• Title/Summary/Keyword: 각성장애

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Gender Differences in Symptoms of Posttraumatic Stress Disorder (외상 후 스트레스 장애 환자에서 성별에 따른 증상 차이)

  • Kim, Yoo-Ra;Woo, Young-Sup;Ko, Hyo-Jin;Jung, Young-Eun;Seo, Ho-Jun;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.4 no.2
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    • pp.121-126
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    • 2008
  • Objective : The present study investigated gender differences in the symptoms of posttraumatic stress disorder (PTSD) among Korean PTSD patients from a multicenter sample. Methods : Data were collected from 18 psychiatric units of training hospitals nationwide. All the patients were interviewed by attending psychiatrists using a structured format for PTSD by DSM-IV diagnoses. Additionally the Davidson Trauma Scale was used to evaluate all self-reported symptomatology. Results : Forty-three patients with PTSD, 23 female and 20 male patients, were enrolled in this study. There were significant differences in the frequency and severity of avoidance symptoms, and severity of re-experience symptoms. The female patients reported a higher level of re-experience and avoidance symptoms than the male patients. Conclusion : The results of the present study were found to be consistent with previous studies on gender differences. Women were more susceptible to PTSD symptoms than men, especially exaggerated re-experience and chronic avoidance. Since all patients groups were enrolled from the hospital, this findings needs to be reexamined using community samples.

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Experimental Models of Schizophrenia (정신분열병의 실험적 모델)

  • Cheon, Jin-Sook
    • 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.

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Classification of Sleep/Wakefulness using Nasal Pressure for Patients with Sleep-disordered Breathing (비강압력신호를 이용한 수면호흡장애 환자의 수면/각성 분류)

  • Park, Jong-Uk;Jeoung, Pil-Soo;Kang, Kyu-Min;Lee, Kyoung-Joung
    • Journal of Biomedical Engineering Research
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    • v.37 no.4
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    • pp.127-133
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    • 2016
  • This study proposes the feasibility for automatic classification of sleep/wakefulness using nasal pressure in patients with sleep-disordered breathing (SDB). First, SDB events were detected using the methods developed in our previous studies. In epochs for normal breathing, we extracted the features for classifying sleep/wakefulness based on time-domain, frequency-domain and non-linear analysis. And then, we conducted the independent two-sample t-test and calculated Mahalanobis distance (MD) between the two categories. As a results, $SD_{LEN}$ (MD = 0.84, p < 0.01), $P_{HF}$ (MD = 0.81, p < 0.01), $SD_{AMP}$ (MD = 0.76, p = 0.031) and $MEAN_{AMP}$ (MD = 0.75, p = 0.027) were selected as optimal feature. We classified sleep/wakefulness based on support vector machine (SVM). The classification results showed mean of sensitivity (Sen.), specificity (Spc.) and accuracy (Acc.) of 60.5%, 89.0% and 84.8% respectively. This method showed the possibilities to automatically classify sleep/wakefulness only using nasal pressure.

Detection of Arousal in Patients with Respiratory Sleep Disorder Using Single Channel EEG (단일 채널 뇌전도를 이용한 호흡성 수면 장애 환자의 각성 검출)

  • Cho, Sung-Pil;Choi, Ho-Seon;Lee, Kyoung-Joung
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.55 no.5
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    • pp.240-247
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    • 2006
  • Frequent arousals during sleep degrade the quality of sleep and result in sleep fragmentation. Visual inspection of physiological signals to detect the arousal events is cumbersome and time-consuming work. The purpose of this study is to develop an automatic algorithm to detect the arousal events. The proposed method is based on time-frequency analysis and the support vector machine classifier using single channel electroencephalogram (EEG). To extract features, first we computed 6 indices to find out the informations of a subject's sleep states. Next powers of each of 4 frequency bands were computed using spectrogram of arousal region. And finally we computed variations of power of EEG frequency to detect arousals. The performance has been assessed using polysomnographic (PSG) recordings of twenty patients with sleep apnea, snoring and excessive daytime sleepiness (EDS). We could obtain sensitivity of 79.65%, specificity of 89.52% for the data sets. We have shown that proposed method was effective for detecting the arousal events.

