• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.24-33
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• 2002

Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.206-217
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• 1995

Background: In patients with obstructive sleep apnea syndrome(OSAS), there are several factors increasing upper airway resistance and there is a predisposition to compromised respiratory function during waking and sleep related to constitutional factors including a tendency to obesity. Several recent studies have suggested a possible relationship between sleep apnea(SA) and systemic hypertension. But the possible pathophysiologic link between SA and hypertension is still unclear. In this study, we have examined the relationship among age, body mass index(BMI), pulmonary function parameters and polysomnographic data in patients with OSAS. And also we tried to know the difference among these parameters between hypertensive OSAS and normotensive OSAS patients. Methods: Patients underwent a full night of polysomnography and measured pulmonary function during waking. OSAS was diagnosed if patients had more than 5 apneas per hour(apnea index, AI). A careful history of previously known or present hypertension was obtained from each patient, and patients with systolic blood pressure $\geq$ 160mmHg and/or diastolic blood pressure $\geq$ 95mmHg were classified as hypertensives. Results: The noctural nadir of arterial oxygen saturation($SaO_2$ nadir) was negatively related to AI and respiratory disturbance index(RDI), and the degree of noctural oxygen desaturation(DOD) was positively related to AI and RDI. BMI contributed to AI, RDI, $SaO_2$ nadir and DOD values. And also BMI contributed to $FEV_1,\;FEV_1/FVC$ and DLco values. There was a correlation between airway resistance(Raw) and AI, and there was a inverse correlation between DLco and DOD. But there was no difference among these parameters between hypertensive OSAS and normotensive OSAS patients. Conclusion: The obesity contributed to the compromised respiratory function and the severity of OSAS. AI and RDI were important factors in the severity of hypoxia during sleep. The measurement of pulmonary function parameters including Raw and DLco may be helpful in the prediction and assessment of OSAS patients. But we could not find clear difference between hypertensive and normotensive OSAS patients.

• Korean Journal of Biological Psychiatry
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• v.6 no.2
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• pp.153-160
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• 1999

Animal models can provide a useful tool for the study of some aspects of psychiatric disorders and their treatment. The four criteria for the evaluation of animal models of psychiatric disorders are as following : 1) similarity of inducing conditions 2) similarity of behavioral state 3) common underlying neurobiological mechanisms 4) reversal by clinically effective treatment techniques. Several animal models have been proposed for schizophrenia : phenylethylamine model, L-dopa model, hallucinogen model, cocaine model, amphetamine model, phencyclidine model, noradrenergic reward system lesion model, reticular stimulation model, social isolation model, conditioned avoidance reaction, catalepsy test, paw test, self-stimulation paradigms, latent inhibition paradigms, blocking paradigms, prepulse inhibition of the startle reflex, rodent interaction, social behavior in monkeys, hippocampal damage, high ambient pressure, and models using selective breeding. Among them, animals with bilateral lesion of the hippocampus may provide an adequate animal model for several symptoms of schizophrenia, and ketamine model can reproduce negative symptoms and cognitive deficits as well as positive symptoms of schizophrenia. In conclusion, no model of schizophrenia is entirely representative of the disease, and findings gleaned from model systems must be cautiously interpreted. Furthermore, the process of developing and validating animal models must work in concert with the process to identify reliable measures of human phenomenology.

• Sleep Medicine and Psychophysiology
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• v.7 no.1
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• pp.18-26
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• 2000

Objectives: To investigate the airway narrowing patterns by multi-level airway pressure(MAP) monitoring during sleep and to evaluate the value of CT scan taken during waking and sleep apneic periods to identify the level of airway narrowing(LAN) in patients with obstructive sleep apnea syndrome(OSAS). Methods: Eleven patients with OSAS underwent a night polysomnography with continuous MAP monitoring by 4-sensor(placed at nasopharynx, caudal-uvula, hypopharynx, esophagus) or 2-sensor(placed at caudal-uvula and esophagus) catheter. All patients had cine CT at five levels of high retro and alatal, low retropalatal, retroglossal, epiglottis and hypopharynx during awake and sleep periods. In each patient, LAN determined by CT scan($LAN_{CT}$) during sleep apnea was compared with LAN by MAP monitoring($LAN_{MAP}$). Results: MAP monitoring showed that four patients(36%) had a single pattern of LAN while the other seven patients(64%) showed two or more different LANs in different apneic episodes. Velopharynx was the most common level of frequently observed airway narrowing during sleep apnea(63.6%). However, a single pattern of airway narrowing was more frequent(72.7%) in airway CT during sleep apnea. Velopharynx was the most common narrowest level also in apneic CT(66%). In comparing $LAN_{CT}$ with $LAN_{MAP}$, the $LAN_{CT}$ of five patients(45.5%) were high-concordant, those of another five(45.5%) low-concordant, and that of one(9%) discordant with $LAN_{MAP}$. Conclusions: Cine CT scan during the awake state or sleep apnea may not reflect the LAN correctly in OSAS because most patients showed two or more different airway narrowing patterns during different episodes of sleep apnea in each patient.

