• The Journal of Pediatrics of Korean Medicine
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• v.27 no.3
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• pp.65-73
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• 2013

The subjects were composed of 308 children who visited the department of pediatrics, ${\bigcirc}{\bigcirc}$ korean medicine hospital from January 2010 to May 2013. Results 1. Among 308 patients, there were 188 boys and 120 girls; their ratio was 1.57:1. The age distribution showed that 38.3% were in the age less than 1 years, 38.0% in 1 years, 7.8% in 2 years, 5.2% in 3 years, 3.3% in 4~5 years, 4.5% in 6~10 years, 2.9% in 19~21 years. 2. It was found that 36.7% of the sleep disorder was caused without motivation, 17.2% caused by negligent accidents, 13.9% by traffic accidents, 10.4% by the unfamiliar environment, 8.1% by separation from parents, 7.5% after suffering disease, and 6.2% by irritating sound. 3. The sleep onset insomnia accounts for 17.2% of sleep disorder, sleep maintenance insomnia for 67.5%, poor sleep quality 24.4%, and daytime sleep disorder takes 19.8%. The ratio of sleep onset insomnia in adolescence comprises larger proportion (44.4%) than it of any other age groups. 4. The symptoms complicated with sleep disorder are the respiratory infection which takes 25.3%, being easily startled 18.2%, anorexia 14.6%, soft stools frequency 13.0%, greenish stools 10.7%, and skin rash 10.7%. Conclusions The causes of sleep disorders, changes of sleeping patterns, and complicated diseases show diversity in children and adolescence. Further study of sleep disorders in children and adolescence should be progressed as well.

• Tuberculosis and Respiratory Diseases
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• v.38 no.3
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• pp.255-261
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• 1991

Frequently patients with chronic obstructive pulmonary disease have lowered arterial oxygen saturation in daytime. During sleep, they are apt to experience additional hypoxemia. These episode of nocturnal hypoxemia are usually associated with periods of relative hypoventilation. Noctunal hypoxemia may be associated with cardiac arrhythmia and with acute increase in pulmonary arterial pressure and may be implicated in the development of chronic pulmonary hypertension and cor pulmonale. We selected 14 patients with chronic obstructive pulmonary disease, 9 with emphysema dominant type and 5 with chronic bronchitis dominant type, to examine the frequency and severity of nocturnal hypoxemia and the effect of oxygen in prevention of nocturnal hypoxemia. The results were as follows; 1) On PFT, FVC, $FEV_1$, and $FEV_1$/FVC showed no significant difference between the emphysema dominant type (pink puffers, PP) and the chronic bronchitis dominant type (blue bloaters, BB). But DLCO/VA for the PP group was $45.7{\pm}15.1%$ which was significantly different from BB group, $82.4{\pm}5.6%$. 2) The daytime arterial oxygen saturation ($SaO_2$) and the lowest $SaO_2$, during sleep for the BB group were significantly lower than for the PP group. 3) The hypoxemic episodes during sleep were more frequent in BB group and the duration of hypoxemic episode was longer in BB group. 4) In both group studied, although there was a tendency for a lower L-$SaO_2$ (the lowest $SaO_2$, during sleep), an increase in hypoxemic episodes and duration as the daytime $SaO_2$, fell lower, the only parameter which showed significant correlation was daytime $SaO_2$, and the frequency of hypoxemic episodes in the PP group (r=-0.68, P<0.05). 5) In PP group, with oxygen supplementation, L-$SaO_2$, during sleep showed significant increase, and there was a tendency for the frequency of hypoxemic episodes and duration to fall but it was not significant. 6) In BB group, oxygen supplementation significantly increased the L-$SaO_2$ during sleep and also significantly decreased the frequency and duration of hypoxemic episode. From these results, we can see that oxygen supplementation during sleep can prevent the decrease in $SaO_2$ to some extent and that this effect of oxygen can be seen more prominently in the BB group.

• Korean Journal of Adult Nursing
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• v.15 no.2
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• pp.296-304
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• 2003

Purpose: This study is to study sleep disorder, sleep pattern, and depression in adult women, and to offer basic data for a program of the improvement of women's health and nursing intervention. Method: A structured questionnaire was carried out from September 1, 2001 to October 30, 2001 on the subject of 441 females, who are above 18 years old and lived in Seoul. This research tool measured insomnia with APA's insomnia scale(1994), sleep pattern and sleep disorder factors scale(Shin et al(1999)'s), and depression with Radloff's CES-D scale (1977). The data were analyzed with a SPSS program for descriptive statistics, ${\chi}^2-test$, and t-test. Result: The result were as follows; 1) 35.1% of all participants have insomnia. 2) Sleep disorder group appeared shorter($50.98{\pm}29.41min$.) than normal group($73.03{\pm}38.7min$.) in daytime sleepiness(p=0.001). 3) Factors of sleep disorder were stress(76.6%), worry(55.6%), without reason(39.6%), and noise outside(37.4%). 4) In relation between sleep disorder and depression, group with sleep disorder($20.20{\pm}11.06$) marked higher depression score than normal group($14.25{\pm}8.81$)(p<0.0001). Conclusion: Based upon these finding, sleep disorder in adult women was influenced by psychological factors, group with sleep disorder showed a higher depression score than normal group, and which indicated correlation with sleep disorder and depression. This study shows that nursing intervention on women's sleep disorder and depression is needed and further research be done to verify the results.

