• Title/Summary/Keyword: 수면각성

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The Changes of Plasma Catecholamines Concentration during Waking and Sleep in Obstructive Sleep Apnea Syndrome Patients with Systemic Hypertension (전신성 고혈압을 동반한 폐쇄성 수면 무호흡증후군 환자에서 각성시와 수면중의 혈장 Catecholamines 농도 변화)

  • Moon, Hwa Sik;Lo, Dae Guen;Choi, Young Mee;Kim, Young Kyoon;Kim, Kwan Hyoung;Song, Jeong Sup;Park, Sung Hak
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.4
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    • pp.600-612
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    • 1996
  • Background : Recent studies deported that untreated patients with obstructive sleep apnea syndrome had high long-term mortality rates, and cardiovascular complications of these patients clad a major effect on mortality. Several data indicates that obstructive sheep apnea syndrome contributes to the development of diurnal systemic hypertension. But the pathophysiological mechanism of the development of systemic hypertension in these patients is still uncertain. This study was performed to evaluate the possible role of sympathetic nervous system activity for the development of systemic hypertension in patients with obstructive sleep apnea syndrome. Method : 35 patients with obstructive sleep apnea syndrome(OSAS) and 13 Control subjects(control) were included in this study. 21 patients of OSAS were normotensives(OSAS-NBP), and 14 patients of OSAS were hypertensives(OSAS-HBP). Full night polysomnography was undertaken to all subjects. We measured plasma norepinephrine(NE) and epinephrine(EP) concentrations during waking and sleep, using high performance liquid chromatography, in all patients and control subjects. Results : In OSAS, OSAS-NBP and control, plasma NE and EP concentrations during sleep were lowed than during waking(p<0.01). But, in OSAS-HBP, these was no difference between during waking and sleep. Plasma NE concentrations during sleep of OSAS, OSAS-NBP and OSAS-HBP were higher than Control(p<0.05). In OSAS-HBP, daytime systolic blood pressure correlated with plasma NE concentration during sleep(r=0.7415, p<0.01), arid correlated inversely with mean arterial oxygen saturation(r=-0.6465, p<0.05) or arterial oxygen saturation nadir(r=-0.6) 14, p<0.05) during sleep. Conclusion : The sympathetic activity during sleep of obstructive sleep apnea syndrome patients was higher than control subjects. In obstructive sleep apnea syndrome patients with systemic hypertension, there was no diurnal variation of sympathetic activity, and there was correlation between daytime systolic blood pressure and sympathetic activity during sleep. These data suggests that chronic hyperactivity of sympathetic nervous system may contribute to the development of diurnal systemic hypertension in patients with obstructive sleep apnea syndrome.

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The Influence of Obstructive Sleep Apnea on Systemic Blood Pressure, Cardiac Rhythm and the Changes of Urinary (폐쇄성 수면 무호흡이 전신성 혈압, 심조율 및 요 Catecholamines 농도 변화에 미치는 영향)

  • Lo, Dae-Keun;Choi, Young-Mee;Song, Jeong-Sup;Park, Sung-Hak;Moon, Hwa-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.1
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    • pp.153-168
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    • 1998
  • Background: The existing data indicate that obstructive sleep apnea syndrome contributes to the development of cardiovascular dysfunction such as systemic hypertension and cardiac arrhythmias, and the cardiovascular dysfunction has a major effect on high long-term mortality rate in obstructive sleep apnea syndrome patients. To a large extent the various studies have helped to clarify the pathophysiology of obstructive sleep apnea, but many basic questions still remain unanswered. Methods: In this study, the influence of obstructive sleep apnea on systemic blood pressure, cardiac rhythm and urinary catecholamines concentration was evaluated. Over-night polysomnography, 24-hour ambulatory blood pressure and ECG monitoring, and measurement of urinary catecholamines, norepinephrine (UNE) and epinephrine (UEP), during waking and sleep were undertaken in obstructive sleep apnea syndrome patients group (OSAS, n=29) and control group (Control, n=25). Results: 1) In OSAS and Control, UNE and UEP concentrations during sleep were significantly lower than during waking (P<0.01). In UNE concentrations during sleep, OSAS showed higher levels compare to Control (P<0.05). 2) In OSAS, there was a increasing tendency of the number of non-dipper of nocturnal blood pressure compare to Control (P=0.089). 3) In both group (n=54), mean systolic blood pressure during waking and sleep showed significant correlation with polysomnographic data including apnea index (AI), apnea-hypopnea index (AHI), arterial oxygen saturation nadir ($SaO_2$ nadir) and degree of oxygen desaturation (DOD). And UNE concentrations during sleep were correlated with AI, AHI, $SaO_2$ nadir, DOD and mean diastolic blood pressure during sleep. 4) In OSAS with AI>20 (n==14), there was a significant difference of heart rates before, during and after apneic events (P<0.01), and these changes of heart rates were correlated with the duration of apnea (P<0.01). The difference of heart rates between apneic and postapneic period (${\Delta}HR$) was significantly correlated with the difference of arterial oxygen saturation between before and after apneic event (${\Delta}SaO_2$) (r=0.223, P<0.001). 5) There was no significant difference in the incidence of cardiac arrhythmias between OSAS and Control In Control, the incidence of ventricular ectopy during sleep was significantly lower than during waking. But in OSAS, there was no difference between during waking and sleep. Conclusion : These results suggested that recurrent hypoxia and arousals from sleep in patients with obstructive sleep apnea syndrome may increase sympathetic nervous system activity, and recurrent hypoxia and increased sympathetic nervous system activity could contribute to the development of cardiovascular dysfunction including the changes of systemic blood pressure and cardiac function.