Menstruation and Sleep (월경과 수면)

  • Park, Doo-Heum
    • Sleep Medicine and Psychophysiology
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    • v.9 no.2
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    • pp.81-85
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    • 2002
  • There are several factors which are more likely to have sleep disorders in fertile women with menstruation than adult men. Menstrual cycle plays an important role in them. We describe herein the overview about the association of menstrual cycle and sleep disorders by viewing the interactions of menstrual cycle and circadian rhythm. We review how menstrual cycle affects sleep-wake cycle by reviewing menstrual cycle and estrous cycle to understand these interactions. Menstrual cycle and estrous cycle are mainly affected by hormonal cycle and light-dark cycle, respectively and they are generally determined in monthly rhythm and annual rhythm, respectively. The determination of estrous cycle is also affected by cyclic changes of hormones besides light-dark cycle. Although sleep-wake cycle almost alternates according to estrous cycle in non-primate mammals, it is hardly affected by menstrual cycle in primate mammals as compared with estrous cycle. But menstrual cycle affects sleep-wake cycle via desynchronization of sleep-wake cycle and temperature rhythm. The decrease of amplitude and phasic change during luteal phase in the daily fluctuation of body core temperature can partially contribute to the induction of sleep disorders in fertile women. In addition to this, premenstrual syndrome which nearly happens during luteal phase commonly have sleep problems. Therefore, we suggest that menstrual cycle and PMS can partially contribute the increase of sleep disorders in fertile women.

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Sleep Disordered Breathing in Children (어린이의 수면호흡장애)

  • Yeonmi, Yang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.49 no.4
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    • pp.357-367
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    • 2022
  • Sleep disordered breathing (SDB) is a disease characterized by repeated hypopnea and apnea during sleep due to complete or partial obstruction of upper airway. The prevalence of pediatric SDB is approximately 12 - 15%, and the most common age group is preschool children aged 3 - 5 years. Children show more varied presentations, from snoring and frequent arousals to enuresis and hyperactivity. The main cause of pediatric SDB is obstruction of the upper airway related to enlarged tonsils and adenoids. If SDB is left untreated, it can cause complications such as learning difficulties, cognitive impairment, behavioral problems, cardiovascular disease, metabolic syndrome, and poor growth. Pediatric dentists are in a special position to identify children at risk for SDB. Pediatric dentists recognize clinical features related to SDB, and they should screen for SDB by using the pediatric sleep questionnaire (PSQ), lateral cephalometry radiograph, and portable sleep monitoring test and refer to sleep specialists. As a therapeutic approach, maxillary arch expansion treatment, mandible advancement device, and lingual frenectomy can be performed. Pediatric dentists should recognize that prolonged mouth breathing, lower tongue posture, and ankyloglossia can cause abnormal facial skeletal growth patterns and sleep problems. Pediatric dentists should be able to prevent these problems through early intervention.

The Changes of Pulmonary Function and Systemic Blood Pressure in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증후군 환자에서 혈압 및 폐기능의 변화에 관한 연구)

  • Moon, Hwa-Sik;Lee, Sook-Young;Choi, Young-Mee;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak
    • 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.

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Open Clinical Trial of Morning Light Therapy in Sleep Disturbance of Alcohol Dependent Patients (알코올의존 환자에서의 수면장애에 대한 아침 광치료의 임상시도)