• Sleep Medicine and Psychophysiology
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• v.28 no.2
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• pp.53-69
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• 2021

Sleep disorders, increasingly prevalent in the general population, induce impairment in daytime functioning and other clinical problems. As changes in cortical excitability have been reported as potential pathophysiological mechanisms underlying sleep disorders, multiple studies have explored clinical effects of modulating cortical excitability through non-invasive brain stimulation in treating sleep disorders. In this study, we critically reviewed clinical studies using non-invasive brain stimulation, particularly transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), for treatment of sleep disorders. Previous studies have reported inconsistent therapeutic effects of TMS and tDCS for various kinds of sleep disorders. Specifically, low-frequency repetitive TMS (rTMS) and cathodal tDCS, both of which exert an inhibitory effect on cortical excitability, have shown inconsistent therapeutic effects for insomnia. On the other hand, high-frequency rTMS and anodal tDCS, both of which facilitate cortical excitability, have improved the symptoms of hypersomnia. In studies of restless legs syndrome, high-frequency rTMS and anodal tDCS induced inconsistent therapeutic effects. Single TMS and rTMS have shown differential therapeutic effects for obstructive sleep apnea. These inconsistent findings indicate that the distinctive characteristics of each non-invasive brain stimulation method and specific pathophysiological mechanisms underlying particular sleep disorders should be considered in an integrated manner for treatment of various sleep disorders. Future studies are needed to provide optimized TMS and tDCS protocols for each sleep disorder, considering distinctive effects of non-invasive brain stimulation and pathophysiology of each sleep disorder.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.2
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• pp.162-166
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• 2001

Obstructive sleep apnea syndrome(OSAS) is a complex sleep disorder characterized by intermittent apnea secondary to sleep-induced obstruction of the upper airway. It occurs because of an airway obstruction anywhere between the trachea and the oronasal apparatus. The hallmark of OSAS is snoring, which is caused by vibration of the tissues of the pharynx as the airway narrows. The consequences of OSAS have focused on excessive daytime sleepiness resulting from sleep fragmentation and the cardiovascular derangements producing hypertension and arrhythmias. The primary method of controlling OSAS has been surgery. The current surgical procedures used for OSAS are tracheostomy, tonsillectomy, nasal septoplasty, uvulopalatopharyngoplasty, anterior mandibular osteotomy with hyoid myotomy and suspension, and maxillary, mandibular and hyoid advancement. We report a case of OSAS that was improved by genial advancement with infrahyoid myotomy and suspension. The patient was objectively documented by polysomnography, cephalometric analysis, and physical examination before the surgical procedure. The patient underwent genial advancement with infrahyoid myotomy and suspension. Patient had a good response from surgery.

• Journal of Power System Engineering
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• v.11 no.3
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• pp.29-34
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• 2007

Existent researches about indoor thermal environment have been focused on to seek human's comfort in daytime. Also researches about thermal comfort during the sleeping time that is important for resting and recharging to modern people have been seldom existed. At present, as global warming phenomenon is being continued, most people are going through inconvenience by sultriness during the sleeping hours in sweltering summer night. Therefore we need another control method of an air conditioner to keep human's thermal comfort. Ambient temperature is a common factor of the environment, but analysis of its effect on human body physiology is still unknown. The effect of ambient temperature on human sleep has been increasingly studied in the last decade. This research investigated about optimal indoor temperature to maintain proper skin temperature and comfortable sleep when indoor air is cooled by an air conditioner in sweltering summer night.

• Sleep Medicine and Psychophysiology
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• v.5 no.2
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• pp.210-215
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• 1998

OSA(Obstructive Sleep Apnea) is a condition with repeated obstruction of the upper airway while sleeping. This obstruction of the upper airway may result if sleep-induced physiologic change in muscle activity is superimposed on various structural defects of the upper airway. Macroglossia, micrognathia, retrognathia, and decreased airway lumen have all been implicated in OSA. There are a variety of surgical and nonsurgical treatment modalities currently available for OSA. Recently the uvulopalatopharyngoplasty has achieved widespread use, but success rates vary and long-term effects are still unknown. Current nonsurgical treatment methods can be cumbersome and uncomfortable with variable responses. For this case. we diagnosed as OSA by using polysomnographic analysis and cephalometric analysis, and delivered intraoral removable appliance which is more conservative, reversible and easy to use for patient. And we got results that Apnea Index(AI) decreased from 14.4 to 3.1, Total Respiratory Disturbance Index(Total RDI) decreased from 18.1 to 7.0 and removal of chronic headache in daytime.

