Objectives: To assess the effectiveness of regular singing exercises in reducing symptoms of snoring and sleep apnoea. Methods: A prospective single blinded randomised controlled trial was conducted in the otolaryngol...Objectives: To assess the effectiveness of regular singing exercises in reducing symptoms of snoring and sleep apnoea. Methods: A prospective single blinded randomised controlled trial was conducted in the otolaryngology department of a UK teaching hospital (Exeter). 127 adult patients with a history of simple snoring or sleep apnoea were recruited. 93 patients completed the study. Patients were excluded because of severe sleep apnoea (apnoea index > 40), or morbid obesity (BMI > 40). The study group completed a self-guided treatment programme of singing exercises contained on a 3CD box set, performed for 20 minutes daily. Outcome measures included the Epworth Sleepiness Scale, the SF-36 generic quality of life assessment tool, visual analogue scales (VAS range 0-10) of snoring loudness and frequency, and visual analogue scale of compliance (for intervention group). Results: The Epworth scale improved significantly in the experimental group compared to the control group (difference -2.5 units;95% CI -3.8 to -1.1;p = 0.000). Frequency of snoring reduced significantly in the experimental group (difference -1.5;95% CI -2.6 to -0.4;p = 0.01), and loudness of snoring showed a trend to improvement which was non-significant (difference -0.8;95% CI -1.7 to 0.1;p = 0.08). Compliance with exercises was good;median 6.6 (quartiles = 4.1, 8.3). Conclusions: Improving the tone and strength of pharyngeal muscles with a 3 months programme of daily singing exercises reduces the severity, frequency and loudness of snoring, and improves symptoms of mild to moderate sleep apnoea.展开更多
Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are prov...Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are proven to be efficient in treating mild to moderate sleep apnea and snoring. We examined patients who had been treated in Community Dental Care with a titrable Herbst-type MAD. The aim of the study was to evaluate the quality of sleep based on self report. Methods: A questionnaire was mailed to patients (n = 184) who had received treatment for OSA or snoring between 2007 and2010 inthe Helsinki Health Centre Oral Care Unit. The patients were referred to the clinic for primary treatment, or because another treatment modality had failed. Results: Of the respondents (n = 142, 78.4%), OSA had been diagnosed in 74%, while the MAD was applied for snoring to the remaining. Among all respondents, 78.4% had worn the MAD at least three nights per week. With the MAD in situ, sleep was felt significantly less disrupted (p < 0.001) and more restorative (p < 0.001), and snoring was markedly reduced (p < 0.001). Daytime tiredness was also markedly less frequent (p < 0.001). Conclusions: Treatment with a MAD improved perceived sleep quality and awoke alertness in mild and moderate OSA patients and in snorers. This study supports such treatment to be initiated and monitored in community dental care.展开更多
Snoring is a very common problem in children and may be an indication of obstructive sleep apnea(OSA). Appropriate diagnosis is of importance due to detrimental effects of OSA. Polysomnography is considered the gold s...Snoring is a very common problem in children and may be an indication of obstructive sleep apnea(OSA). Appropriate diagnosis is of importance due to detrimental effects of OSA. Polysomnography is considered the gold standard for the diagnosis of OSA. However, it is impractical for several reasons and this is why other tests have been developed as alternatives to formal polysomnography(PSG) for the assessment of children with snoring. In this mini-review basic features of PSG as well as alternative tests are presented and future perspectives are provided in addition to current guideline for the diagnosis and monitoring of childhood snoring. The aim of this review is to highlight briefly currently developed technologies that seem promising for the evaluation of snoring.展开更多
Snoring is common in people with obstructive sleep apnea (OSA). Although not every snorer has OSA or vice-versa, many studies attempt to use snoring sounds for classification of people into two groups of OSA and simpl...Snoring is common in people with obstructive sleep apnea (OSA). Although not every snorer has OSA or vice-versa, many studies attempt to use snoring sounds for classification of people into two groups of OSA and simple snorers. This paper discusses the relationship between snorers’ anthropometric parameters and statistical characteristics of snoring sound (SS) and also reports on classification accuracies of methods using SS features for screening OSA from simple snorers when anthropometric parameters are either matched or unmatched. Tracheal respiratory sounds were collected from 60 snorers simultaneously with full-night Polysomnography (PSG). Energy, formant frequency, Skewness and Kurtosis were calculated from the SS segments. We also defined and calculated two features: Median Bifrequency (MBF), and projected MBF (PMBF). The statistical relationship between the extracted features and anthropometric parameters such as height, Body Mass Index (BMI), age, gender, and Apnea-Hypopnea Index (AHI) were investigated. The results showed that the SS features were not only sensitive to AHI but also to height, BMI and gender. Next, we performed two experiments to classify patients with Obstructive Sleep Apnea (OSA) and simple snorers: Experiment A: a small group of participants (22 OSA and 6 simple snorers) with matched height, BMI, and gender were selected and classified using Na?ve Bayes classifier, and Experiment B: the same number of participants with unmatched height, BMI, and gender were chosen for classification. A sensitivity of 93.2% (87.5%) and specificity of 88.4% (86.3%) was achieved for the matched (unmatched) groups.展开更多