• Sleep Medicine and Psychophysiology
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• v.17 no.1
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• pp.21-27
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• 2010

Objectives: It is well established that primary insomnia affects the activity of autonomic nervous system. We tried to know how the activity of autonomic nervous system during night sleep changes by analyzing correlation between heart rate variability (HRV) index and the variables related with sleep structure in primary insomnia. Methods: Thirty three subjects (mean age: $36.2{\pm}14.2$ years, male:female=15:18) who were diagnosed with primary insomnia were selected for the study. Nocturnal polysomnography (NPSG) was carried out on each subject and correlation was analyzed between high frequency/low frequency ratio (LF/HF ratio), one of HRV indices and the variables related with sleep structure which were calculated from NPSG. Results: When age and sex were controlled, LF/HF ratio showed negative correlations with slow wave sleep and stage 2 sleep, respectively ($r_p$=-0.43, p=0.01; $r_p$=-0.37, p=0.04). On the other hands LF/HF ratio showed a positive correlation with arousal index ($r_p$=0.65, p<0.001). The activity of autonomic nervous system responded differentially depending on the change of sleep structure in primary insomnia. Especially the increase of arousal index and the decrease of slow wave sleep and stage 2 sleep which are the components of non-REM sleep provoked hyperactivity of sympathetic nervous system. Conclusion: This study suggests that the typical change of sleep structure in primary insomnia can negatively impact on cardiovascular system.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.48-55
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• 2002

Objective: Stress is known to be a common cause of short-term insomnia and insomniacs often complain that stress induces sleep problems. However, previous studies on the correlation between stress and sleep do not show consistent results. We aimed to investigate the effects of minor stressful events on sleep among college students. Method: Physically and mentally healthy college student volunteers filled out a self-assessment questionnaire to evaluate their stress and sleep. To find out the status of average stress and sleep, the volunteers filled out K-DSI and daily sleep assessments on three consecutive days. In addition, we surveyed the amount of caffeine beverage intake and assessed the degree of depression and anxiety. Results: The total number of students participating in this study was 202, 101 men and 101 women. Minor stress turned out to significantly affect non-restorative sleep and secondary symptoms of insomnia (awakening difficulty, displeasure, feeling of dissatisfaction with sleep, physical uneasiness or pain at awakening, daytime sleepiness, depressive moods, tiredness and concentration difficulty). However, global PSQI score, self-reported sleeping hours, sleep latency, awakening frequency, frequency and duration of napping, were not explained by stress scores. Conclusion: In this study, minor stresses seemed to affect sleep, especially secondary symptoms caused by non-restorative sleep. We can thus infer that minor stresses impair the restorative effects of sleep by inducing arousal, and the direct relationship the two can be confirmed by polysomnogram.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.6 no.3
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• pp.147-175
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• 2011

The purpose of this study is to examine the effects of store choice criteria on customer satisfaction and store loyalty, and the moderating effects of customer emotions on the causal relationship between store choice criteria and customer satisfaction. In this regard, this study tries to identify the effects of store choice criteria on customer satisfaction and store loyalty in case of mass merchandisers, and to analyze the moderating effects of customer emotions on the causal relationship between store choice criteria and customer satisfaction. For this purpose, 300 customers, who have ever shopped at mass merchandisers, were surveyed and 246 valid responses were finally used for the data analysis. The results of this study are as follows. First, out of six store choice criteria, product factors, store reputation and physical environment turn out to have statistically significant effects on customer satisfaction. This result confirms those of the previous studies. On the other hand, store accessibility, subsidiary facilities and store atmosphere are not found to have statistically significant effects on customer satisfaction. This result is somewhat different from those of previous studies, and so further research on the subject needs to be carried out. Secondly, it turns out that customer satisfaction has a statistically significant effect on store loyalty, which is in line with the results of previous studies that perceived emotions affect customers' store attitudes which in turn influence their revisit intentions. Thirdly, as for the moderating effects of customer emotions on the relationship between store choice criteria and customer satisfaction, pleasure moderates the effects of store accessibility, subsidiary facilities and store atmosphere on customer satisfaction, arousal moderates the effects of product factors, subsidiary facilities and store reputation on customer satisfaction, and finally dominance moderates the effects of product factors and subsidiary facilities on customer satisfaction. These findings partially support the results of previous studies that customers' in-store emotional experiences such as feeling good or bad enhance their store loyalty.

