilaee, Elham Rajaei, M. Karandish","doi":"10.17241/smr.2022.01207","DOIUrl":"https://doi.org/10.17241/smr.2022.01207","url":null,"abstract":"Background and Objective In rheumatoid arthritis (RA) patients sleep disturbance is one of serious and prevalent problems. Considering the known effects of melatonin on sleep quality and inflammation, this study aimed to investigate melatonin supplementation effect on quality of sleep and disease activity in patients with RA.Methods In this randomized, placebo-controlled trial (double-blind), 64 RA patients were selected and divided into experimental and placebo groups randomly; experimental group received 3 mg/d of melatonin and another group consumed placebo for 60 days. Before and after the investigation, assessment of the quality of sleep determined using the Pittsburgh Sleep Quality Index (PSQI). Disease Activity Score-28 (DAS28) and the Visual Analogue Scale (VAS) questionnaires were used for evaluation of disease activity and pain intensity, respectively.Results Melatonin significantly reduced PSQI, DAS28 and VAS scores, when values compared with baseline. In contrast to placebo group, good sleep quality within the melatonin group increased significantly compared to baseline and this improvement in sleep quality was significant when compared between groups. The scores of DAS28 and pain VAS at the end of trial were significantly reduced compared to the baseline in both groups. However, reduction in the DAS28 and VAS scores of the melatonin group were stronger than reductions in the placebo receiving group.Conclusions This study results revealed that melatonin was safe and effective in improving sleep quality and reducing DAS28 and pain VAS scores in RA patients.","PeriodicalId":37318,"journal":{"name":"Sleep Medicine Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45126742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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