Snoring is part of the spectrum of sleep disordered breathing. The patients with snoring should be evaluated for nasal airway obstruction. In this study, the upper air way tract was characterized in snoring patients a...Snoring is part of the spectrum of sleep disordered breathing. The patients with snoring should be evaluated for nasal airway obstruction. In this study, the upper air way tract was characterized in snoring patients and compared with none snoring using a quantify method for the corresponding anatomic upper air way (UA) parameters examined by Computerized Tomography (CT). Two hundred Asian patients undergoing CT scanning for head and neck were included and were divided into two groups (snoring group [n = 127] and non-snoring group [n = 73]) (mean age: 44.8 ± 15.9 years and 26.2 ± 7.0). Total 8 parameters were measured on sagital reconstructed CT images for each subject. The differences in neck circumference (NC), linear distance between mandibular plane and hyoid bone (Mp-H), upper airway length (UAL), the maximum thickness of the soft palate (SP max), soft palate length (PNS-U), linear distance between anterior and posterior nasal spine (ANS-PNS), retroglosal width (RS), retroplatal width (RP) between the snoring and non-snoring groups were compared statistically using independent sample t-test. Results showed that the NC, UAL, and SP max were significantly higher in snoring group;however RP was found to be significantly lower. Inferior positioning of hyoid bone gives longer measurement for MP-H. In snoring group UAL was found to be significantly different at p ≤ 0.000 between the two genders. All the measured variables showed no significant differences in respect to age. UA CT quantitative features play an important role in the characterization of the anatomy and are compared between snoring patients and non-snoring subjects.展开更多
In this paper, an active noise control(ANC) system is developed to provide an effective and non-intrusive solution for reducing loud snoring to provide a quiet environment for a snorer's bed partner. An adaptive l...In this paper, an active noise control(ANC) system is developed to provide an effective and non-intrusive solution for reducing loud snoring to provide a quiet environment for a snorer's bed partner. An adaptive least mean square(LMS)algorithm optimized for different kinds of snore signals is introduced and theoretically analyzed. Also, a residual noise masking approach is proposed to further reduce the effect of the snore noise without interfering with the LMS algorithm. Computer simulations followed by real-time experiments are conducted to demonstrate the feasibility of the snore ANC systems based on a pillow setup. For the optimum effect based on the characteristics of human hearing, the performance of the proposed approach is evaluated by using the multi-channel feedforward ANC systems based on the filtered-X least mean square(FXLMS) algorithm.Compared with a traditional headboard setup for snoring noise control, the proposed snore ANC systems optimized for ear field operation yield much higher noise reduction around the ears of the snorer's bed partner.展开更多
Objective:Pilot study to examine the effect of radiofrequency ablation (RFA) of the lateral palatal fat pad in patients with socially-disruptive snoring.Method:Snoring outcomes and complications were compared between ...Objective:Pilot study to examine the effect of radiofrequency ablation (RFA) of the lateral palatal fat pad in patients with socially-disruptive snoring.Method:Snoring outcomes and complications were compared between a group of patients with treated with RFA ablation of the lateral soft palate fat pad with or without inferior turbinate reduction (8 patients) and another group undergoing inferior turbinate reduction alone (12 patients).Results:Snoring loudness and bothersomeness improved in the palate but not inferior turbinate group.Pain was mild and no major complications were observed.Conclusion:The study supports RFA ablation of the lateral palatal space as a potential low morbidity procedure for snoring.展开更多