• Science of Emotion and Sensibility
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• v.6 no.4
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• pp.9-14
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• 2003

Sleep stages have been useful indicator to check a person's comfortableness in a sleep, But the traditional method of scoring sleep stages with polysomnography based on the integrated analysis of the electroencephalogram(EEG), electrooculogram(EOG), electrocardiogram(ECG), and electromyogram(EMG) is too restrictive to take a comfortable sleep for the participants, While the sympathetic nervous system is predominant during a wakefulness, the parasympathetic nervous system is more active during a sleep, Cardiovascular function is controlled by this autonomic nervous system, So, we have interpreted the heart rate variability(HRV) among sleep stages to find a simple method of classifying sleep stages, Six healthy male college students participated, and 12 night sleeps were recorded in this research, Sleep stages based on the "Standard scoring system for sleep stage" were automatically classified with polysomnograph by measuring EEG, EOG, ECG, and EMG(chin and leg) for the six participants during sleeping, To extract only the ECG signals from the polysomnograph and to interpret the HRV, a Sleep Data Acquisition/Analysis System was devised in this research, The power spectrum of HRV was divided into three ranges; low frequency(LF), medium frequency(MF), and high frequency(HF), It showed that, the LF/HF ratio of the Stage W(Wakefulness) was 325% higher than that of the Stage 2(p＜.05), 628% higher than that of the Stage 3(p＜.001), and 800% higher than that of the Stage 4(p＜.001), Moreover, this ratio of the Stage 4 was 427% lower than that of the Stage REM (rapid eye movement) (p＜.05) and 418% lower than that of the Stage l(p＜.05), respectively, It was observed that the LF/HF ratio decreased monotonously as the sleep stage changes from the Stage W, Stage REM, Stage 1, Stage 2, Stage 3, to Stage 4, While the difference of the MF/(LF+HF) ratio among sleep Stages was not significant, it was higher in the Stage REM and Stage 3 than that of in the other sleep stages in view of descriptive statistic analysis for the sample group.

• Sleep Medicine and Psychophysiology
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• v.28 no.1
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• pp.27-33
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• 2021

Objectives: The purpose of this study is to investigate the difference in the effects of eye-mask and light-off on sleep status according to a commercial fitness tracker and a sleep diary of psychiatric in-patients in correctional facilities where nocturnal light is compulsory. Methods: This study was conducted over 3 consecutive nights. In-patients of the National Forensic Psychiatric Hospital (n = 29) were assigned random subject numbers and slept as usual in the light-on condition on the first night. The subjects slept with eye-masks in the light-on condition on another night and without an eye-mask in the light-off condition on the other night. Subjects were asked to sleep wearing a commercial fitness tracker and to keep a sleep diary. The order of these changes in bedroom lighting condition on the second and third nights was assigned randomly to participants. Results: In comparison of the sleep variables between the light-on condition and the eye-mask condition, the Wakefullness After Sleep Onset (WASO) was shorter and sleep satisfaction was higher in the latter.(respectively, Z = 3.66, p < 0.017 ; Z = 2.69, p < 0.017) In comparison of the sleep variables between the light-on and light-off conditions, the WASO was shorter and sleep efficiency and sleep satisfaction were higher in the latter (respectively, Z = 2.40, p < 0.017 ; Z = 3.02, p < 0.017 ; Z = 3.88, p < 0.017). However, there were no differences in the sleep variables between the eye-mask condition and the light-off condition. Conclusion: Subjective improvements in sleep variables were noted in sleep diaries of institutionalized psychiatric patients under either the 'eye-mask' or 'light-off' condition. However, there were no significant differences between the 'eye-mask' and 'light-off' conditions. Therefore, we suggest that psychiatric patients in correctional facilities use eye-masks when sleeping.

• Journal of Life Science
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• v.23 no.9
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• pp.1170-1176
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• 2013

Essential oils have been used to treat psychophysiological disorders, but their effects on human electroencephalographic (EEG) activity have not been thoroughly investigated. We evaluated the effects of essential oil of Zizyphus jujuba seeds, a Korean folk medicine known as San-Jo-In, on human EEG activity. For this purpose, essential oil was extracted from San-Jo-In by the supercritical carbon dioxide extraction method. The effect of its inhalation on EEG activity was evaluated by measuring the EEG power spectrum (25 indices) in 20 healthy participants. The results of the EEG power spectrum indicated that the values of the theta wave decreased significantly (p<0.05) in the left (from 17.277 to $13.854{\mu}V$) and right parietal (from 15.324 to $13.020{\mu}V$) regions compared to the other regions. During the inhalation of San-Jo-In oil, the EEG spectrum values of fast alpha, relative gamma, and spectral edge frequency increased 50% compared to those before inhalation. The values of the fast alpha wave increased significantly (p<0.05) in the left prefrontal (from 0.063 to $0.085{\mu}V$), right prefrontal (from 0.064 to $0.085{\mu}V$), and left frontal (from 0.073 to $0.100{\mu}V$) regions following inhalation of the San-Jo-In essential oil. The changes in the EEG activities following inhalation of San-Jo-In suggest that the oil can improve psychological well-being by increasing attention and relaxation.