Background: Actigraphy is a reliable and valid method for assessing sleep in normal, healthy populations, but it may be less reliable and valid for detecting disturbed sleep in patients. In this study, we attempted to assess the utility of actigraphy in the estimation of sleep quality in patients with obstructive sleep apnea syndrome (OSAS), a major sleep disorder. Method: We analyzed the data of patients who underwent polysomnography (PSG) and actigraphy simultaneously for one night at the Center for Sleep and Chronobiology, Seoul National University Hospital from November 2004 to March 2006. Eighty-nine subjects with OSAS alone and 21 subjects with OSAS and periodic limb movement disorder (PLMD) were included for final data analyses between groups. Polysomnographic and actigraphic data were also compared. Results: In subjects with mild OSAS (RDI<15), modretae ($15{\leq}RDI$<30), and OSAS with PLMD, PSG and actigraphy did not show significant difference in total sleep time and sleep efficiency. However in severe ($30{\leq}RDI$) OSAS subjects, PSG and actigraphy showed significant difference in total sleep time and sleep efficiency. In all patients, no correlations were found between sleep parameters from PSG and from those using actigraphy. Conclusions: We suggest that in severe OSAS patients, PSG is the diagnostic tool. In mild and moderate cases, actigraphy might be used as a screening tool.
Objectives: Obstructive sleep apnea syndrome (OSAS) is the most common form of sleep-disordered breathing and often presents with comorbid depressive symptoms. In this study, we evaluated the relationship between depressive symptoms and sleep parameters as measured by nocturnal polysomnography (NPSG) and simultaneous wrist actigraphy. Methods: Two hundred sixty-four subjects with clinically suspected cases of OSAS underwent one-night polysomnography, while simultaneously wearing a wrist actigraphy device. They also completed two questionnaires;the Epworth Sleepiness Scale-Korean version (ESS-K) and the Beck Depression Inventory (BDI). Of the cases studied, 105 subjects were proven by NSPG to have OSAS without other sleep disorders. NPSG and wrist actigraphy data from the subjects were analyzed. Pearson correlation and paired t-test were used in order to evaluate the relationship between depressive symptoms and sleep-parameters. Results: Mean age of the subjects was $46.1{\pm}13.1$ years. Means of the ESS-K score and BDI scores were $10.9{\pm}4.7$ and $12.8{\pm}8.1$, respectively. NPSG sleep parameters significantly differed from those of wrist actigraphy. There was no correlation found between subjects' respiratory disturbance index (RDI) and BDI scores. When directly comparing sleep parameters between subjects who were more depressed versus subjects who were less depressed, both total sleep time and sleep efficiency were decreased in the more depressed. A correlation between RDI and ESS-K scores was also found in the more depressed group. Conclusions: Although our findings suggest that there is no relationship between RDI and depressive symptoms, there are other significant differences in the sleep parameters between subjects who are more depressed versus those without depression. We recommend that patients with depression should also be evaluated for clinical symptoms of OSAS.
