Sleep-related breathing disorder (SRBD) is a sleep disease with high incidence and many complications. However, patients are often unaware of their sickness. Therefore, SRBD harms health seriously. At present, home SRBD monitoring equipment is a popular research topic to help people get aware of their health conditions. This article fully compares recent state-of-art research results about home SRBD monitors to clarify the advantages and limitations of various sensing techniques. Furthermore, the direction of future research and commercialization is pointed out. According to the system design, novel home SRBD monitors can be divided into two types: wearable and unconstrained. The two types of monitors have their own advantages and disadvantages. The wearable devices are simple and portable, but they are not comfortable and durable enough. Meanwhile, the unconstrained devices are more unobtrusive and comfortable, but the supporting algorithms are complex to develop. At present, researches are mainly focused on system design and performance evaluation, while high performance algorithm and large-scale clinical trial need further research. This article can help researchers understand state-of-art research progresses on SRBD monitoring quickly and comprehensively and inspire their research and innovation ideas. Additionally, this article also summarizes the existing commercial sleep respiratory monitors, so as to promote the commercialization of novel home SRBD monitors that are still under research.
Humans ; Polysomnography ; Sleep ; Sleep Apnea Syndromes/diagnosis* ; Sleep Wake Disorders

The sleep breathing disorders (SDB) include obstructive sleep apnea (OSA), central sleep apnea disorders, sleep related hypoventilation disorders, and sleep related hypoxemia disorder in international classification of sleep diseases 3rd edition (ICSD-3). Latest diagnosis criteria are introduced. Treatments, which target to Individual contributors, should be applied. Thus identification of the phenotype in patients with OSA is important. The methods of evaluation patients' arousal thresholds, loop gain as well as neuromyopathy in clinical setting are reported. Several new treatment strategies are developed and applied for OSA. Long term follow up and more data are needed for evaluation the outcomes of hypoglossal nerve stimulation, bariatric surgery as well as medicine as treatments for OSA.
Humans ; Sleep Apnea Syndromes ; diagnosis ; therapy ; Sleep Apnea, Central ; Sleep Apnea, Obstructive

OBJECTIVES: The sensitivity and accuracy of thermistor airflow signal has been debated. The purposes of this study were to compare apnea-hypopnea index(AHI) detected from a conventional thermistor signal and a nasal pressure transducer of airflow(NPT), to evaluate the value of NPT for the diagnosis of upper airway resistance syndrome (UARS), and to measure airway pressure fluctuations which produced respiratory arousals in UARS by naso-oro-esophageal manometer catheter. The subjects were 30 patients with obstructive sleep apnea syndrome [mild(540), 10), and 6 UARS patients. Airway resistance arousal in this study was defined as arousals which were not associated with apnea or hypopnea of thermistor signal, but showed significant decrease of nasal airflow pressure just before arousal and a prompt recovery of nasal airflow pressure after arousal, The airway pressure fluctuations were measured during 260 airway resistance arousals observed in 10 patients with OSAS, 2 with UARS. RESULTS: Mean AHIs of patients with OSAS were 33.4 by thermistor and 48.4 by NPT. The AHIs of mild, moderate and severe OSAS group were 10.2, 32.1, 65.4 respectively by thermistor and 23.1, 45.9, 76.4 by NPT. The mean AHI of patients with UARS was 3.2 by tehrmistor and 108 by NPT. The mean AHI of patients with nonspecific arousals was 2.7 by thermistor and 4.4 by NPT. The mean airway pressure changes during resiratory arousals of different groups were 8.7 cmH2O in mild OSAS, 11.4 cmH2O in moderate OSAS, 24.7 cmH2O in severs OSAS and 6.6 cmH2O in UARS. CONCLUSION: The nasal pressure transducer of airflow was more sensitive and accurate for assessing respiratory disturbances of patients with OSAS and was extremely helpful for the diagnosis of UARS without esophageal pressure monitoring. From the results, we would like to propose carefully the NPT diagnostic criteria for sleep disordered breathing as follows : NPT-AHI 5-15->UARS, 15-35->mild OSAS, 35-55->moderate OSAS and >55 ->severe OSAS.
Airway Resistance* ; Apnea ; Arousal ; Catheters ; Diagnosis ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Transducers, Pressure