Background: It is crucial for the army to know the prevalence of obstructive sleep apnea(OSA) syndrome in activeduty army personnel. Little information has been reported on the prevalence of OSA and clinical features ...Background: It is crucial for the army to know the prevalence of obstructive sleep apnea(OSA) syndrome in activeduty army personnel. Little information has been reported on the prevalence of OSA and clinical features in activeduty army personnel. This study was aimed to estimate the prevalence of snoring and risk of developing OSA in activeduty army personnel in Thailand and to identify the co-morbidities of OSA. In total, 1107 participants who were aged20–60 years and were deployed to the three southernmost provinces of Thailand were enrolled. All the participants completed the Phramongkutklao(PMK) Hospital OSA Questionnaire that was modified and validated from the Berlin Questionnaire and underwent physical examination. The participants were 1107 active-duty army personnel in the three southernmost provinces of Thailand, both males and females, aged 20–60 years.Methods: The PMK OSA Questionnaire was used to assess the risk of OSA together with interviewing for snoring,fatigue, falling asleep and day-time sleepiness. Physical examination of the neck, chest and hip circumference,and height was performed. Information concerning physical training, co-morbid diseases, smoking and alcoholic consumption was collected.Results: The prevalence of snoring was 58.5, and 4.8% met the PMK OSA Questionnaire criteria, thus indicating a high risk of OSA. The information obtained indicated that laryngopharyngeal reflux(LPR), current smoking and alcoholic consumption were significantly higher in the high-risk OSA group.Conclusions: Early detection and treatment of OSA in active-duty army personnel are imperative. Physical examination and polysomnography can be used to reveal the high-risk group. High body mess index(BMI), laryngopharyngeal reflux, current smoking and alcoholic consumption are modifiable factors for OSA and are avoidable. A policy to decrease the BMI and risk of LPR, as well as to stop smoking and alcoholic consumption, should be applied.展开更多
PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalen...PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.展开更多
Background: Historically frenotomy was performed at newborn babies’ baptism for healthy breast-feeding over many centuries. Although it was necessary for nursing babies, its application was denied subjectively withou...Background: Historically frenotomy was performed at newborn babies’ baptism for healthy breast-feeding over many centuries. Although it was necessary for nursing babies, its application was denied subjectively without clinical observation since the early 20th century. As a result solutions for breastfeeding and breast problems are confused now. Methods: We studied changes in breastfeeding and mothers’ breasts before and one month after the surgeries for ADEL by standards for healthy breastfeeding and breasts. Results: With regard to suckling, before the surgeries 24% of babies opened their eyes during breastfeeding, while after surgeries 76% opened eyes while nursing. 30% of the babies latched onto the mother’s breast with a wide-open mouth. After surgeries, 84% properly latched on. 73% of the babies had calluses on the upper lip before surgeries, and no calluses were observed after surgeries. 27% of babies before surgeries moved the jaws during breast-feeding, but after surgeries 88% moved the jaws while nursing. White debris was on the dorsum tongue in 70% of babies prior to surgeries. After surgeries, 22% were with debris. 67% of mothers experienced nipple pain before their babies’ surgeries while 6% had pain after the surgeries. Flattened nipples were observed in 55% of mothers before the infants’ surgeries, 7% after surgeries. 23% of mothers had breast pain before the surgeries, and 4% had breast pain after the surgeries. Mastitis was also reduced from 9% to 1% after surgeries. 73% of women had palpable breast masses, and after the surgeries 25% had palpable masses. Summary: Remarkable improvements in breastfeeding and in women’s breasts were achieved after their infants underwent operations for ADEL. These results indicate the necessity of surgical interventions in babies with ADEL for healthy breastfeeding and breasts (279).展开更多
Nowadays mandibular advancement appliances (MA- As) are available and distributed widely in the field of dentistry for the treatment of snoring and ob- structtive sleep apnea (OSA). However, a few stud- ies discussed ...Nowadays mandibular advancement appliances (MA- As) are available and distributed widely in the field of dentistry for the treatment of snoring and ob- structtive sleep apnea (OSA). However, a few stud- ies discussed temporomandibular joint (TMJ) discom- fort and masticatory muscle stiffness during wearing MAAs are found. A new appliance that we introduced in this pilot study has shown significant jaw move- ment and could diminish TMJ and masticatory side effects.展开更多
Background: Despite overwhelming evidence for gender differences in sleep quality as well as gender-specific changes of sleep parameters with respect to habitual sleeping arrangements, studies on snorers and their bed...Background: Despite overwhelming evidence for gender differences in sleep quality as well as gender-specific changes of sleep parameters with respect to habitual sleeping arrangements, studies on snorers and their bed partners have ignored the influence of individual quality of sleep as a potential co-factor. Objective: The objective of this study was to record subjective and objective sleep parameters and to analyze the effects of alternating of sleeping arrangements in snorers and their bed partners. Methods: Habitual snorers and their bed partners were recruited via newspaper