Y. Inoue

Tokyo Medical University, Edo, Tokyo, Japan

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Publications (11)32.13 Total impact

  • Y. Komada · Y. Inoue

    No preview · Article · Jun 2014 · Clinical Neurophysiology

  • No preview · Article · Dec 2013 · Sleep Medicine

  • No preview · Article · Dec 2013

  • No preview · Article · Dec 2013 · Sleep Medicine

  • No preview · Article · Dec 2013 · Sleep Medicine
  • K Maeda · S Tsuiki · S Isono · K Namba · M Kobayashi · Y Inoue
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    ABSTRACT: A large tongue is recognised as a factor that increases the collapsibility of the upper airway in obstructive sleep apnoea (OSA) patients. We hypothesised that the propensity to develop severe OSA could be minimised if the dental arches were enlarged in obese OSA people who are thought to have a large tongue. We therefore compared the size of the dental arches in obese and non-obese OSA patients. Using a lateral cephalogram and study models, we compared the sizes of the tongue and dental arches in 23 obese and 23 non-obese Japanese male OSA patients, who were matched for age, apnoea hypopnea index (AHI) and maxillomandibular size. The median age (years) and AHI (events per hour) for the obese and non-obese groups were 36·5 and 39·0, and 13·4 and 14·3, respectively. The maxillomandibular size was matched with regard to SNA, SNB and lower face cage obtained from cephalometric measurements. The parameters that were measured for the study model included dental arch width, dental arch length, overjet and overbite. Tongue size (P < 0·05) and both upper (P < 0·01) and lower (P < 0·05) dental arch widths were significantly larger in obese than in non-obese OSA patients, and there was no difference in the severity of OSA between the two groups. These findings suggest that the tongue was larger and dental arches were enlarged in obese patients compared with non-obese patients under the same disease severity. Wider dental arches in obese OSA patients may help to offset the impact of the enlarged tongue on upper airway patency.
    No preview · Article · Aug 2011 · Journal of Oral Rehabilitation
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    ABSTRACT: Recent studies have shown an association between rapid eye movement sleep behavior disorder (RBD) and neurodegenerative disorders, especially alpha-synucleinopathies. We investigated regional cerebral blood flow (rCBF) changes using single photon emission computed tomography (SPECT) in patients with idiopathic RBD (iRBD), to determine functional brain alterations associated with the disorder. The SPECT data of 24 patients with iRBD were compared with those of 18 age-matched normal controls using statistical parametric mapping 2. We found decreased rCBF in the parietooccipital lobe (precuneus), limbic lobe, and cerebellar hemispheres in patients with iRBD, which is commonly seen in patients with Lewy body disease (Parkinson's disease and dementia with Lewy bodies) or multiple system atrophy. Our SPECT study suggests that iRBD can be a presymptomatic stage of alpha-synucleinopathies.
    No preview · Article · Dec 2010 · European Journal of Neurology
  • T. Sasai · Y. Inoue

    No preview · Article · Oct 2010 · Clinical Neurophysiology
  • Y. Komada · A. Usui · Y. Inoue

    No preview · Article · Oct 2010 · Clinical Neurophysiology
  • K. MAEDA · S. TSUIKI · Y. INOUE
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    ABSTRACT: Introduction:An excessive constricted maxillary dentition as observed in patients with congenital anomaly including Marfan's syndrome and Treacher Collins syndrome is considered to be related to the pathogenesis of Obstructive Sleep Apnea (OSA). Even in individuals without such anomalies, however, a narrowed upper dental arch appears to increase the vulnerability of OSA since dental arch narrowing decreases the tongue space, leading to upper airway constriction. Accordingly, we hypothesized that dental arch size is involved in the development of OSA. Methods:The study protocol was approved by the ethics committee of the Neuropsychiatric Research Institute, Tokyo, Japan. Patients with dental prostheses and/or missing teeth at the target teeth for dental arch measurement were excluded. A total of 169 Japanese male OSA patients agreed to participate in the study and subsequently provided written informed consent. The study models for each patient were fabricated for analyses. With the use of multiple logistic regression analysis, we investigated the association between moderate OSA (Apnea Hypopnea Index >15/hour) and the patients' characteristics including age, Body Mass Index (BMI), the ratio of upper and lower dental arch width (i.e., upper dental arch width/lower dental arch width), overjet, and overbite. Results:The ratio of upper and lower dental arch width (OR=0.008, 95%CI=0.000-0.967, p<0.05) and age (OR=1.052, 95%CI=1.017-1.089, p<0.01) were found to be statistically significant risk factors of OSA. Conclusion:The more constricted upper dental arch in relation to lower dentition would increase OSA development. These findings may partially explain why orthodontic expansion of maxillary dentition is often effective as a fundamental treatment of OSA. This work was supported by Grant-in-Aid for Young Scientists (B) 21792107 from The Ministry of Education, Culture, Sports, Science and Technology and by Grant-in-Aid for Scientific Research (B) 21406033 from Japan Society for the Promotion of Sciences.
    No preview · Conference Paper · Jul 2010
  • Source
    S Tsuiki · M Kobayashi · K Namba · Y Oka · Y Komada · T Kagimura · Y Inoue
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    ABSTRACT: Patients with less severe obstructive sleep apnoea (OSA) are usually prescribed oral appliances and/or smaller optimal nasal continuous positive airway pressure (P(nCPAP)) in nCPAP therapy. We hypothesised that OSA patients with greater P(nCPAP) would not respond favourably to oral appliances. Oral appliances were inserted in nCPAP users after washing-out the nCPAP effect. Follow-up polysomnography was undertaken with the adjusted oral appliance in place. The predictability of P(nCPAP) was evaluated with receiver-operating characteristic (ROC) curves. The median baseline apnoea/hypopnoea index (AHI) was reduced with the oral appliance from 36 to 12 events.h(-1) in 35 patients. When responders were defined as patients showing a follow-up AHI of <5 events.h(-1) with >50% reduction in baseline AHI, the area under the ROC curve for P(nCPAP) was 0.76. The best cut-off value of P(nCPAP) turned out to be 10.5 cmH(2)O with a high negative predictive value (0.93) and a low negative likelihood ratio (0.18). OSA patients with a P(nCPAP) of >10.5 cmH( 2)O are unlikely to respond to oral appliance therapy. This prediction is clinically helpful to both OSA patients and medical personnel in discussing oral appliances as a temporary substitute and/or alternative for nCPAP.
    Preview · Article · Oct 2009 · European Respiratory Journal

Publication Stats

44 Citations
32.13 Total Impact Points

Institutions

  • 2009-2011
    • Tokyo Medical University
      • Department of Somnology
      Edo, Tokyo, Japan
  • 2010
    • Japan Research Institute
      Edo, Tōkyō, Japan