• Sleep Medicine and Psychophysiology
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• v.29 no.2
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• pp.40-44
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• 2022

Bipolar disorders are a group of mood disorders characterised by relapsing mood episodes throughout the course of illness. Patients with bipolar disorders commonly present with various sleep problems. Patients in a manic episode generally show decreased need of sleep and those in a depressed episode frequently complain about hypersomnia. Current literature even points to evidence that patients with bipolar disorder in euthymic state may still show signs of sleep disturbances when compared to the general population. Clinicians may also note intricate interactions between changes of circadian rhythm and evolution of mood episodes in patients with bipolar disorder. Also, commonly prescribed medications which plays a crucial role in treatment of bipolar disorders including mood stabilisers and antipsychotic medications often cause significant weight gain over time. Being a risk factor of sleep apnoea, weight gain can predispose the patient to develop sleep apnoea. In this narrative review, we summarised current evidence and literature regarding characteristics of circadian rhythm and comorbid sleep apnoea in patients with bipolar disorder. We also present literature regarding implications of circadian disturbance and comorbid sleep apnoea in managing patients with bipolar disorder.

• Sleep Medicine and Psychophysiology
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• v.26 no.1
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• pp.5-15
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• 2019

Chronotype (CT) is defined as an inter-individual difference in sleep-wake cycles and daily activities. Previous studies have suggested that this individual difference can influence our biological and psychological functioning. Literature regarding the psychometric properties and validity of CT measures are reviewed. We provide an overview of biological indicators (sleep-wake cycle, body temperature, cortisol, and melatonin) that are used for distinguishing two chronotypes: morningness (MT) and eveningness (ET). We also review the differences between CT in relation to personality traits and the occurrence of psychopathology. In addition, the methodological limitations of studies on CT are discussed. Finally, future research directions in terms of CT are proposed.

• Sleep Medicine and Psychophysiology
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• v.15 no.1
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• pp.12-16
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• 2008

Light therapy (also called light treatment or phototherapy) involves scheduled exposure to bright artificial light. Evidence-based treatments for sleep disorders especially for circadian rhythm sleep disorders include light therapy and pharmacotherapy. In clinical practice, many of patients with sleep problems tend to impair circadian rhythmicity. Considering that light is the most potent entraining agent of circadian rhythm, careful use of light therapy can be recommended for patients with several kinds of sleep disorders. I briefly review the possible therapeutic mechanisms and clinical applications of light therapy, focusing on circadian sleep disorders.

• Journal of Life Science
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• v.23 no.8
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• pp.1064-1072
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• 2013

Circadian rhythm is controlled by hormonal oscillations governing the physiology of all living organisms. In mammals, the main function of the pineal gland is to transform the circadian rhythm generated in the hypothalamic suprachiasmatic nucleus into rhythmic signals of circulating melatonin characterized by a largely nocturnal increase that closely reflects the duration of night time. The pineal gland has lost direct photosensitivity, but responds to light via multi-synaptic pathways that include a subset of retinal ganglion cells. Rhythmic control is achieved through a tight coupling between environmental lighting and arylalkylamine-N-acetyltransferase (AANAT) expression, which is the rhythm-controlling enzyme in melatonin synthesis. Previous studies on the nocturnal expression of AANAT protein have described transcriptional, post-transcriptional, and post-translational regulatory mechanisms. Molecular mechanisms for dependent AANAT expression provide novel aspects for melatonin's circadian rhythmicity. Extensive animal research has linked pineal melatonin for the expression of seasonal rhythmicity in many mammalian species to the modulation of circadian rhythms and to sleep regulation. It has value in treating various circadian rhythm disorders, such as jet lag or shift-work sleep disorders. Melatonin, also, in a broad range of effects with a significant regulation influences many of the body's physiological functions. In addition, this hormone is known to influence reproductive, cardiovascular, and immunological regulation as well as psychiatric disorders.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.2
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• pp.123-130
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• 2014

Purpose: The purpose of this study was to identify quality of sleep and health-promoting behaviors in rotating-shift nurses and to explore the influence of health promoting behaviors on quality of sleep. Method: Participants were 161 staff nurses working in an irregular three shift system in one of three general hospitals located in Kyungpook province. Data were collected using the Pittsburgh Sleep Quality Index and the Health Promoting Lifestyle Profile-IIand were analyzed using hierarchical multiple regression analysis. Results: The majority of the participants had very poor quality of sleep and performed a low level of health promoting behaviors. In terms of health promoting behaviors, nutrition and stress management significantly influenced quality of sleep of these nurses. Conclusion: Results indicate the importance of encouraging rotating-shift nurses to enhance their health promoting behaviors in order to improve quality of sleep.

