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Investigation of 'First-Night Effect' in Normal Young Adult Male Subjects on Polysomnography (젊은 정상인 남자에서 수면다원기록상의 '첫날밤 효과' 분석)

  • Kim, Eui-Joong;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.5 no.1
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    • pp.111-117
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    • 1998
  • Objectives : 'First-night effect' has been a well-known concept since 1960's. It is important because it is one of the major factors to be considered in assessing the reliability of polysomnographic data. However, 'reverse first-night effect' has also been described, resulting in the inconsistency of conceptualization. We attempted to investigate on the first-night effect in adults by having each of them take two nights of polysomnography in a controlled environment. Young healthy adult volunteers were chosen as subjects in order to rule out age- or health-related confounders. Methods : Polysomnography was performed on eight male medical students (mean $age=23.5\;{\pm}\;0.9$) for two nights with Grass model 78 polysomnograph. We scored manually under the standard protocol each epoch of the sleep records. Sleep variables were obtained and compared between the two nights. Results : Sleep period time(SPT) and total sleep time(TST) of the third fraction of night were significantly longer on the first night than on the second night (p<0.05). However, other sleep variables such as percentage of each sleep stage, sleep latency, REM sleep latency, number of waking, and sleep efficiency were not different between the two nights. Conclusion : We could not confirm the existence of first-night effect in this study. In healthy young male adults, it may not happen at all or may happen to a very negligible degree. Young healthy adults may have more adaptability to a new sleep environment. Also, the provision of a reasonably comfortable sleep environment could have helped them with abolition of first-night effect.

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Attention Deficits and Characteristics of Polysomnograms in Patients with Obstructive Sleep Apnea (폐쇄성 수면무호흡증 환자의 주의력 결함 및 수면다원검사 특징)

  • Lee, Yu-kyoung;Chang, Mun-Seon;Lee, Ho-Won;Kwak, Ho-Wan
    • Korean Journal of Health Psychology
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    • v.16 no.3
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    • pp.557-575
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    • 2011
  • This study tried to examine the characteristics of attention deficits in patients with Obstructive Sleep Apenea(OSA) with different age levels, and to examine which indices of polysomnograms might be related to the indices of attention deficits in OSAs. Two age-level groups and a normal control group were subjected to two computerized attention tests, including a continuous performance test(CPT) and a change blindness task(CBT). In addition, the three groups were subjected to a Polysomnography to extract several sub-indicators of polysomnogram, and an Epworth Sleepiness Scale which measures subjective sleepiness. As results, the OSAs showed significantly more omission and commission errors in CPT, and they showed lower accuracy in CBT compared to the normal group. The results of a correlational analysis showed that attention deficits in OSA are significantly correlated with arterial oxygen saturation among sub-indicators of polysomnograms. In conclusion, OSAs seems to be less attentive, having difficulties in response inhibition, and having deficiencies in noticing important environmental changes. Age seems to make these deficiencies even worse. Especially, the relationship between attention deficiency and hypoxia which could cause irreversible cerebrum damage has an implication in cognitive impairment prevention through early treatment.

Comparison of Actigraphic Performance between $ActiWatch^{(R)}$ and $SleepWatch^{(R)}$:Focused on Sleep Parameters Utilizing Nocturnal Polysomnography as the Standard (활동기록기($ActiWatch^{(R)}$$SleepWatch^{(R)}$) 성능 비교 연구:야간수면다원기록을 표준으로 한 수면변인을 중심으로)