articles not stating the exact purpose of the study. Both filled out a 90-day sleep diary. During this time, we recorded subjective and objective sleep parameters in the snorers and their bed partners via wrist actigraphy and sleep diaries for 14 days. For statistical analysis, we used two-sided t-tests and Spearman’s Rho. Results: The dataset included 45 snorers (11 females) and 45 bed partners (34 females) with a mean age of 47 ± 13 and 43 ± 12 years. Screening for sleep apnea yielded snoring without OSAS, mild-, moderate- and severe OSAS in 27 (60%), eight (18%), three (7%) and six (15%) snorers. PSQI total scores were significantly lower in snorers than in bed partners (4 ± 2 vs. 6 ± 4, p = 0.002). We could not find a significant correlation between subjective and objective sleep latency and efficiency. Couples who changed their sleeping arrangement were significantly younger than those who habitually slept alone or together (p = 0.01). Subjective sleep parameters of snorers or bed partners were not related to the number of consecutive nights spent either together or apart. Conclusions: Our study confirmed the weak correlation of subjective and objective sleep parameters in pairs with snoring problems. Couples changing their sleeping arrangement were the youngest among the whole group, but their separation of sleeping arrangements did not improve subjective sleep parameters.展开更多
Objectives: The aim of the present study was to analyze the recovery rate of symptoms in patients with adenoid hypertrophy and investigate the role of nasal pathologies, allergy and gastroesophageal reflux (GER) as th...Objectives: The aim of the present study was to analyze the recovery rate of symptoms in patients with adenoid hypertrophy and investigate the role of nasal pathologies, allergy and gastroesophageal reflux (GER) as the reason of failure in patients with persistent symptoms. Patients and Methods: Patients undergoing adenoidectomy were enrolled in this study. There were 58 males and 42 females, aged between 1 - 13 years (mean ± SD: 4.9 ± 2.2 years). The parents of each child were questioned about the following symptoms;apnea, nasal obstruction, mouth breathing, snoring and nasal discharge. Presence or absence of nasal obstruction due to septal deviation and/or chonchal hypertrophy was noted. All children were evaluated for GER by upper gastrointestinal endoscopy or pH monitorization and for allergy by specific IgE analysis or skin prick test. Three months after the operation the children were re-examined and their parents were interviewed about persistent symptoms. Patients with persistent symptoms were re-evaluated with rigid endoscopy for residual adenoid vegetation. Results: Apnea was cleared in the entire group postoperatively. However, 9 patients complained of nasal obstruction, 16 patients had mouth breathing, 9 patients had snoring and 17 patients continued to have nasal discharge two months after the operation. Statistical assessment showed a significant difference for each symptom between the pre- and postoperative level (p Conclusions: Adenoidectomy alone is an effective treatment for nasal obstruction and obstructive sleep symptoms in children. Persistent obstructive symptoms are usually due to nasal pathology and allergy.展开更多
Background Adenotonsillectomy (AT) has been an effective treatment for sleep-disordered breathing (SDB) in children, and several studies described the risk of postoperative weight gain and obesity in children treated ...Background Adenotonsillectomy (AT) has been an effective treatment for sleep-disordered breathing (SDB) in children, and several studies described the risk of postoperative weight gain and obesity in children treated with AT. The present study aimed to evaluate behavioral improvements in children with SDB one year after adenotonsillectomy and to investigate an influence of postoperative weight gain on behaviors. Methods The study included 170 children aged 5–11 years who underwent adenotonsillectomy for SDB and 150 controls. Body mass index percentile was obtained for age and gender, and parental sleep-related breathing disorder (SRBD) question-naire was used to assess the severity of SDB. Psychological assessment was performed pre- and post-adenotonsillectomy using standardized questionnaires including strength and difficulties questionnaire, children's depression inventory and screen for child anxiety-related emotional disorder. Results The mean age of 170 patients was 7.7 ± 1.5 years with 73 (42.9%) girls and 97 (57.1%) boys. The mean follow-up period were 15.4 ± 2.7 months. The patients had shown significant improvements in SDB scores as well as in questionnaire-based behavioral problems after adenotonsillectomy. The odds of a child being overweight were significantly increased after adenotonsillectomy. Less improvements in hyperactivity and conduct problems were observed in the patients with older ages, higher SRBD scores, and overweight/obesity at 1-year follow-up after adenotonsillectomy. Conclusion These data suggest that abnormal behavioral outcomes should be evaluated postoperatively, which potentially could be reduced with the early adenotonsillectomy and adequate postoperative weight control.展开更多