• Journal of Korean Biological Nursing Science
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• v.19 no.1
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• pp.48-54
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• 2017

Purpose: This study was done to identify the influence of severity of drinking problem, circadian rhythm and sleep quality in patients with alcohol use. Methods: A descriptive study design was utilized. Data were collected using self-report questionnaires from 139 patients with alcohol use disorder who were admitted to a psychiatric hospital in D city, Korea. The questionnaires included Alcohol Use Disorders Identification Test (AUDIT), Composite Scale of Morningness (CMS), Pittsburgh Sleep Quality Index (PSQI), and Korea sleep scale A. Data were analyzed using descriptive statistics, Pearson's correlation coefficients, and multiple regressions using the SPSS 20.0 program. Results: There was significant correlations among severity of problem drinking, circadian rhythm, sleep quality and sleep disorder. The significant factors influencing sleep disorder were severity of problem drinking(${\beta}=.12$, p= .042), circadian rhythm(${\beta}=-.14$, p= .039) and sleep quality(${\beta}=.63$, p= < .001). This model explained 56% of variance in sleep disorder(F = 57.34, p= < .001). Conclusion: The results of this study suggest that the development of sleep intervention programs for alcohol use disorder patients needs to consider severity of alcohol use, circadian rhythm and sleep quality, and sleep assessment and intervention are needed the early stage of the treatment and recovery process.

• Sleep Medicine and Psychophysiology
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• v.4 no.1
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• pp.66-76
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• 1997

Objectives : The purpose of this study is to analyse sleep habits and sleep disorders in the elderly population ased 65-84 years. Methods : Epidemiological survey was performed at home by means of semi structured interviews in the city of Pusan, Korea. Subjects were randomly selected. The questionnaire consisted of 128 items including demographic findings, sleep habits, sleep disorders, somatic illnesses, and psychological distresses. Results : (1) The mean retiring time was 10.28 h (SD 1.30 h) and the mean wake-up time was 5.24 h (SD 1.33 h). The mean duration of sleep was 5.63 h (SD 1.80 h). The mean sleep onset time was 44.51 min. The mean frequency of daytime napping was 2.49 (SD 3.23). The subjects reported they woke up an average of 2.05 (SD 1.59) times per night. All of the above results were not related to age or gender. However, the mean frequency of difficulty in initiating/maintaining sleep was 2.2 times for men and 3.2 times for women (p<0.05). (2) The prevalence of insomnia was 57.7% and was not related to age or gender. Difficulty in initiating sleep was the most commonly reported insomnia complaint(52.4%). Early morning awakening was reported by 50.0% of patients and difficulty in maintaining sleep was reported by 45.1% of them. Worrying in bed and physical pain were strong contributing factor to insomnia. Conclusions : The results of our study showed several characteristics of sleep habits in the elderly. Sleep disorder in old age is not inevitable or trivial. Since sleep disturbance in older adults is common and distressing, it has implications for general health and well-being. Active concern and therapeutic intervention for the sleep habits and sleep disorders in the elderly are needed.