BACKGROUND AND OBJECTIVES: Most of the patients with upper airway resistance syndrome (UARS) remain undiagnosed and are left untreated because of the disagreement with diagnostic criteria of obstructive sleep apnea syndrome (OSAS). The aim of this study is to help understanding UARS through evaluating differences of polysomnographic findings and subjective symptoms between UARS and OSAS. SUBJECTS AND METHOD: One hundred nineteen patients, who visited for snoring and/or apnea, excessive daytime sleepiness, were included. All patients underwent full night polysomnography (PSG) and performed tests on the 10 cm visual analogue scale (VAS) for 14 symptoms and Epworth sleepiness scale (ESS). PSG results and VAS score were compared between UARS group and OSAS group. RESULTS: Among 119 patients, 4 patients had simple snoring, 19 patients had UARS and 96 patients had OSAS. Patients with UARS were younger and had lower BMI than OSAS. Apnea index, hypopnea index, respiratory disturbance index, arousal index, portion of slow wave sleep, mean and lowest oxygen saturation were more severe in patients with OSAS than UARS. But subjective symptoms and ESS were similar in both groups. CONCLUSION: Although significant differences were found in PSG results in patients with UARS and OSAS, complaints and symptoms were similar in both groups. We suggest that diagnosis and treatment for sleep-disordered breathing should not be based solely upon the presence of apnea/hypopnea. We also suggest that more consideration should be given to UARS diagnosis and treatment.
Airway Resistance* ; Apnea ; Arousal ; Diagnosis ; Humans ; Oxygen ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring

Obstructive sleep apnea (OSA) is a common disorder. It usually results from the structural compromise of the upper airway. In patients with OSA, the obstruction predominantly occurs along the pharyngeal airway, and also a variety of tumors have been reported to cause such a condition. We present here the case of a thyroglossal duct cyst causing OSA in adult. This case demonstrates that thyroglossal duct cyst or some kind of mass lesions in the airway lesions should be considered in the differential diagnosis of OSA patients.
Adult ; Diagnosis, Differential ; Humans ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Thyroglossal Cyst ; Sleep Wake Disorders

BACKGROUND AND OBJECTIVES: OSA (obstructive sleep apnea) is considered a disorder that occurs predominantly in men. A thorough understanding of the sex difference in OSA can help the medical community in consultation, diagnosis and treatment of the diseases. So, differences between female and male should be taken into consideration in further evaluation and management of OSA. SUBJECTS AND METHOD: Three hundred and sixteen patients (47 women and 269 men), diagnosed as having OSA based on polysomnography (PSG) in the sleep disorder clinic between July 1994 and December 2002, were evaluated retrospectively. RESULTS: Female patients were older and had less severe OSA than men. In the group of patients showing the similar degree of sleep apnea measured according to RDI, female patients were significantly older, with more of them in the postmenopausal age; there were no difference with respect to obesity, except for the severe group. In the group of patients having the same age and obesity, males had more severe apnea, but females tended to have severe apnea over the age of 50. In terms of subjective symptoms, male patients noted more severe OSA symptom, daytime fatigue, attention deficiency than female patients, who noted morning headache and depression more often than their counterpart. CONCLUSION: Female patients showed less morbidity than male patients and also tended to be more obese. Current clinical evaluation of OSA must take into account this gender disparity
Apnea ; Depression ; Diagnosis ; Fatigue ; Female* ; Headache ; Humans ; Male* ; Obesity ; Polysomnography ; Retrospective Studies ; Sex Characteristics ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive*

OBJECTS: This study was conducted to investigate the effects of sleep apnea syndromes on the systemic blood pressure. METHODS: The subjects were 140 patients who were consulted to Yon-jung brain auction and sleep research center for polysomnography due to snoring and sleep apnea from Jan. 1st 1995 to Oct. 31st 1995. Twenty-four out of 140 were excluded due to cardiovascular diseases other than systemic hypertension, antihypertensive medication, inadequate data or diagnosis other than sleep apnea syndrome. The remaining 116 were accepted as proper subjects. Using Pearson's correlation and multiple regression analysis, we looked for the relationship between sleep and respiratory variables to systemic blood pressure. RESULTS: The results were as follows : 1) According to the correlation analysis, statistically significant variables to mean systolic and diastolic blood pressure were the total time and total number of sleep apnea, degree of oxygen saturation of total sleep time, apnea index, total time and total number of central apnea, and the total time of obstructive apnea. 2) According to the multiple regression analysis, only the total time of sleep apnea significantly affected mean systolic and diastolic blood pressure, and the degrees of affection were 7.9% and 6.2% respectively. CONCLUSION: These findings showed that sleep apnea syndrome had lower influence over systemic blood pressure than expected and regardless of the type, only the total time of sleep apnea influenced systemic blood pressure. In the case of central apnea, mechanisms other than hypoxemia and the increase of sympathetic activity during arousal may make it possible to increase systemic blood pressure.
Anoxia ; Apnea ; Arousal ; Blood Pressure* ; Brain ; Cardiovascular Diseases ; Diagnosis ; Humans ; Hypertension ; Oxygen ; Polysomnography ; Sleep Apnea Syndromes* ; Sleep Apnea, Central ; Snoring