文摘Objectives: To assess the effectiveness of regular singing exercises in reducing symptoms of snoring and sleep apnoea. Methods: A prospective single blinded randomised controlled trial was conducted in the otolaryngology department of a UK teaching hospital (Exeter). 127 adult patients with a history of simple snoring or sleep apnoea were recruited. 93 patients completed the study. Patients were excluded because of severe sleep apnoea (apnoea index > 40), or morbid obesity (BMI > 40). The study group completed a self-guided treatment programme of singing exercises contained on a 3CD box set, performed for 20 minutes daily. Outcome measures included the Epworth Sleepiness Scale, the SF-36 generic quality of life assessment tool, visual analogue scales (VAS range 0-10) of snoring loudness and frequency, and visual analogue scale of compliance (for intervention group). Results: The Epworth scale improved significantly in the experimental group compared to the control group (difference -2.5 units;95% CI -3.8 to -1.1;p = 0.000). Frequency of snoring reduced significantly in the experimental group (difference -1.5;95% CI -2.6 to -0.4;p = 0.01), and loudness of snoring showed a trend to improvement which was non-significant (difference -0.8;95% CI -1.7 to 0.1;p = 0.08). Compliance with exercises was good;median 6.6 (quartiles = 4.1, 8.3). Conclusions: Improving the tone and strength of pharyngeal muscles with a 3 months programme of daily singing exercises reduces the severity, frequency and loudness of snoring, and improves symptoms of mild to moderate sleep apnoea.
文摘Background: The high efficacy of continuous positive airway pressure (CPAP) in treating obstructive sleep apnea (OSA) patients is sometimes limited because of intolerance. Mandibular advancement devices (MAD) are proven to be efficient in treating mild to moderate sleep apnea and snoring. We examined patients who had been treated in Community Dental Care with a titrable Herbst-type MAD. The aim of the study was to evaluate the quality of sleep based on self report. Methods: A questionnaire was mailed to patients (n = 184) who had received treatment for OSA or snoring between 2007 and2010 inthe Helsinki Health Centre Oral Care Unit. The patients were referred to the clinic for primary treatment, or because another treatment modality had failed. Results: Of the respondents (n = 142, 78.4%), OSA had been diagnosed in 74%, while the MAD was applied for snoring to the remaining. Among all respondents, 78.4% had worn the MAD at least three nights per week. With the MAD in situ, sleep was felt significantly less disrupted (p < 0.001) and more restorative (p < 0.001), and snoring was markedly reduced (p < 0.001). Daytime tiredness was also markedly less frequent (p < 0.001). Conclusions: Treatment with a MAD improved perceived sleep quality and awoke alertness in mild and moderate OSA patients and in snorers. This study supports such treatment to be initiated and monitored in community dental care.
文摘Snoring is a very common problem in children and may be an indication of obstructive sleep apnea(OSA). Appropriate diagnosis is of importance due to detrimental effects of OSA. Polysomnography is considered the gold standard for the diagnosis of OSA. However, it is impractical for several reasons and this is why other tests have been developed as alternatives to formal polysomnography(PSG) for the assessment of children with snoring. In this mini-review basic features of PSG as well as alternative tests are presented and future perspectives are provided in addition to current guideline for the diagnosis and monitoring of childhood snoring. The aim of this review is to highlight briefly currently developed technologies that seem promising for the evaluation of snoring.
文摘Snoring is common in people with obstructive sleep apnea (OSA). Although not every snorer has OSA or vice-versa, many studies attempt to use snoring sounds for classification of people into two groups of OSA and simple snorers. This paper discusses the relationship between snorers’ anthropometric parameters and statistical characteristics of snoring sound (SS) and also reports on classification accuracies of methods using SS features for screening OSA from simple snorers when anthropometric parameters are either matched or unmatched. Tracheal respiratory sounds were collected from 60 snorers simultaneously with full-night Polysomnography (PSG). Energy, formant frequency, Skewness and Kurtosis were calculated from the SS segments. We also defined and calculated two features: Median Bifrequency (MBF), and projected MBF (PMBF). The statistical relationship between the extracted features and anthropometric parameters such as height, Body Mass Index (BMI), age, gender, and Apnea-Hypopnea Index (AHI) were investigated. The results showed that the SS features were not only sensitive to AHI but also to height, BMI and gender. Next, we performed two experiments to classify patients with Obstructive Sleep Apnea (OSA) and simple snorers: Experiment A: a small group of participants (22 OSA and 6 simple snorers) with matched height, BMI, and gender were selected and classified using Na?ve Bayes classifier, and Experiment B: the same number of participants with unmatched height, BMI, and gender were chosen for classification. A sensitivity of 93.2% (87.5%) and specificity of 88.4% (86.3%) was achieved for the matched (unmatched) groups.