Kim, Seog-Ju;Lee, Yu-Jin;Kim, Eui-Joong;Jeong, Do-Un
Sleep Medicine and Psychophysiology
/
v.11
no.1
/
pp.37-43
/
2004
Objective: The purpose of this paper is to study the possible differences in clinical and polysomnographic findings, depending on the presence or absence of subjective complaints of abnormal sleep behavior, in patients with RWA on polysomnography. Method: We reviewed patient records and polysomnographic data of patients referred to the Sleep Laboratory at Seoul National University Hospital from June 1996 through October 2002. We defined the manifest RBD group (n=32) as patients having both complaints of abnormal sleep behavior and RWA on polysomnography. The latent RBD group (n=20) consisted of patients who exhibited RWA on polysomnography but did not complain of abnormal sleep behavior. The clinical characteristics and polysomnographic findings between the two groups were compared and analyzed. Results: Fifty-two subjects had RWA, as detected by polysomnography (42 males and 10 females, mean age of $55.1{\pm}19.1\;years$). Subjects in the manifest RBD group were significantly older than those in the latent RBD group ($61.59{\pm}13.5$ vs. $44.70{\pm}2.76\;years$, independent t-test, p<0.01). More subjects in the manifest RBD group exhibited abnormal REM behavior on polysomnography than did subjects in the latent RBD group (81.3 vs. 50.0%, Fisher's exact test, p<0.05). No significant differences between the groups were found in the prevalence of brain disorders and primary sleep disorders, gender proportion, and sleep architecture. Conclusion: No difference in sleep architecture was found between the manifest and the latent RBD groups. Only age and the presence of abnormal sleep behavior on polysomnography differentiated the two groups. We suggest that RWA on polysomnography without complaints of abnormal sleep behavior may be early manifestation of manifest RBD. Attention to RWA on polysomnography is necessary to help prevent full-blown RBD from developing.
Objectives: We aimed to evaluate the effects of mattress type on both objective and subjective sleep quality in healthy good sleepers. Methods: Fifteen healthy good sleepers with a mean age of 30.8 years participated in this study. A randomized crossover trial was carried out using two different mattress types: a standard mattress and a contour coil mattress. After a night of adaptation, all participants were randomized to either a standard mattress or a contour coil mattress. Then, nocturnal polysomnography was conducted for two consecutive nights. Subjective evaluations were obtained using a self-report questionnaire before and after the polysomnographic recording sessions. Results: The polysomnographic showed no differences in total sleep time, sleep stage, or wake time after sleep onset between the two mattress conditions. Of the polysomnographic variables, only sleep onset latency was significantly reduced for the contour coil mattress. Additionally, participants reported better subjective sleep quality when sleeping on the contour coil mattress, according to the questionnaires. Conclusion: The type of mattress might affect not only subjective, but also objective sleep quality, including sleep onset latency.
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.
Objectives: Obstructive sleep apnea syndrome (OSAS) not only causes respiratory disturbances during sleep but also decreases the quality of nocturnal sleep through sleep fragmentation and sleep structure change. We aimed at comparing the changes in sleep fragmentation and structure between baseline (diagnostic) nocturnal polysomnography (NPSG) and nCPAP (nasal continuous positive airway pressure) titration trial. Methods: One hundred and three patients with a baseline night of respiratory disturbance index (RDI) of 5 or greater and reduced RDI score during nCPAP titration night were retrospectively selected for the study. Sleep fragementation and sleep structure between baseline NPSG and the NPSG during nCPAP titration were compared. Sleep fragmentation index (SFI) was defined as the total number of awakenings and shifts to stage 1 sleep divided by the total sleep time in hour. SFI and other polysomnographic parameters were statistically compared between the two nights. Results: SFI during baseline NPSG and nCPAP titration nights were $29.0{\pm}13.8$ and $15.2{\pm}8.8$, respectively, indicating a significant SFI decrease during nCPAP titration (t=9.7, p<0.01). SFI showed significant negative correlations with sleep efficiency (r=-0.60, p<0.01) and total sleep time (r=-0.45, p<0.01) and a positive correlation with RDI (r=0.28, p<0.01). Conclusion: Use of nCPAP, even during the titration, significantly decreases sleep fragmentation and improves sleep structure in OSAS patients. We suggest that SFI may be utilized as a measure of assessing OSAS severity and nCPAP efficacy.
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.
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.