The etiology of the obstructive sleep apnea includes the various factors such as anatomical abnormality in upper airway, craniofacial structure, obesity and personal habit. To establish reasonable treatment plan, multi-department approach is should be emphasized because the treatment modality is depend on the result of analysis for degree and site of obstruction and various behavioral factors. In Sleep Clinic in Keimyung University Medical Center, the standard of care for sleep apnea patient was established according to the Standard of practice committee of Americal Sleep Disorders Association. After one year experience of comprehensive approach for sleep apnea we could achieve following recommendation for the treatment. 1) The multi-department examination and diagnosis could prevent unnessesary treatment because the treatment plan could be established under comprehensive discussion. 2) Determination of the site of obstruction is important for treatment planning. However, no single determinant could be found. We expect multi-department approach can reduce the mistake in detection of obstruction. 3) Further evaluation of treatmet outcome should be succeeded to establish Korean standard of care for sleep apnea treatment.
Academic Medical Centers ; Dentistry* ; Diagnosis ; Humans ; Obesity ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Wake Disorders ; Standard of Care

BACKGROUND AND OBJECTIVES: Respiratory scoring guidelines for children and adults have been used for evaluating adolescents both in the 2007 and 2012 American Academy of Sleep Medicine (AASM) scoring manuals. We compared the scoring methods of polysomnography used in these scoring manuals, where pediatric and adult scoring rules were adopted for the diagnosis of sleep apnea in adolescents. SUBJECTS AND METHOD: 106 Korean subjects aged between 13 and 18 years were enrolled. All subjects underwent overnight polysomnography in a sleep laboratory. Data were scored according to both pediatric and adult guidelines in the 2007 and 2012 AASM scoring manuals. RESULTS: Both pediatric and adult apnea hypopnea index (AHI) using the 2012 method were significantly higher than those using the 2007 method. The difference in AHI compared between pediatric and adult scores with the 2012 AASM scoring system was markedly decreased from that with the 2007 method. There was a significant discordance in sleep apnea diagnosis between pediatric and adult scoring rules in the 2012 method. CONCLUSION: Both pediatric and adult rules were used for the diagnosis of adolescent sleep apnea in the 2012 method. However, there was significant discordance in the diagnosis between pediatric and adult scoring guidelines in the 2012 AASM manual, probably due to different cut-off values of AHI for the diagnosis of sleep apnea in pediatric (≥1) and adult (≥5) patients. Further studies are needed to determine a more reasonable cut-off value for the diagnosis of sleep apnea in adolescents.
Adolescent* ; Adult ; Apnea ; Child ; Diagnosis* ; Humans ; Methods ; Polysomnography* ; Research Design* ; Sleep Apnea Syndromes*

BACKGROUND: Standard polysomnography is generally used in the diagnosis of sleep apnea syndrome. However, this technique is laborious, costly and inconvenient as a screening test or a test for epidemiological study. A simple screening test for sleep apnea, administered at home, would provide physicians with a convenient and less costly means of evaluating possible sleep apnea. OBJECTIVES: The aim of this study was to evaluate the validity of portable sleep monitoring devices. The validity of measurements made by the portable sleep monitoring devices was assessed by comparing respiratory parameters obtained using the portable sleep monitoring devices with those obtained using standard polysomnography. MATERIALS AND METHOD: Eighteen patients were collected and divided into two groups. Direct comparison was made between data obtained by the portable monitoring devices(MESAM IV in group 1 and Edentec in group 2) and data simultaneously obtained by standard polysomnographic techniques. RESULTS: In group 1, oxygen desaturation index(ODI) and heart variation index(HVI) in MESAM IV were significantly correlated with apnea index(AI) and respiratory disturbance index(RDI) in standard polysomnography. In group 2, AI and RDI in Edentec were significantly correlated with those in standard polysomnography. CONCLUSIONS: The results of this study suggest that portable monitoring devices(MESAM IV and Edentec) may be useful in screening test of sleep apnea syndrome.
Apnea ; Diagnosis ; Heart ; Humans ; Mass Screening ; Oxygen ; Polysomnography* ; Sleep Apnea Syndromes*