文摘Snoring is part of the spectrum of sleep disordered breathing. The patients with snoring should be evaluated for nasal airway obstruction. In this study, the upper air way tract was characterized in snoring patients and compared with none snoring using a quantify method for the corresponding anatomic upper air way (UA) parameters examined by Computerized Tomography (CT). Two hundred Asian patients undergoing CT scanning for head and neck were included and were divided into two groups (snoring group [n = 127] and non-snoring group [n = 73]) (mean age: 44.8 ± 15.9 years and 26.2 ± 7.0). Total 8 parameters were measured on sagital reconstructed CT images for each subject. The differences in neck circumference (NC), linear distance between mandibular plane and hyoid bone (Mp-H), upper airway length (UAL), the maximum thickness of the soft palate (SP max), soft palate length (PNS-U), linear distance between anterior and posterior nasal spine (ANS-PNS), retroglosal width (RS), retroplatal width (RP) between the snoring and non-snoring groups were compared statistically using independent sample t-test. Results showed that the NC, UAL, and SP max were significantly higher in snoring group;however RP was found to be significantly lower. Inferior positioning of hyoid bone gives longer measurement for MP-H. In snoring group UAL was found to be significantly different at p ≤ 0.000 between the two genders. All the measured variables showed no significant differences in respect to age. UA CT quantitative features play an important role in the characterization of the anatomy and are compared between snoring patients and non-snoring subjects.
文摘In this paper, an active noise control(ANC) system is developed to provide an effective and non-intrusive solution for reducing loud snoring to provide a quiet environment for a snorer's bed partner. An adaptive least mean square(LMS)algorithm optimized for different kinds of snore signals is introduced and theoretically analyzed. Also, a residual noise masking approach is proposed to further reduce the effect of the snore noise without interfering with the LMS algorithm. Computer simulations followed by real-time experiments are conducted to demonstrate the feasibility of the snore ANC systems based on a pillow setup. For the optimum effect based on the characteristics of human hearing, the performance of the proposed approach is evaluated by using the multi-channel feedforward ANC systems based on the filtered-X least mean square(FXLMS) algorithm.Compared with a traditional headboard setup for snoring noise control, the proposed snore ANC systems optimized for ear field operation yield much higher noise reduction around the ears of the snorer's bed partner.
文摘Objective:Pilot study to examine the effect of radiofrequency ablation (RFA) of the lateral palatal fat pad in patients with socially-disruptive snoring.Method:Snoring outcomes and complications were compared between a group of patients with treated with RFA ablation of the lateral soft palate fat pad with or without inferior turbinate reduction (8 patients) and another group undergoing inferior turbinate reduction alone (12 patients).Results:Snoring loudness and bothersomeness improved in the palate but not inferior turbinate group.Pain was mild and no major complications were observed.Conclusion:The study supports RFA ablation of the lateral palatal space as a potential low morbidity procedure for snoring.
基金Sleep Center,Department of Otolaryngology,Phramongkutklao Hospital
文摘Background: It is crucial for the army to know the prevalence of obstructive sleep apnea(OSA) syndrome in activeduty army personnel. Little information has been reported on the prevalence of OSA and clinical features in activeduty army personnel. This study was aimed to estimate the prevalence of snoring and risk of developing OSA in activeduty army personnel in Thailand and to identify the co-morbidities of OSA. In total, 1107 participants who were aged20–60 years and were deployed to the three southernmost provinces of Thailand were enrolled. All the participants completed the Phramongkutklao(PMK) Hospital OSA Questionnaire that was modified and validated from the Berlin Questionnaire and underwent physical examination. The participants were 1107 active-duty army personnel in the three southernmost provinces of Thailand, both males and females, aged 20–60 years.Methods: The PMK OSA Questionnaire was used to assess the risk of OSA together with interviewing for snoring,fatigue, falling asleep and day-time sleepiness. Physical examination of the neck, chest and hip circumference,and height was performed. Information concerning physical training, co-morbid diseases, smoking and alcoholic consumption was collected.Results: The prevalence of snoring was 58.5, and 4.8% met the PMK OSA Questionnaire criteria, thus indicating a high risk of OSA. The information obtained indicated that laryngopharyngeal reflux(LPR), current smoking and alcoholic consumption were significantly higher in the high-risk OSA group.Conclusions: Early detection and treatment of OSA in active-duty army personnel are imperative. Physical examination and polysomnography can be used to reveal the high-risk group. High body mess index(BMI), laryngopharyngeal reflux, current smoking and alcoholic consumption are modifiable factors for OSA and are avoidable. A policy to decrease the BMI and risk of LPR, as well as to stop smoking and alcoholic consumption, should be applied.
