An infant's sleep varies considerably from that of adults in terms of structure, amount, and breathing pattern. After birth, sleep becomes evenly distributed throughout the day and night. Nighttime sleep gradually increases with the maturation of circadian rhythm, and sleep is gradually consolidated. Electroencephalography characteristics change with age, from early and dominant active (REM) sleep in newborns to increasing NREM sleep. Similar to other elements of growth, the upper respiratory tract and ribcage gradually increase in size with age, and respiratory control also improves. With these changes, sleep patterns also change. At this time that various sleep disorders may appear. Improved understanding of age-dependent changes in infant sleep can help determine the etiology and facilitate diagnosis of infant sleep diseases.
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.
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
/
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.
Objectives: Suicide is one of the leading causes of death among young adults. We investigated whether anxiety level and sleep quality were related to suicide ideation among university students. Methods: Questionnaires were distributed to 1094 students at a local college. The scale for suicide Ideation, the Hospital Anxiety-Depression scale, the Pittsburgh Sleep Quality Index, and Morningness-eveningness questionnaires were used. Multiple linear regression analysis was conducted to examine the relationship between these variables and suicide ideation. Results: Among the 292 students who answered the suicide ideation questionnaire, 31 students had a high suicide ideation score and 261 patients had a low suicide ideation score. Demographic variables that showed significant differences between the two groups were gender, exercise, chronotype, sleep quality, depression and anxiety. The results of multiple linear regression analysis showed that suicidal ideation increased as the level of sleep quality decreased. There was no significant relationship between depression and suicidal ideation. Another multiple linear regression analysis was performed to evaluate the relationship between sleep quality sleep related factors. This suggested the quality of sleep decreased as weekend oversleep increased. Conclusion: The results of this study showed that when anxiety was higher and the quality of sleep was lower, the more suicide ideation increased. Therefore, improving sleep quality and reducing anxiety are important strategies for reducing suicidal ideation.
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.
Some circadian rhythms can become disorgnized due to rotating shift work. This lack of organization, termed desynchronization, can produce a group of symptoms such as insomnia, GI disturbance and fatigue among many rotating shift workers. The magnitude of these symptoms are influenced by personal and environmental factors and the patterns of shift work. This study was carried out to investigate the subjective symptoms related to rotational schedules of shift work after personal and environmental factors adjusted. 182 male workers in rapidly rotating shift system and 86 male workers in weekly rotating shift system were conducted the questionnaire on personal factors and subjective sleep, GI and fatigue symptoms. Major findings obtained from this study are as follows: 1. The symptoms of 'feeling tired at work' and 'being irritable' were more frequent in weekly rotating shift workers (P<0.05), and the mean of symptom score was significantly higher in weekly rotating shift workers(P<0.01). 2. According to 6 hours of sleeping which is a definite elevation point of fatigue, there was not a significant difference between two groups in sleeping hours. Among workers in rapidly rotating shift system, the mean of symptom score was significatly higher in workers of less than 6 hours of sleeping(P<0.05), but it was not different among weekly rotating shift workers. 3. The symptoms of GI disturbance were more frequent in weekly rotating shift workers but statistically not significant. 4. The positive rate of mental and physical fatigue symptoms were significantly higher in weekly rotating shift workers(P<0.01) and mental and physical fatigue symptoms were more frequent in them (P<0.01). 5. After the effect of the factors that were significantly different between two groups by $X^2-test$ were controlled, the mean score of sleep disturbance was significantly higher in weekly rotating shift workers (P<0.01) and mental physical fatigue symptoms were more frequent in them (P<0.01). Based on these study results, subjective symptoms were more common in the weekly rotating shift workers. In future, medical examination and laboratory test will be also administered to evaluate a more accurate health outcomes and the review of current shift schedules will be required.
The purpose of this study was to identify the relationships between sleep time and depression and suicidal ideation in middle aged women. The subjects of this study were 1,617 women aged 40-64 years who participated in the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-2), 2017. Data were downloaded from the KNHANES website and were analysed through complex sampling design data analysis using IBM SPSS 21.0 program. Suicidal ideation is 3.65 times higher in women who sleeps for five hours or less in weekend than in women who sleeps more than seven hours and less than nine hours in weekend. These result indicate that suicide prevention program for middle aged women should include strategies for maintaining proper sleep times and women who sleeps for five hours or less should be considered as a priority intervention case. In additions, further studies on the relationship between sleep times and depression of middle aged women should be conducted.