Lee, Mi Hyun;Choi, Jae-Won;Oh, Seong Min;Lee, Yu Jin
Sleep Medicine and Psychophysiology
/
v.25
no.2
/
pp.51-57
/
2018
Objectives: Previous studies have shown that periodic limb movements in sleep (PLMS) could be one of risk factors for cardiovascular morbidity. The purpose of this study was to investigate the association between PLMS and blood pressure changes during sleep. Methods: We analyzed data from 358 adults (176 men and 182 women) aged 18 years and older who were free from sleep apnea syndrome (Respiratory Disturbance Index < 5) and sleep disorders such as REM sleep behavior disorder or narcolepsy. Demographic characteristics, polysomnography records, and clinical variable data including blood pressure, body mass index, alcohol, smoking, and current medications were collected. In addition, self-report questionnaires including the Beck Depression Index, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index were completed. Blood pressure change from bedtime to awakening was compared between the two periodic limb movement index (PLMI) groups [low PLMI ($PLMI{\leq}15$) and high PLMI (PLMI > 15)]. Blood pressure change patterns were compared using repeated measures analysis of variance. Results: Systolic blood pressure in the high PLMI group was lower than that in the low PLMI group (p = 0.036). These results were also significant when adjusted for gender and age, but were not statistically significant when adjusted for BMI, alcohol, smoking, anti-hypertension medication use and sleep efficiency (p = 0.098). Systolic blood pressure dropped by 9.7 mm Hg in the low PLMI group, and systolic blood pressure in the high PLMI group dropped by 2.9 mm Hg. There was a significant difference in delta systolic blood pressure after sleep between the two groups in women when adjusted for age, BMI, alcohol, smoking, antihypertensive medication use and sleep efficiency (p = 0.023). Conclusion: PLMS was significantly associated with a decreasing pattern in nocturnal BP during sleep, and this association remained significant in women when adjusted for age, BMI, alcohol, smoking, antihypertension medication use and sleep efficiency related to blood pressure. We suggest that PLMS may be associated with cardiovascular morbidity.
Objectives: Obstructive sleep apnea syndrome (OSA) is a moderately prevalent disorder. Even though much progress has been made in the diagnosis of this disorder, the cost-effectiveness of nocturnal polysomnography is undertermined and physicians and patients are still hesitant to undergo this procedure. The authors wanted to see the validity of chin press/tongue curl maneuver in estimating the severity of OSA which is easy to measure and was originally proposed by Simmons etc. by looking at the correlations between this score and the conventional respiratory disturbance indices. Methods: Forty-three sleep-related breathing disorder patients (28 OSA patients and 15 upper airway resistance syndrome (UARS) patients) who underwent investigation for posssible OSA were studied. Two conventional indices of OSA (apnea/hypopnea index (AHI) and oxygen saturation dip rate (SaO2 dips)), four other sleep variables (lowest SaO2, % of time with SaO2<90% (%SaO2 <90), % of sleep stage 1, mean length of SaO2 dips) and the score of Epworth sleepiness scale (ESS) were compared with the chin press score (CPS) which was newly revised by the author and ranges from 0 to 6. Results: The age of subjects was $45.95{\pm}12.47$ (range 14-76) and their average BMI was $25.98{\pm}3.61$ (range 19.65-37.64). There were no significant differences in age, sex and BMI except repiratory disturbance indices and ESS (p<0.05) between OSA and UARS group. Grouped median CPS of the all subjects was 4.14 (range 1-6). There was a remarkable relationship between CPS and diagnosis category (Likelihood Ratio $X^2$ test; $X^2$=17.41, df=5, p=0.004) and measures of association (Somers' $d=0.65{\pm}0.12$, t=4.83, p=0.000) indicated that CPS increased when the diagnosis changed from UARS to OSA. Spearman's rank correlations between CPS and SaO2 dips (R=0.83), between CPS and AHI (R=0.77) were good (p<0.001). Other variables except mean length of SaO2 dips showed good correlations with CPS as well (p<0.05). Regression analysis indicated that when CPS is 3 there is a provability of 0.35 to have AHI of less than 5. Conclusion: Chin press scores that can be measured easily is well correlation with the conventional sleep apnea indices. They may therefore provide a useful guide in diagnosing obstructive sleep apnea synrome.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.