文摘PURPOSE: United Arab Emirates (UAE) is part of the GCC countries and ranks 18 on 2007 WHO list of the fattest countries with 68.3% of its citizens with an unhealthy weight. The WHO data in 2008 state that the prevalence of overweight in UAE is 71%, while it is 61% in the UK, 54% in Germany, and 45% in France. The increasing overweight and obesity in the UAE are closely related to high social-economic development. Accordingly, the medical authority has observed that the rates of hypertension and diabetes mellitus type 2 appear to be one of the highest rates worldwide. We presume that the increase prevalence of obesity in the UAE would be linked to the increase in prevalence of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in women followed up in the primary health care (PHC) setting in Dubai and the relationship between obesity and sleep apnea in females in the UAE. DESIGN: Prospective observational community-based survey. SETTING: 20 primary health centers in Dubai. PARTICI-PANTS: Consecutive female patients who were older than 14 years, regardless of the reason of their visit. METHODS: In this prospective survey, trained medical nurse administered the Berlin Questionnaire (which includes questions about self-reported snoring, witnessed apneas, daytime sleepiness, hypertension, and obesity) to a consecutive random sample of female patients in the age group older than 14 years, attending the PHC center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire, individuals were classified into high-risk and low-risk groups for OSAS. RESULTS: Based on the responses and measurement of the Berlin Questionnaire of 704 female subjects studied, 137 respondents met the criteria for the high-risk scoring. This gives a prevalence rate of 19.5% while the remainders of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 ± 11.73 years. The highest prevalence was noticed between age group 51 to 60 years. 70% of the high risk group patients had Body Mass Index (BMI) ≥30 kg/m2 and nearly 75% of the low risk group had BMI 2 and the Mean BMI was 33.59 ± 6.44 kg/m2. CONCLUSIONS: One in five women in Dubai, UAE is at high risk of having OSAS. Awareness by the primary care medical community about this disorder in females should be increased so that the patients would benefit from proper evaluation and treatment of OSAS.
文摘Background: Historically frenotomy was performed at newborn babies’ baptism for healthy breast-feeding over many centuries. Although it was necessary for nursing babies, its application was denied subjectively without clinical observation since the early 20th century. As a result solutions for breastfeeding and breast problems are confused now. Methods: We studied changes in breastfeeding and mothers’ breasts before and one month after the surgeries for ADEL by standards for healthy breastfeeding and breasts. Results: With regard to suckling, before the surgeries 24% of babies opened their eyes during breastfeeding, while after surgeries 76% opened eyes while nursing. 30% of the babies latched onto the mother’s breast with a wide-open mouth. After surgeries, 84% properly latched on. 73% of the babies had calluses on the upper lip before surgeries, and no calluses were observed after surgeries. 27% of babies before surgeries moved the jaws during breast-feeding, but after surgeries 88% moved the jaws while nursing. White debris was on the dorsum tongue in 70% of babies prior to surgeries. After surgeries, 22% were with debris. 67% of mothers experienced nipple pain before their babies’ surgeries while 6% had pain after the surgeries. Flattened nipples were observed in 55% of mothers before the infants’ surgeries, 7% after surgeries. 23% of mothers had breast pain before the surgeries, and 4% had breast pain after the surgeries. Mastitis was also reduced from 9% to 1% after surgeries. 73% of women had palpable breast masses, and after the surgeries 25% had palpable masses. Summary: Remarkable improvements in breastfeeding and in women’s breasts were achieved after their infants underwent operations for ADEL. These results indicate the necessity of surgical interventions in babies with ADEL for healthy breastfeeding and breasts (279).
文摘Nowadays mandibular advancement appliances (MA- As) are available and distributed widely in the field of dentistry for the treatment of snoring and ob- structtive sleep apnea (OSA). However, a few stud- ies discussed temporomandibular joint (TMJ) discom- fort and masticatory muscle stiffness during wearing MAAs are found. A new appliance that we introduced in this pilot study has shown significant jaw move- ment and could diminish TMJ and masticatory side effects.