Kim, Yeong-Hwa;Hwang, Byong-Chol;Park, Sung-Geun;Kim, Jong-Man
The Journal of Engineering Geology
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v.19
no.2
/
pp.217-225
/
2009
A series of model borehole experiments and analyses for density compensation were performed to achieve the effective density correction of gamma-gamma log obtained from PVC cased boreholes. A follow-up survey was made for clarifying the variation property of detector responses depending on casing types, the presence of borehole fluid, and the degree of separation between probe and borehole wall. A special emphasis was placed on the comparison of gamma responses obtained from above and below ground water tables. Finally, we could quantify the detector responses as a function of separation between the probe and borehole wall, construct standoff compensation charts, and the limitations of the compensation have been discussed for the environments of both above and below ground water tables.
The Journal of Korean Academy of Sensory Integration
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v.21
no.2
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pp.69-83
/
2023
Objective : This study sought to systematically examine the intervention effect of social stories when applied in relation to children with sleep disorders. Methods : Studies available in the SCOPUS, ScienceDirect, PsycArticles, and PubMed databases that were published from 2001 to 2022 were searched. The keywords used for the search were as follows: ("social story" OR "social stories") AND ("sleep" OR "sleep disorders" OR "sleep wake disorder bedtimes" OR "sleep initiation and maintenance disorders" OR "sleep wake disorder" OR "sleep arousal disorders"). Based on the selection criteria, six experimental studies were selected and analyzed. Results : The selected studies were two randomized controlled trials, three individual trials, and one case study. The subjects were mostly children diagnosed with autism spectrum disorder who were school-aged or adolescent. The intervention types were often complex interventions, including social stories and other interventions, while the durations of the interventions varied from one day to more than 40 days. The interventions had a positive effect on the subjects' sleep quality, with night wakings, sleep onset delay, and sleep anxiety all being improved. As standardized assessment tools to evaluate the effectiveness of social stories, the Child Sleep Habits Questionnaire and the Child Behavior Checklist were used in two papers each, and were the most commonly used. As non-standardized assessment tools, each of the four papers used turbulence and sleep diaries as assessment tools. Conclusion : The effect of social story mediation can be divided into sleep quality and sleep-related behavior. In terms of sleep quality, studies showing improvements in night wakings, sleep onset delay, and sleep anxiety accounted for a large proportion of the sample. The detailed effect area of sleep quality showed a significant improvement after the interventions in most studies, and in all six studies analyzed in the present study, the continuation of the effect after the intervention was confirmed via follow-up tests. Thus, the findings of this study are expected to be helpful when applying social stories in children with sleep disorders in clinical practice due to presenting the intervention effects, outcome evaluation tools, and intervention periods in children with sleep disorders in prior investigations involving social stories.
Objectives: We investigated whether sleep behaviors, severity of insomnia and circadian typology are associated with quality of life among Gyeongsang National University (GNU) medical students. Methods: Questionnaires were distributed to 46 fourth-year students of GNU Medical School. The hospital anxiety-depression scale, insomnia severity index (ISI), morningness-eveningness questionnaire (MEQ) and WHO Quality of Life-BREF (WHOQOL-BREF) were used. Results: Quality of life in terms of physical health was associated with age, weekday total sleep time (TST), weekend TST, catch up sleep, depression, ISI score, and MEQ score. Quality of life in terms of psychological health was correlated to weekday and weekend TST, anxiety, ISI score and MEQ score. Sex, weekday TST, depression, and ISI score were revealed to influence the social aspect of quality of life, and weekday and weekend TST, and ISI score were associated with quality of life in terms of environment. Multiple regression analysis showed that better sleep quality predicted to a higher quality of life in terms of physical, psychological and environmental health, and eveningness was associated with a better quality of life in terms of physical and psychological health. Conclusion: It is concluded that physical, psychological, and environmental aspects of quality of life were associated with quality of sleep and that physical and psychological aspects of quality of life were related to eveningness in GNU medical students. Therefore, it is equally important to treat emotional problem as well as improve sleep quality.
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