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각성-졸림 과도기 생리신호 분석 연구

  • 김원식;박세진;신재우;윤영로
    • Proceedings of the ESK Conference
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    • 1997.10a
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    • pp.220-225
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    • 1997
  • 졸음에 의한 순간적 과오는 자동차운전을 비롯한 각종 산업안전에 인명피해를 포함하는 치명적 손실 을 수반한다. 따라서 이분야에 대한 연구가 국내를 포함한 전세계에서 활발히 진행되어 상업화가 추진 중이다. 그러나 이러한 연구는 실용적 차원에서 주로 피부전기활동(Electrodermal Activity: EDA)과 눈 깜박임 등의 측정방법에 의존하고 있으며 졸음의 첫 지시치로서 중요하고 객관적인 각성-졸음 과도기 뇌파를 포함하는 수면 다원생리신호 측정에 관한 연구는 이 방법이 피험자에게 구속성을 주고 측정 자체가 까다로워서 현실적으로어려운 실정이다. 본 연구에서는 그 동안 Medilog SAC847 Polysomnography를 이용한 수면에 관련된 종합적 생리신호를 측정.분석 연구해온 경험을 토대로 정상적인 성인의 각성-졸음 과도기 생리신호특징으로서 뇌전도(Electroencephalogram:EEG), 턱 및 다리근전도(Electromyogram:EMG), 심전도( Electrocardiogram:ECG), 안전도(Electrooculogram:EOG) 등을 종합적으로 분석한 결과 졸음상태가 각성상 태에 비하여 EEG의 주파수는 감소하고, EMG와 ECG의 진폭은 줄어들고, EOG에서는 느린 안구운동의 특징을 갖는 것을 알 수 있었다.

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Changes of sleep during simulated heliox saturation diving at 19 ATA and 24 ATA (19 ATA와 24 ATA에서의 Heliox포화잠수시 수면 변화)

  • 서유진;박영만
    • Proceedings of the ESK Conference
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    • 1998.04a
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    • pp.131-136
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    • 1998
  • 2개의 simulated된 잠수 실험 즉, 심도 19 ATA와 24 ATA의 고압 Heliox 환경하에서, 4명의 다이 버를 대상으로 하여연 188일간 매일 23:00부터 익일7:00시 사이에 각 다이버에대해서 표준적인 polysomnography를 기록했다. 2개의 잠수조건 하에서 양 실험 모두 해저에서 체재하는 동안 의 밤과 감압하는 동안의 밤 동안에는 총수면시간 (Total Sleep Time)의 단축, 수면효율(Sleep Efficiency)의 감소, 입면잠시(Sleep Latency)의 연장, 중도각성회수 (Number of Awakeningss) 와 감소를 보였지만, 어느쪽도 뚜려한 변화가 있었다라고는 할 수 없었다. 24 ATA 잠수조건에서 의 해저에서 체재하는 동안의 밤과 감압하는 동안의 밤 동안에서는 19 ATA 잠수조건에 비해서 4 단계수면(stage 4 sleep )만 유의한 감소를 보였다. 2개의잠수조건 모두 잠수기간 중에 있어서 는 각성하기 쉬운 상황이었으며, 기본적인 수면패턴에 있어서는 큰 변화는 보이지 않았다.

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Children's Interpretation of Facial Expression onto Two-Dimension Structure of Emotion (정서의 이차원 구조에서 유아의 얼굴표정 해석)

  • Shin, Young-Suk;Chung, Hyun-Sook
    • Korean Journal of Cognitive Science
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    • v.18 no.1
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    • pp.57-68
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    • 2007
  • This study explores children's categories of emotion understanding from facial expressions onto two dimensional structure of emotion. Children of 89 from 3 to 5 years old were required to those facial expressions related the fourteen emotion terms. Facial expressions applied for experiment are used the photographs rated the degree of expression in each of the two dimensions (pleasure-displeasure dimension and arousal-sleep dimension) on a nine-point scale from 54 university students. The experimental results showed that children indicated the greater stability in arousal dimension than stability in pleasure-displeasure dimension. Emotions about sadness, sleepiness, anger and surprise onto two dimensions was understand very well, but emotions about fear, boredom were showed instability in pleasure-displeasure dimension. Specifically, 3 years old children indicated highly the perception in a degree of arousal-sleep than perception of pleasure-displeasure.