文摘Background: Despite overwhelming evidence for gender differences in sleep quality as well as gender-specific changes of sleep parameters with respect to habitual sleeping arrangements, studies on snorers and their bed partners have ignored the influence of individual quality of sleep as a potential co-factor. Objective: The objective of this study was to record subjective and objective sleep parameters and to analyze the effects of alternating of sleeping arrangements in snorers and their bed partners. Methods: Habitual snorers and their bed partners were recruited via newspaper articles not stating the exact purpose of the study. Both filled out a 90-day sleep diary. During this time, we recorded subjective and objective sleep parameters in the snorers and their bed partners via wrist actigraphy and sleep diaries for 14 days. For statistical analysis, we used two-sided t-tests and Spearman’s Rho. Results: The dataset included 45 snorers (11 females) and 45 bed partners (34 females) with a mean age of 47 ± 13 and 43 ± 12 years. Screening for sleep apnea yielded snoring without OSAS, mild-, moderate- and severe OSAS in 27 (60%), eight (18%), three (7%) and six (15%) snorers. PSQI total scores were significantly lower in snorers than in bed partners (4 ± 2 vs. 6 ± 4, p = 0.002). We could not find a significant correlation between subjective and objective sleep latency and efficiency. Couples who changed their sleeping arrangement were significantly younger than those who habitually slept alone or together (p = 0.01). Subjective sleep parameters of snorers or bed partners were not related to the number of consecutive nights spent either together or apart. Conclusions: Our study confirmed the weak correlation of subjective and objective sleep parameters in pairs with snoring problems. Couples changing their sleeping arrangement were the youngest among the whole group, but their separation of sleeping arrangements did not improve subjective sleep parameters.
文摘Objectives: The aim of the present study was to analyze the recovery rate of symptoms in patients with adenoid hypertrophy and investigate the role of nasal pathologies, allergy and gastroesophageal reflux (GER) as the reason of failure in patients with persistent symptoms. Patients and Methods: Patients undergoing adenoidectomy were enrolled in this study. There were 58 males and 42 females, aged between 1 - 13 years (mean ± SD: 4.9 ± 2.2 years). The parents of each child were questioned about the following symptoms;apnea, nasal obstruction, mouth breathing, snoring and nasal discharge. Presence or absence of nasal obstruction due to septal deviation and/or chonchal hypertrophy was noted. All children were evaluated for GER by upper gastrointestinal endoscopy or pH monitorization and for allergy by specific IgE analysis or skin prick test. Three months after the operation the children were re-examined and their parents were interviewed about persistent symptoms. Patients with persistent symptoms were re-evaluated with rigid endoscopy for residual adenoid vegetation. Results: Apnea was cleared in the entire group postoperatively. However, 9 patients complained of nasal obstruction, 16 patients had mouth breathing, 9 patients had snoring and 17 patients continued to have nasal discharge two months after the operation. Statistical assessment showed a significant difference for each symptom between the pre- and postoperative level (p Conclusions: Adenoidectomy alone is an effective treatment for nasal obstruction and obstructive sleep symptoms in children. Persistent obstructive symptoms are usually due to nasal pathology and allergy.
文摘Background Adenotonsillectomy (AT) has been an effective treatment for sleep-disordered breathing (SDB) in children, and several studies described the risk of postoperative weight gain and obesity in children treated with AT. The present study aimed to evaluate behavioral improvements in children with SDB one year after adenotonsillectomy and to investigate an influence of postoperative weight gain on behaviors. Methods The study included 170 children aged 5–11 years who underwent adenotonsillectomy for SDB and 150 controls. Body mass index percentile was obtained for age and gender, and parental sleep-related breathing disorder (SRBD) question-naire was used to assess the severity of SDB. Psychological assessment was performed pre- and post-adenotonsillectomy using standardized questionnaires including strength and difficulties questionnaire, children's depression inventory and screen for child anxiety-related emotional disorder. Results The mean age of 170 patients was 7.7 ± 1.5 years with 73 (42.9%) girls and 97 (57.1%) boys. The mean follow-up period were 15.4 ± 2.7 months. The patients had shown significant improvements in SDB scores as well as in questionnaire-based behavioral problems after adenotonsillectomy. The odds of a child being overweight were significantly increased after adenotonsillectomy. Less improvements in hyperactivity and conduct problems were observed in the patients with older ages, higher SRBD scores, and overweight/obesity at 1-year follow-up after adenotonsillectomy. Conclusion These data suggest that abnormal behavioral outcomes should be evaluated postoperatively, which potentially could be reduced with the early adenotonsillectomy and adequate postoperative weight control.
