• 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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.12
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• pp.148-156
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• 2019

This study identified the effects of Depression, Anxiety, and Quality of Sleep on Excessive Daytime Sleepiness (EDS) in nursing students. Totally, 213 students of a nursing college located in C do, Korea, were enrolled for the study, which was accomplished through a questionnaire. Data were collected from May 20 to 30, 2019. The collected data were compiled using the SPSS/WIN 25.0 statistic program by applying Chi-square test, Paired t-test, Pearson's Coefficient, and Multiple logistic regression. The following results were obtained. The mean score for EDS was 8.95(±4.56), and Prevalence of EDS was determined to be 40.8%. The mean scores obtained for the affecting factors were Depression 10.05(±7.85), STAI-S 46.09(±9.50), STAI-T 46.47(±9.93), and Quality of Sleep 6.51(±2.95). Depression, STAI-S, STAI-T, and Quality of Sleep were significantly different for EDS and Non-EDS students (t=1.955, p=0.024; t=5.446, p<0.001; t=1.716, p=0.007; t=12.168, p<0.001; respectively). Multiple logistic regression revealed that factors associated with EDS were STAI-S and Quality of Sleep (adjusted odds ratio=1.04, 95% Confidence Interval=1.01-1.08; adjusted odds ratio=1.16, 95% Confidence Interval=1.04-1.29; respectively). These findings indicate the necessity to improve the quality of sleep and manage anxiety alleviation of nursing students, to reduce excessive daytime sleepiness.

• Sleep Medicine and Psychophysiology
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• v.12 no.2
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• pp.117-121
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• 2005

Objectives: The purpose of this study was to assess the difference of subjective daytime sleepiness level between primary insomnia patients and healthy control subjects. We also investigated the relationship between subjective daytime sleepiness level and variables of nocturnal polysomnograghic sleep architecture of insomnia patients. Method: Total subjects were 87 patients with primary insomnia diagnosed with polysomnography and 88 normal controls. The daytime sleepiness level in each group was measured by Korean version of Epworth Sleepiness Scale (ESS). The correlations of ESS score and nocturnal polysomnographic variables were calculated in the patient group. Results: Patients with insomnia had the lower ESS scores than the control group. In patients group, the ESS score showed significant negative correlations with total sleep time, sleep efficiency%, and stage 2 sleep time%. The ESS score also showed significant positive correlations with number of awakenings, number of awakenings more than 2 minutes, and wake after sleep onset time. Conclusions: Insomnia patients showed lower level of subjective daytime sleepiness that may indicate their higher alertness comparing to control subjects. Daytime sleepiness of patients with insomnia was associated with polysomnographic variables including total sleep time, sleep efficiency%, stage 2 sleep time% and disrupted continuity of nocturnal sleep.

• Sleep Medicine and Psychophysiology
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• v.19 no.2
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• pp.89-96
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• 2012

Objectives: Individuals differ in their biological rhythms. This study investigated the association between the morningness-eveningness and sleep patterns, daytime sleepiness and fatigue in Korean male adolescents. Methods: Participants were 501 eleventh grade male students ($16.9{\pm}0.2$ years of age) in one male high school in Seoul. Each student completed the Korean translation of composite scale (KtCS), Epworth sleepiness scale (ESS), Fatigue Severity Scale (FSS) and a questionnaire about their sleep schedule. Results: The evening group had shorter weekday sleep time than the intermediate (p<0.001) or morning group (p=0.029). The evening group had more daytime napping (16.8%, p<0.001), high rate of caffeine use (58.8%, p<0.001) and snoring (18.5%, p=0.037). The evening group showed more daytime sleepiness (8.7, SD=3.2, p<0.001) and severe fatigue (4.4, SD=1.2, p<0.001) than the intermediate or morning group. Conclusion: Adolescents with eveningness have higher problems in weekday sleep, daytime sleepiness and fatigue. An intervention program for sleep problem in these adolescents should be considered.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.5
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• pp.121-130
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• 2020

This study identified the differences and relationships between clinical practice stress, sleep quality, and daytime sleep disorder before and after clinical practice of college nursing students. The subjects were 130 students in the third year of nursing science. The results showed that the average clinical stress of the study subjects was 3.15 out of 5 points. Out of the external factors for clinical practice stress, the score for the task was 3.64. There was a significant difference in gender (t=-3.88, p<).001), subjective health status (F=5.78, p=.004), residence (F=3.20, p=.026). Nursing students showed lower sleep quality (80.0% before practice, 70.0% after practice), and those with daytime sleepiness (26.9% before practice, 42.3% after practice) were more than those of general college students. There was a difference between sleep quality (χ²=4.06, p=.004) and daytime sleepiness (χ²=6.08, p=.009) before and after clinical practice. There was also a negative correlation between daytime sleepiness and sleep quality (r=-.259, p<0.01). Therefore, strategies to reduce clinical practice stress and improve the quality of sleep are needed for the physical and mental health of nursing college students. The quality of nursing can be improved in the future by helping nursing students adapt to the clinical practice of changing nursing education field.

• Sleep Medicine and Psychophysiology
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• v.22 no.1
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• pp.11-19
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• 2015

Objectives: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. Methods: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; $PSQI{\leq}5$) and group B (n = 160; PSQI > 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. Results: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI ($r_p=0.313$, p = 0.008), AI ($r_p=0.339$, p = 0.004), ODI ($r_p=0.289$, p = 0.015) and ATI ($r_p=0.256$, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. Conclusion: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.

• Sleep Medicine and Psychophysiology
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• v.13 no.1
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• pp.27-32
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• 2006

Objectives: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. Methods: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. Results: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. Conclusions: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.

• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.56-60
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• 2009

Excessive daytime sleepiness in childhood might be abnormal phenomenon and often related to the sleep disorders or insufficient sleep duration. The most common cause of excessive daytime sleepiness would be insufficient sleep. However, narcolepsy, idiopathic hypersomnia, circadian rhythm sleep disorders, medication, medical illness and other sleep disorders that could cause insomnia and poor quality of sleep also result in excessive daytime sleepiness. The misdiagnosed and untreated excessive daytime sleepiness in childhood can lead to serious developmental and educational problem.

• Anxiety and mood
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• v.10 no.2
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• pp.137-142
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• 2014

Objective : The aim of this study was to investigate the relationship among daytime sleepiness, depressive symptoms, anxiety symptoms, and stress response of students in a university Methods : A total of 557 students were recruited in this study. The participants filled out stress response inventory, Epworth sleepiness scale, overall anxiety severity and impairment scale, and quality of life scale. Results : Excessive daytime sleepiness group showed higher scores in all factors in stress response inventory, overall anxiety severity and impairment scale, and quality of life scale. Sleepiness might be correlated with somatization and depression and anger in Stress response inventory. Conclusion : Excessive daytime sleepiness group exhibited poor quality of life scale. Screening about overall quality of sleep, such as mood and anxiety should be considered for students in a university.

• Sleep Medicine and Psychophysiology
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• v.14 no.2
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• pp.92-98
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• 2007

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.