• Title/Summary/Keyword: Daytime

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Diurnal Variation and Sleep Pattern in Depressive Patients (우울증 환자의 주간기분변동과 수면 양상)

  • Park, Young-Min;Kim, Leen;Suh, Kwang-Yoon;Joe, Sook-Haeng;Kang, Seung-Gul;Yoon, Ho-Kyung
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.30-36
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    • 2001
  • Object: Diurnal variation is included in the diagnostic criteria of the major depressive disorder, melancholic specifier. But there has been controversy over whether diurnal variation is an unique depressive symptoms or a symptom related to a change of sleep patterns, or that of another mechanism, when the previous studies are reviewed. We investigated the existence of diurnal variation according to the subtype of depression and whether diurnal variation is charateristic of melancholic depression or not. We also compared sleep variables according to the existence of diurnal variation. Method: We examined diurnal variation, sleep patterns, severity of depression using the Visual Analogue Mood Scale, Pittsburgh Sleep Quality Index, and Hamilton Depression Rating Scale. Patients recorded their mood state on the Visual Analogue Mood Scale twice a day, morning and evening, for diurnal variation. We divided depressive patients into two groups,-diurnal variation group and nondiurnal variation group,-and compared the mood and sleep variables using SPSS. Results: The frequency of diurnal variation is not significantly different among the subtypes of depression. Significant differences between the diurnal variation group and the nondiurnal variation group existed in middle insomnia and sleep time (p<0.05). In melancholic type, al significant difference between the diurnal variation group and the nondiurnal variation group was noticed in PSQI total, sleep latency, sleep disturbances, daytime dysfunction as well as middle insomnia and sleep time (p<0.05). Conclusions: Diurnal variation existed in other types of depression as well as melancholic type. The results showed that diurnal variation was not a specific symptom of melancholic type, and existence of diurnal variation might be related to sleep patterns.

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Supplemental Value of the Wrist-Worn Actigraphy in Diagnosing the Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증 진단에서 손목부착형 활동기록기의 보조적 진단가치)

  • Im, Mee-Hyang;Shin, Hong-Beom;Lee, Yu-Jin;Lee, Seung-Hi;Won, Chang-Yeon;Lee, Myung-Hee;Lee, Soo-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.32-38
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    • 2005
  • 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.

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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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Sleep Habits and Sleep Disorders among the Elderly Between 65-84 years Who are Living in a Part of Pusan (부산광역시 일지역 65-84세 노인 인구에서의 수면습관 및 수면장애에 대한 조사)

  • Yang, Chang-Kook;Yoo, Seung-Yoon;Joo, Young-Hee;Hahn, Hong-Moo
    • 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.

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Characteristics of Patients Who Need Hypnotics on the Night before Elective Surgery (수면전일 수면제를 필요로 하는 환자들의 특성)

  • Lee, Soo-In;Yoon, Jin-Sang;Lee, Hyung-Young
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.172-180
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    • 1997
  • Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.

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Morningness-Eveningness Affects the Depressive Mood and Day Time Sleepiness of Obstructive Sleep Apnea Syndrome Patient (폐쇄성 수면무호흡증 환자에서 일주기 리듬 특성에 따른 주간 졸음과 우울감의 차이)

  • Kim, Seong Ho;Joo, Eun-Jeong;Lee, Kyu Young;Koo, Young Jin;Kim, Eui-Joong
    • 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.

VKOSPI Forecasting and Option Trading Application Using SVM (SVM을 이용한 VKOSPI 일 중 변화 예측과 실제 옵션 매매에의 적용)