• Animal cells and systems
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• v.6 no.3
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• pp.239-245
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• 2002

Plasma melatonin, thyroid-stimulating hormone (TSH) and body temperature were measured simultaneously and continuously before and after the sleep-wake cycle was shifted in 4 healthy males and changes in the circadian rhythm itself and in the phase relationship among these circadian rhythms were determined. Normal sleep-wake cycle (sleep hours: 2300-0700) was delayed by 10 h (sleep hours: 0900-1700) during the experiment. Even after this shift the typical melatonin rhythm was maintained: low during daytime and high during night. The melatonin rhythm was gradually delayed day by day. The TSH rhythm was also maintained fundamentally during 3 consecutive days of altered sleep-wake cycle. The phase was also delayed gradually but remarkably. The daily rhythm of body temperature was changed by the alteration of sleep-wake cycle. The body temperature began to decrease at the similar clock time as in the control but the decline during night awake period was less steep and the lowered body temperature persisted during sleep. The hormonal profiles during the days of shifted sleep/wake cycle suggest that plasma melatonin and TSH rhythms are basically regulated by an endogenous biological clock. The parallel phase shift of melatonin and TSH upon the change in sleep-wake cycle suggests that a common unitary pacemaker probably regulates these two rhythms. The reversal phase relationship between body temperature and melatonin suggests that melatonin may have a hypothermic effect on body temperature. The altered body temperature rhythm suggests that the awake status during night may inhibit the circadian decrease in body temperature and that sleep sustains the lowered body temperature. It is probable but uncertain that there ave causal relationships among sleep, melatonin, TSH, and body temperature.

• Sleep Medicine and Psychophysiology
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• v.2 no.2
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• pp.146-155
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• 1995

Jet lag can be defined as the cumulative physiological and psychological effects of rapid air travel across multiple time zone. The consequences of jet lag include fatigue, general malaise, sleep disturbances, and reductions of cognitive and psychomotor performance, all of which have been documented in experimental biological and air crew personnel studies. Thus authors tried to study the jet lag of natural travellers by modified self reporting sleep log. Total 61 healthy travellers was studied for 3 days before and 7 days after jet-flights across seven to ten time zone. The eastbound travelling group was 38 persons, aged 19 -70 and westbound travelling group was 23 persons, aged 13 - 69. Sleep onset time, wake-up time, sleep latency, awakening frequency on night sleep, awakening duration on night sleep, sleepiness at wake-up and nap length were evaluated. Our results suggested that the 7 to 10 time zone shift gave significant influence to traveller's sleep-wake cycles. The date which subjective physical condition was recovered on was $5.16{\pm}1.50$ day after arrivals for eastbound, while for westbound, $4.91{\pm}1.62$ day. In eastbound travelling, sleep onset time became later than baselines and could not recover until 7th day. But in westbound, it became earlier than baseline and could recover until 6th day. The mean score of 24-hour sleepiness was greater in eastboumd than westbound. Therefore the eastbound travelling caused more sleep-wake cycle disturbance and daytime dysfunction than westbound travelling. In other parameters, there was no definite difference between east and westbound. From our results, it was suggested that the symptom severity of jet lag was dependent on the travelling direction. To demonstrate more definite evidence, large sized data collections and comparision by age difference were needed.

• Sleep Medicine and Psychophysiology
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• v.13 no.2
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• pp.52-58
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• 2006

Objectives: Continuous positive airway pressure (CPAP) is effective in the treatment of obstructive sleep apnea syndrome (OSAS), but the major limitation of CPAP may be poor compliance. The aims of the study were to investigate the compliance and side effects of CPAP, and to evaluate the efficacy of CPAP in patients with OSAS. Methods: This study enrolled 106 patients with OSAS who took the CPAP treatment. The severity of daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and sleep quality and depressive symptoms were assessed by Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI), respectively. Results: During 29 months of the study period, 41.5% of patients were using CPAP and 38.7% of patients stopped using it. Compared to non-compliant patients, compliant patients had a higher PSQI score and obstructive apnea index. Among non-compliant patients, 51.2% of them stopped using CPAP within 1months. 85.7% of non-compliant patients were discomforted by the CPAP, but much more nasopharyngeal symptoms were reported in the compliant group. ESS (p<0.01), PSQI (p<0.01) and BMI (p<0.01) were reduced significantly after CPAP treatment but not BDI (p=0.86). Conclusions: We concluded that CPAP can reduce the daytime sleepiness, nocturnal sleep disturbance, and body mass index. To increase the compliance of CPAP, we suggest that some education and support are needed at the early stage of the CPAP treatment.