  • Ko, Young-Hoon;Joe, Sook-Haeng;Jeon, Seung-Kyu;Kim, Byoung-Kyu;Kwon, Sung-Min
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.196-204
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    • 2003
  • Objectives: It is known that sedative hypnotics would make cross tolerance with alcohol and deteriorate quality of sleep in alcoholics. Light therapy is effective non-pharmacological intervention for sleep disturbance in circadian phase disorders, jet-lag, shift-work and age-related sleep disorders. Authors would investigate the effects of morning light therapy on sleep of patients with alcohol dependence during recovery state without withdrawal symptoms. Methods: 13 patients with alcohol dependence who have not any alcohol withdrawal symptom were recruited. Light therapy during 1 hour in the morning had been administered by 2500 Lux light box through serial 3 days. Sleep state of subjects were assessed by sleep log and the subjective satisfaction at sleep was by 100 mm visual analogue scale. Sleepiness, depressive mood, anxiety were evaluated by 100mm visual analogue scale at 8 AM, 2 PM and 8 PM. For assessment of performance ability that would be associated with sleepiness and vigilance, trail making test A, B and digit symbol substitution test were performed by two times on base line and 4th day. Univariate repeated-measures ANOVAs were performed for each measures except performance tests which were analysed by paired t-test. Results: Sleep latency and sleep efficiency were significantly improved with light therapy and satisfaction at sleep was. There was no significant difference in sleepiness at 2 PM with light therapy but sleepiness at 8 AM significantly decreased and at 8 PM increased. The time to complete Trail making test and digit symbol substitution test were significantly shortened at 4th day compared with baseline. Fatigue at 8 AM were not significantly changed with light therapy but at 2 PM and 8 PM significantly decreased. Depressive mood and anxiety were not significantly changed with light therapy. Conclusion: Although this study had some limitations, it showed that light therapy would be effective modality on sleep disturbance of patients with alcohol dependence who have recovered from alcohol withdrawal symptoms. It is proposed that short term light therapy could be used clinically for alcoholics with insomnia. In the future, long term controlled studies using more objective tools for sleep are required to further investigate the effect of light therapy in alcoholics.

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Blood Pressure Reactivity during Nasal Continuous Positive Airway Pressure in Obstructive Sleep Apnea Syndrome (폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症)에서 지속적(持續的) 상기도(上氣道) 양압술(陽壓術)이 혈력학적(血力學的) 변화(變化)에 끼치는 영향(影響))

  • Park, Doo-Heum;Jeong, Do-Un
    • 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.

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Recent study of Acupuncture in Treatment of Urianry Disturbance (배뇨장애(排尿障碍)에 대한 침구치료(鍼灸治療)의 연구동향(硏究動向))

  • Kim, Kyung-tai;Ko, Young-jin;Kim, Yong-suk;Kim, Chang-hwan
    • Journal of Acupuncture Research
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    • v.22 no.3
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    • pp.123-135
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    • 2005
  • Objective : The aim of this study was to rivew systemically literature and clinical trials in the treatment of urinary incontinence or lower urinary tract syndrome(LUTS). Methods : Computerized literature searches were carried out on two electronic database, and computerized searching on some korea oriental medicine journals in library of Kyung-Hee Medical center. Results : 1. Three reports of review study, six reports of experimental study and fourteen reports of clinical trials were collected and reviewed. Three reports of review study were all printed in the korea oriental medicine journal. From 2000, researches and studies have been increased in quantity and improved in quality. 2. Urinary disturbance include variable symptoms of lower urinary tract symptoms, urinary incontinence, in theaspect of Oriental medicine these symptoms are anurin, dysuria, urinary incontinence, nochumal enuresis, uracratia and so on. 3. Roughly physiological procedure of Acupuncture in Treatment of Urianry Disturbance may be that effect of acupuncture stimulation for parasympathetic nerve, sleep-arousal system in cerebrum, pontine/spinal urination center and pudendal/pelvic nerve affect bladder in expansion of bladder capacity, inhibition of urinary contraction and affection in periurethral muscle by continuous excitement of spinal annular circuit and synapse of neuron. 4. Clinical result for acupuncture treatment in urinary disturbance is summarized that acupuncture treatment in urianation disturbance of Neurogenic Bladder, Incontinence, Cycitis, Nocturnal Enuresis, Prostatitis/Pelvic Pain Syndrom and so on is significant clinical trials and technique. Conclusion : Hereafter, in the old age society these variable urinary disturbance patients are increased and desire of treatment may be also increased. So study of various and formal treatment and tecnnique is needed.

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