  • Ra, Yun Seon;Choi, Heung Sik;Kim, Sun Woong
    • Journal of Intelligence and Information Systems
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    • v.22 no.4
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    • pp.177-192
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    • 2016
  • Machine learning is a field of artificial intelligence. It refers to an area of computer science related to providing machines the ability to perform their own data analysis, decision making and forecasting. For example, one of the representative machine learning models is artificial neural network, which is a statistical learning algorithm inspired by the neural network structure of biology. In addition, there are other machine learning models such as decision tree model, naive bayes model and SVM(support vector machine) model. Among the machine learning models, we use SVM model in this study because it is mainly used for classification and regression analysis that fits well to our study. The core principle of SVM is to find a reasonable hyperplane that distinguishes different group in the data space. Given information about the data in any two groups, the SVM model judges to which group the new data belongs based on the hyperplane obtained from the given data set. Thus, the more the amount of meaningful data, the better the machine learning ability. In recent years, many financial experts have focused on machine learning, seeing the possibility of combining with machine learning and the financial field where vast amounts of financial data exist. Machine learning techniques have been proved to be powerful in describing the non-stationary and chaotic stock price dynamics. A lot of researches have been successfully conducted on forecasting of stock prices using machine learning algorithms. Recently, financial companies have begun to provide Robo-Advisor service, a compound word of Robot and Advisor, which can perform various financial tasks through advanced algorithms using rapidly changing huge amount of data. Robo-Adviser's main task is to advise the investors about the investor's personal investment propensity and to provide the service to manage the portfolio automatically. In this study, we propose a method of forecasting the Korean volatility index, VKOSPI, using the SVM model, which is one of the machine learning methods, and applying it to real option trading to increase the trading performance. VKOSPI is a measure of the future volatility of the KOSPI 200 index based on KOSPI 200 index option prices. VKOSPI is similar to the VIX index, which is based on S&P 500 option price in the United States. The Korea Exchange(KRX) calculates and announce the real-time VKOSPI index. VKOSPI is the same as the usual volatility and affects the option prices. The direction of VKOSPI and option prices show positive relation regardless of the option type (call and put options with various striking prices). If the volatility increases, all of the call and put option premium increases because the probability of the option's exercise possibility increases. The investor can know the rising value of the option price with respect to the volatility rising value in real time through Vega, a Black-Scholes's measurement index of an option's sensitivity to changes in the volatility. Therefore, accurate forecasting of VKOSPI movements is one of the important factors that can generate profit in option trading. In this study, we verified through real option data that the accurate forecast of VKOSPI is able to make a big profit in real option trading. To the best of our knowledge, there have been no studies on the idea of predicting the direction of VKOSPI based on machine learning and introducing the idea of applying it to actual option trading. In this study predicted daily VKOSPI changes through SVM model and then made intraday option strangle position, which gives profit as option prices reduce, only when VKOSPI is expected to decline during daytime. We analyzed the results and tested whether it is applicable to real option trading based on SVM's prediction. The results showed the prediction accuracy of VKOSPI was 57.83% on average, and the number of position entry times was 43.2 times, which is less than half of the benchmark (100 times). A small number of trading is an indicator of trading efficiency. In addition, the experiment proved that the trading performance was significantly higher than the benchmark.

Differences in the Soundscape Characteristics of a Natural Park and an Urban Park (자연공원과 도시공원의 Soundscape 특성 차이)

  • Gim, Ji-youn;Lee, Jae-Yoon;Ki, Kyong-Seok
    • Korean Journal of Environment and Ecology
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    • v.31 no.1
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    • pp.112-118
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    • 2017
  • The purpose of this study is to clarify the characteristics of the soundscape in a natural park and an urban park. The study sites were a natural park (Chiaksan Nationalpark) and an urban park (Rose Park) in Wonju City, Gangwon Province. Soundscape recording was conducted using Digital Recorder from April 2015 to January 2016. The analysis period was 8 days per season, with a total of 64 days (2 places). Analysis items were soundscape's daily cycle, soundscape type, and seasonal variation. According to the result of the daily cycle analysis of the soundscape, the natural park was dominated by the biophony in accordance with the cycle of the sun, and the airplane sound was observed in the daytime. Meanwhile, anthrophony was consistently produced in the urban park 24 hours a day. As a result of the detailed type analysis of the soundscape, the sources of biophony were classified into wild birds, mammals, insects and amphibians, and the sources of geophony were classified into rain and wind. The anthrophony was mostly airplane sound. In the urban park, wild birds appeared to most influence the biophonic sounds while rain and the wind were the most frequent sounds that contribute to geophony. The most influential components of anthrophony in the urban park were in the order of automobiles, people, music, construction, cleaning, and airplane sound. As a result of the seasonal difference analysis of the soundscape, it was statistically significant that the natural park shows higher biophony in spring, summer, and autumn compared to the urban park. Anthrophony in the urban park appeared to be higher than the natural park in all seasons. The significance of this study is that it is the first study to identify the characteristics of the soundscape of a natural park and an urban park emanating from different landscapes in South Korea.