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The Effects of Modafinil on Clinical Features and Sleep Structure of Narcolepsy Patients and Healthy Controls (모다피닐이 기면병 환자와 대조군의 임상 양상과 수면구조에 구조에 미치는 영향)

  • Shin, Hong-Beom;Jeong, Do-Un;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.13 no.2
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    • pp.67-74
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    • 2006
  • Introduction: Excessive daytime sleepiness and cataplexy are key features of narcolepsy. Modafinil is psychostimulant used in the treatment of narcolepsy. In this study, we evaluated effects of modafinil on nocturnal sleep structure and sleep latency in multiple sleep latency test and clinical features. Methods: Twelve narcoleptic patients (7 male, age: $22.9{\pm}2.6\;yrs$) were participated in the study. All of them had done nocturnal polysomnography (nPSG), multiple sleep latency test (MSLT), clinical symptoms scales and have repeated same procedure after taking 200 mg of modafinil. We have done linear mixed model analysis to describe effects of group, medication and nap time on these measures. Results: Modafinil did not affect clinical scales except PSQI which had been reduced after medication. In this study, Modafinil reduced total sleep time, sleep efficiency and increased wake after sleep onset and percent of arousal during sleep in nocturnal polysomnography and prolonged mean sleep latency in multiple sleep latency tests in both group. Discussion: Modafinil has stimulant effect of central nervous system but its effect on night sleep is less than other psychostimulants such as methylphenidate. We ascertained that modafinil affected total sleep time, sleep efficiency and percent of wake during sleep but did not effect on sleep structure. Modafinil was effective in the management of day time sleepiness. Modafinil can enhance alertness of control group without day time sleepiness.

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The Changes of Plasma Atrial Natriuretic Peptide Concentrations During Waking and Sleep in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증후군 환자에서 각성시와 수면중의 혈중 Atrial Natriuretic Peptide 농도 변화)

  • Moon, Hwa-Sik;Choi, Young-Mee;Song, Jeong-Sup;Park, Sung-Hak
    • Sleep Medicine and Psychophysiology
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    • v.2 no.2
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    • pp.156-164
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    • 1995
  • Objectives : Patients with obstructive sleep apnea syndrome(OSAS) often complain of nocturnal enuresis. There are a few reports that OSAS patients have altered renal function, and there are some evidences that the increased release of atrial natriuretic peptide(ANP) may be involved in the pathogenesis of nocturnal urinary symptoms of OSAS patients. In this study, we measured plasma ANP concentrations during waking and sleep in OSAS patients and normal controls to investigate whether there were differences of ANP concentrations between OSAS patients and normal subjects. Methods : 27 patients with OSAS and 10 normal subjects were studied. All subjects underwent a full-night polysomnographic study. Venous blood samples were separately drawn during waking and sleep. Plasma ANP concentrations were measured using radioimmunoassay. Results : In OSAS patients, ANP concentrations during sleep($122.9\;{\pm}\;29.9pg/ml$) were significantly higher than ANP concentrations during waking($60.2\;{\pm}\;5.8pg/ml$)(p < 0.05). However, in normal subjects, there was no significant difference between ANP concentrations during waking($59.2\;{\pm}\;5.7pg/ml$) and sleep($69.6\;{\pm}\;3.0pg/ml$)(p > 0.05). There was no significant difference of ANP concentrations during waking between OSAS patients($60.2\;{\pm}\;5.8pg/ml$) and normal controls($59.2\;{\pm}\;5.7pg/ml$)(p > 0.05), and also there was no significant difference during sleep between OSAS patients($122.9\;{\pm}\;29.9pg/ml$) and normal subjects($69.6\;{\pm}\;3.0pg/ml$)(p > 0.05). Plasma ANP concentrations during sleep showed significant positive correlations with apnea index(r = 0.3846, p < 0.05) and respiratory disturbance index(r = 0.3939, p < 0.05) in OSAS patients. Conclusion : These data suggest that, in OSAS patients, plasma ANP concentrations during sleep are significantly higher than plasma ANP concentrations during waking, and there is a positive correlation between the plasma ANP concentration during sleep and the severity of sleep apnea.

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Portable arousal control system using electrodermal activities (피부 전기활동을 이용한 휴대형 각성도 측정 및 제어 시스템)

  • Ko, Han-Woo;Lee, Woan-Kyu;Kim, Youn-Ho
    • Journal of Sensor Science and Technology
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    • v.5 no.3
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    • pp.55-64
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    • 1996
  • To control arousal level using physiological index, electrodermal activity signal was detected and separated into skin impedance level and response. Arousal state decision and control algorithm was studied to implement and evaluate real time portable arousal control system. The implemented system can detect and control arousal state from initial drowsy state. This system will be applicable to the evaluation of the effect of warning signal, driver's drowsy detecting system, and sleep study.

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