Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Comparison of Positional and Non-Positional Obstructive Sleep Apnea Patients by Nocturnal Polysomnography

야간수면다원검사를 이용한 자세성 및 비자세성 수면무호흡증 환자의 비교 연구

  • Park, Min-Woo (Department of Oral Medicine and Oral Diagnosis School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Cho, Jung-Hwan (Department of Oral Medicine and Oral Diagnosis School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Park, Won-Kyu (Department of Oral Medicine and Oral Diagnosis School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Nam, Jin-Woo (Department of Oral Medicine and Oral Diagnosis School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Yun, Chong-Il (Department of Oral Medicine and Oral Diagnosis School of Dentistry and Dental Research Institute, Seoul National University) ;
  • Chung, Jin-Woo (Department of Oral Medicine and Oral Diagnosis School of Dentistry and Dental Research Institute, Seoul National University)
  • 박민우 (서울대학교 치의학대학원 구강내과진단학교실, 치학연구소) ;
  • 조정환 (서울대학교 치의학대학원 구강내과진단학교실, 치학연구소) ;
  • 박원규 (서울대학교 치의학대학원 구강내과진단학교실, 치학연구소) ;
  • 남진우 (서울대학교 치의학대학원 구강내과진단학교실, 치학연구소) ;
  • 윤종일 (서울대학교 치의학대학원 구강내과진단학교실, 치학연구소) ;
  • 정진우 (서울대학교 치의학대학원 구강내과진단학교실, 치학연구소)
  • Published : 2009.12.30
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Abstract

Objectives: The aim of this study was to evaluate the differences in the polysomnography data between positional and non-positional obstructive sleep apnea (OSA) patients. Methods: Forty-seven patients diagnosed with OSA were evaluated using full night polysomnography. According to the criteria of Cartwright et al., the patients were classified into two groups with 37 positional (supine apnea-hypopnea index [AHI] $\geq$ 2x's the lateral AHI) and 10 non-positional (supine AHI < 2x's the lateral AHI) OSA patients, and the differences of polysomnography data between the two groups were evaluated. Results: There were no significant differences in demographic variables (age, gender, and BMI), daytime sleepiness, overall AHI, total arousal index, and percent time of snoring between two groups. However, AHI, arousal index, and mean oxygen saturation ($SpO_2$) of the REM sleep stage were significantly more severe in the positional OSA group than the non-positional OSA group. Mean $SpO_2$ and the lowest $SpO_2$ during overall sleep stage were also significantly lower in the positional OSA group than the non-positional OSA group. Conclusions: Our results of differences in the polysomnography data of REM sleep stage suggest that non-positional OSA patients may have higher collapsibility of the oropharyngeal airway during sleep than positional OSA patients.

본 연구의 목적은 자세성 수면무호흡증 환자군과 비자세성 수면무호흡증 환자군의 수면다원검사 결과를 비교 분석하여 그 원인 요소를 알아보는데 있다. 서울대학교치과병원에 코골이 및 수면무호흡증을 주소로 내원한 환자들 중 수면다원검사 결과 수면무호흡증으로 진단된 (무호흡-저호흡 지수 5이상) 환자 47명을 Cartwright 등의 분류에 따라 37명의 자세성 수면무호흡증 환자 (앙와위에서의 수면무호흡-저호흡 지수가 측와위에서의 수면무호흡-저호흡 지수의 2배 이상)와 10명의 비자세성 수면무호흡증 환자 (앙와위에서의 수면무호흡-저호흡 지수가 측와위에서의 수면무호흡-저호흡 지수의 2배 미만)로 분류하여 각 군간의 수면다원검사 지수들을 비교 분석 하였다. 연구 결과, 나이, 성별, 체질량지수, 주간졸리움 지수, 전체 수면무호흡-저호흡 지수, 전체 각성 지수, 코골이 시간에서 두 군간의 유의한 차이를 보이지 않았다. 그러나 비자세성 수면무호흡증 환자군에서 자세성 수면무호흡증 환자군보다 높은 REM 수면에서의 수면무호흡-저호흡 지수 및 각성지수와 낮은 REM 수면 평균혈중산소포화도를 나타내었다. 결론적으로 본 연구의 결과는 비자세성 수면무호흡환자가 자세성 수면무호흡증 환자보다 구인두 기도에서의 더 높은 협착도를 갖고 있을 가능성을 제시하여 준다.

Keywords

References

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