  • Shin, Hong-Beom;Lee, Ju-Young;Lee, Yu-Jin;Kim, Kwang-Jin;Lee, Eun-Young;Han, Jong-Hee;Im, Mee-Hyang;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.27-31
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    • 2005
  • Objectives: We attempted to compare the performance of 2 commercially available actigraphies with focus on sleep parameters, using polysomnography as standard comparison tool. Methods: Fourteen normal volunteers (5 males and 9 females, mean age of $28{\pm}4.6\;years$) participated in this study. All the participants went through one night of polysomnography, simultaneously wearing 2 different kinds of actigraphies on each wrist. Polysomnographic and actigraphic data were stored, downloaded, and processed according to standard protocols and then statistically compared. Results: Both $ActiWatch^{(R)}$ and $SleepWatch^{(R)}$ tended to overestimate the total sleep time, compared to the polysomnography. $SleepWatch^{(R)}$ tended to underestimate the sleep latency. The two actigraphs and the polysomnograph did not show significant difference of sleep efficiency, when compared with one another. In addition, all of the sleep parameters from the instruments showed linear correlations except in $SleepWatch^{(R)}'s$ sleep latency. The sleep parameters from the two actigraphs did not show much noteworthy difference, and linear relationships were found between the sleep parameters from the two actigraphs. There was no significant distinction in the results of the two different actigraphs. Conclusion: The results of two actigraphies can be used interchangeably since the sleep parameters of the two different actigraphies do not show significant differences statistically. Overall, it is not legitimate to use actigraphy as a substitute for polysomnography. However, since sleep parameters except sleep latency show linear correlations, actigraphy might possibly be used to follow up patients after polysomnography.

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Supplemental Value of the Wrist-Worn Actigraphy in Diagnosing the Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 진단에서 손목부착형 활동기록기의 보조적 진단가치)

  • Im, Mee-Hyang;Shin, Hong-Beom;Lee, Yu-Jin;Lee, Seung-Hi;Won, Chang-Yeon;Lee, Myung-Hee;Lee, Soo-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.32-38
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    • 2005
  • Objectives: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. Methods: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male:female 20: 7;age $47.6{\pm}12.9$ years old;age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. Results: Mean total sleep time on polysomnography was $401.4{\pm}57.8\;min$ (range of 274.0 to 514.1 min). Mean RDI was $21.7{\pm}20.4/hour$. Mean FI was $21.9{\pm}13.0/hour$. RDI and FI showed significant correlation (r=0.55, p<0.01). Conclusions: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.

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Comparison of Daytime Sleepiness between Normal Subjects and Patients with Sleep Disorders and Analysis of Its Clinical Implications (정상인과 수면장애 환자군 간의 주간졸림증 비교 및 임상적 의미 분석)

  • Lee, Jin-Sung;Kim, Seog-Ju;Choi, Jong-Bae;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.9 no.2
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    • pp.106-114
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    • 2002
  • Objectives: Daytime sleepiness is a common symptom and is associated with sleep behavior, sleep deprivation, and night shift, etc. It is also one of the most important symptoms of sleep disorders like obstructive sleep apnea (OSA). According to our survey on Korean literature, a few studies have dealt with daytime sleepiness, and we have not been able to locate any study comparing normal subjects with polysomnography-proven sleep disorder patients regarding daytime sleepiness. We aimed at comparing daytime sleepiness among normal healthy daytime workers, medical students being expected to have daytime sleepiness due to chronic sleep deprivation, and patients having sleep disorders diagnosed with polysomnography. We also studied the association between subjective daytime sleepiness and objective polysomnographic findings in patients with sleep disorders. Methods: One hundred three hospital workers, 137 medical students, and patients with sleep disorders were studied. Sleep disorders included OSA, periodic limb movements in sleep (PLMS), insomnia, and narcolepsy. The degree of subjective sleepiness in each group was measured by the Korean version of Epworth sleepiness scale and compared. The relationship between polysomnographic findings reflecting severity of sleep disorder in each patient group and subjective sleepiness was analyzed. As for patients with narcolepsy, the relationship between the mean sleep latency and subjective sleepiness was studied. Results: There was a significant difference of ESS score (F=68.190, dF=5.752, p<0.001) among daytime workers, medical students, and sleep disorder patients. In OSA patient group, the degree of the sleepiness had no significant correlation either with mean O2 satuaration (p=0.062) or with RDI (p=0.807). In PLMS patient group, there was no correlation between periodic limb movement index (PLMI) and subjective sleepiness (p=0.761). In narcolepsy patient group, the subjective sleepiness had no correlation with mean sleep latency measured with MSLT (p=0.055). Conclusion: We found a significant difference of subjective sleepiness among daytime workers, medical students, and patients with sleep disorders. However, no consistent correlation was found between severity of subjective sleepiness and objective polysomnographic findings reflecting severity of each sleep disorder. This research confirms that the evaluation of subjective sleepiness is important clinically, but it cannot substitute the objective measures such as nocturnal polysomnography and MSLT.

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