• Journal of Korean Biological Nursing Science
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• v.23 no.3
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• pp.227-236
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• 2021

Purpose: The purpose of this study was to investigate the sleep duration, social jetlag (SJL), and subjective sleep disturbance according to the individual chronotype in rotating shift nurses. Methods: A total of 344 rotating 3-shift nurses (mean age 28.67 years) were recruited at one university affiliated hospital. They completed the following questionnaires, which were used to assess their chronotype and sleep: the morningness-eveningness questionnaire (MEQ), self-reported sleep duration of work days (SDW_shift) and free days (SDF_shift) in each shift (day [D], evening [E], night [N]), and sleep disturbance (Insomnia severity index, ISI). SJL_shift was calculated as the difference in midsleep (MS=sleep onset+1/2 sleep duration) between work days (MSW) and free days (MSF). Results: Subjects were divided into 3 chronotype groups according to the MEQ; morning (MG, 4.4%) intermediate (IG, 57.8%), and evening groups (EG, 37.8%). SDW_D was shortest (4.68 hr) and SDF_E was longest (8.93 hr) in the EG. SJL_D was longest in the EG (3.77 hr), and SJL_N was longest in the MG (7.37 hr). The prevalence of sleep disturbance was 33.3% (MG), 29.6% (IG), and 40.0% (EG), respectively, without any statistical significance. Conclusion: In order to improve the sleep of shift workers, it is recommended that the evening chronotypes should reduce the day shifts and the morning chronotypes should reduce the night shifts. We also propose a study to determine whether these shift assignments can improve the sleep in shift nurses.

• Sleep Medicine and Psychophysiology
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• v.30 no.1
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• pp.13-21
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• 2023

The Seasonal Affective Disorder (SAD) is a disorder characterized by prolonged periods of depression and various physical and psychological symptoms experienced during specific seasons, typically winter. In this review aims to provide a comprehensive overview of SAD with a specific focus on psychophysiological aspects. Through the review from ancient times to the present, this paper explores the characteristics, causes, and underlying mechanisms of SAD. Particularly, it comprehensively reviews the research findings on the relationship between external factors such as light, sunlight, climate, and their association with SAD. Furthermore, the paper discusses the interplay between SAD and psychophysiological changes, along with the latest research trends in treatment and prevention strategies. By combining theoretical and practical perspectives on SAD, this article aims to provide a holistic understanding and offer suggestions for future research directions and clinical interventions.

• Sleep Medicine and Psychophysiology
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• v.19 no.2
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• pp.77-83
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• 2012

Objectives: Recent studies have reported a correlation between obstructive sleep apnea syndrome (OSA) and depression. In attempt to verify the suggestion that eveningness is related to depression, we examined the effect of morningness-eveningness on their depressive mood in patinets with OSA. Methods: The examination was based on the medical records and polysomnography reports of 211 OSA patients. Information was gathered from the patients who filled out the H$\ddot{o}$rne and Ostberg questionnaire (HOQ), profile of mood states-Korean version (K-POMS), and Epworth sleepiness scale (ESS). We compared mean values of K-POMS total, subscales of K-POMS, ESS, and OSA severity variables among the 3 morningness-eveningness groups (morningness, eveningness, and neither groups). Partial correlation analysis was performed between variables and ANCOVA was performed among the 3 groups after adjustment with age and weight. Results: There were significant negative correlations between HOQ and the followings : K-POMS total, POMS-T (tension-anxiety), POMS-D (depression-dejection), POMS-A (anger-hostility), POMS-F (fatigue-inertia), POMS-C (confusion-bewilderment), spontaneous arousal index, average O2 saturation. There were significant positive correlations between HOQ and the followings : POMS-V (vigor-activity), apnea-hypopnea index, respiratory arousal index, snore time. There were significant negative correlations between POMS-D and the followings : HOQ, POMS-V, stage 1 sleep (%), AHI, TAI (total arousal index), oxygen desaturation index, respiratory arousal index, neck circumference, average O2 desaturation, snore time (%). There were significant positive correlations between POMS-D and K-POMS total, POMS-T, POMS-A, POMS-F, POMS-C, sleep latency, stage 2 sleep (%), heart rate, spontaneous arousal index. There were significant differences in K-POMS total, POMS-T, POMS-D, POMS-F, POMS-C, spontaneous arousal index among the three HOQ groups in ANCOVA. Conclusion: The depressive correlates of OSA patients might be affected, not by excessive daytime sleepiness or OSA severity indexes, but by eveningness circadian characteristics. It would be important to take into account the morningness-eveningness tendency when we manage the depressive mood of OSA patients.