Insomnia in Patients with Chronic Renal Failure on Hemodialysis (혈액투석 중인 만성 신부전증 환자에서의 불면증에 대한 연구)

  • Kim, Gyung-Ryul;Yang, Chang-Kook;Hahn, Hong-Moo
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.126-132
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    • 1999
  • Objectives: The purposes of this study were to investigate 1) the incidence of insomnia, 2) the clinical characteristics of the insomniacs, 3) the correlation of severity of insomnia with somatic complaints and psychological distresses, and 4) the beliefs and attitudes about sleep in patients with chronic renal failure on hemodialysis. Methods: The author evaluated 153 patients, receiving hemodialysis therapy at the four outpatients hemodialysis units in Pusan, Korea. The patients had completed a self-administered questionnaire package, which consisted of basic demographic findings, questions characterizing insomnia, Beck Depression Inventory(BDI), Spielburger's State-Trait Anxiety Inventory(STAI), and visual analogue scales measuring quantitatively the severity of the self-perceived psychological and somatic symptoms. And several laboratory data were collected. Diagnosis of insomnia was made in the base of insomnia criteria of DSM-IV and international classification of sleep disorders. Subjects were dichotomized into those who reported any characteristics of insomnia or those who had no insomnia during the preceding two weeks. Results: Insomnia was found in 100(65.4%) of 153 patients. No statistical differences were found between the patients with and without insomnia in terms of age, gender, education, marital status, mean duration of hemodialysis and all considered laboratory findings except serum albumin. The patients with insomnia had significantly higher BDI score and predialysis systolic blood pressure, and lower serum albumin as compared to non-insomnia group. Significant differences were found between two groups in terms of self-perceived distress such as sadness, anxiety, worry, pruritus, and dysfunction of daily life. The data showed statistically significant correlation between insomnia severity and some variables such as physical dysfunction, pruritus, bone pain, sadness, anxiety, worry, dysfunction of daily life and excessive daytime sleepiness. The patients with insomnia had significantly several dysfunctional beliefs and attitudes about sleep than those without insomnia. Conclusion: These results indicate that insomnia is very common in hemodialysis patients and likely contribute to the impaired quality of life experienced by many these patients. The author suggests that physical and psychological distresses would be reduced and the quality of life could be improved if their sleep disturbances are properly ameliorated in patients on hemodialysis.

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Evaluation of Autonomic Neuropathy in Patients with Sleep Apnea Syndrome (수면 무호흡 증후군 환자에서 자율 신경 장애의 평가)

  • Lee, Hak-Jun;Park, Hye-Jung;Shin, Chang-Jin;Kim, Ki-Beom;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.404-415
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    • 1998
  • Background: Sleep apnea syndrome, which occurs in 1~4 % of the adult population, frequently has different cardiovascular complications such as hypertension, ischemic heart disease, cardiac arrythmia as well as sleep-wake disorder such as excessive daytime hypersomnolence or insomnia. Mortality and vascular morbidity are reported to be significantly higher in sleep apnea syndrome patients than in normal population. According to the recent studies, autonomic dysfunction as well as hypoxemia, hypercapneic acidosis, and increased respiratory effort, may playa role in the high prevalence of cardiovascular complications in patients with sleep apnea syndrome. However the cause and mechanism of autonomic neuropathy in patients with sleep apnea syndrome are not well understood. We studied the existence of autonomic neuropathy in patients with sleep apnea syndrome and factors which influence the pathogenesis of autonomic neuropathy. Method: We used the cardiovascular autonomic neuropathy(CAN) test as a method for evaluation of autonomic neuropathy. The subjects of this study were 20 patients who diagnosed sleep apnea syndrome by polysomnography and 15 persons who were normal by polysomnography. Results: Body mass index and resting systolic blood pressure were higher in sleep apnea group than control group. Apnea index(Al), respiratory disturbance index(RDI) and snoring time percentage were significantly higher in sleep apnea group compared with control group. But there were no significant differences in saturation of oxygen and sleep efficiency in two groups. In the cardiac autonomic neuropathy test, the valsalva ratio was significantly low in sleep apnea group compared with control group but other tests had no differences between two groups. The CAN scores and corrected QT(QTc) interval were calculated significantly higher in sleep apnea group, but there were no significant correlations between CAN scores and QTc interval. There were no significant data of polysomnography to correlate to the CAN score. It meant that the autonomic neuropathy in patients with sleep apnea was affected by other multiple factors. Conclusion: The cardiovascular autonomic neuropathy test was a useful method for the evaluation of autonomic neuropathy in patients with sleep apnea syndrome and abnormalities of cardiovascular autonomic neuropathy were observed in patients with sleep apnea syndrome. However, we failed to define the factors that influence the pathogenesis of autonomic neuropathy of sleep apnea syndrome. This study warrants futher investigations in order to define the pathogenesis of autonomic neuropathy in patients with sleep apnea syndrome.

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