• 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.3 no.1
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• pp.47-55
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• 1996

Narcolepsy is characterized by sleep attack with excessive daytime sleepiness(EDS), cataplexy, sleep paralysis, and hypnagogic hallucination. Paradoxically, narcoleptics tend to complain of frequent arousals and shallow sleep during the night time despite their excessive sleepiness. However, nocturnal sleep fragmentation in narcoleptics is relatively ignored in treatment strategies, compared with sleep attack/EDS and cataplexy. In our paper, we attempted to investigate further on the poor nocturnal sleep in narcoleptics and to discuss possible treatment interventions. Out of consecutively seen patients at Seoul National University Sleep Disorders Clinic and Division of Sleep Studies, we recruited 57 patients, clinically assessed as having sleep attack and/or EDS. Nocturnal polysomnography and multiple sleep latency test(MSLT) were done in each of the subjects. We selected 19 subjects finally diagnosed as narcolepsy(mean age $26.0{\pm}18.3$ years, 16 men and 3 women) for this study, depending on the nocturnal polysomnographic and MSLT findings as well as clinical history and symptomatology. Any subject co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep was excluded. Sleep staging was done using Rechtschaffen and Kales criteria. Sleep parameters were calculated using PSDENT program(Stanford Sleep Clinic, version 1.2) and were compared with the age-matched normal values provided in the program. In narcoleptics, compared with the normal controls, total wake time was found to be significantly increased with significantly decreased sleep efficiency(p<.01, p<.05, respectively), despite no difference of sleep period time and total sleep time between the two groups. Stage 2 sleep%(p<.05), slow wave sleep%(p<.05), and REM sleep%(p<.01) were found to be significantly decreased in narcoleptics compared with normal controls, accompanied by the significant increase of stage 1 sleep%(p<.01). Age showed negative correlation with slow wave sleep%(p<.05). The findings in the present study indicate significant fragmentation of nocturnal sleep in narcoleptics. Reduction of REM sleep% and the total number of REM sleep periods suggests the disturbance of nocturnal REM sleep distribution in narcoleptics. No significant correlations between nocturnal polysomnographic and MSLT variables in narcoleptics suggest that nocturnal sleep disturbance in narcoleptics may be dealt with, in itself, in diagnosing and managing narcolepsy. With the objective demonstration of qualitative and quantitative characteristics of nocturnal and daytime sleep in narcoleptics, we suggest that more attention be paid to the nocturnal sleep fragmentation in narcoleptics and that appropriate treatment interventions such as active drug therapy and/or circadian rhythm-oriented sleep hygiene education be applied as needed.

• Journal of Preventive Medicine and Public Health
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• v.54 no.3
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• pp.182-189
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• 2021

Objectives: This study investigated the relationship between sleep quality during pregnancy and preterm birth. Methods: This longitudinal study was conducted between August 2018 and May 2019. The participants were 150 pregnant women who had been referred to 7 healthcare centers in the city of Qazvin, Iran and met the inclusion criteria. The Petersburg Sleep Quality Index, the Epworth Sleepiness Scale, and 2 questions about daytime sleep status and a demographic questionnaire were administered at 14-18 weeks and 28-32 weeks of gestation. Data were analyzed using the Mann-Whitney test, the Fisher exact test, and univariate and multivariable logistic regression. Results: In the present study, poor sleep quality affected 84.7% of the participants at 14-18 weeks and 93.3% at 28-32 weeks of gestation. The final model for preterm birth prediction incorporated age and the Petersburg Sleep Quality Index score in the second and third trimesters. Preterm birth increased by 14% with each unit increase in age. With each unit increase in the Petersburg Sleep Quality Index score in the second and third trimesters, preterm birth increased by 42% and 28%, respectively, but the p-values of these factors were not significant. Conclusions: Although a significant percentage of pregnant women had poor sleep quality, no significant relationship was found between sleep quality during pregnancy and preterm birth.

• Journal of agricultural medicine and community health
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• v.38 no.4
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• pp.229-242
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• 2013

Objectives: The objective of this study was to identify the influence of shift work on sleep quality, daytime sleepiness, and perceived errors during nursing work among hospital nurses. Methods: The study subjects were 209 hospital nurses working in two general hospitals in South Korea. The data were collected through self-administered questionnaires in May 2013. Sleep quality was measured using Korea Pittsburgh Sleep Quality Index (PSQI-K), daytime sleepiness was measured using Epworth Sleepiness Scale (ESS), and perceived errors in past 6 months during nursing duty hours with the tool developed in this study. Results: The sleep quality was significantly worse among rotating shift nurses when compared to fixed day duty nurses. However, the odds ratio (OR) of 1.92 [95% confidence interval(CI): 0.58-6.37] adjusted for sociodemographic variables, health behaviors, and working environment in logistic regression was not significant. There was no significant difference in the daytime sleepiness between rotating shift nurses and fixed day duty nurses in both simple and multivariable analyses. There were significantly more perceived errors in rotating shift nurses than fixed day duty nurses. However, the OR of 1.26 (95% CI: 0.38-4.21) adjusted for sociodemographic variables, health behaviors, working environment, sleep quality, and daytime sleepiness in logistic regression was not significant. Depression (OR=3.31, 95% CI: 1.11-9.84) and daytime sleepiness(OR=1.18, 95% CI: 1.07-1.30) were significantly associated with perceived errors in logistic regression. Conclusion: This study suggested shift work among hospital nurses had no independent influence of sleep quality, daytime sleepiness, and perceived errors. However, daytime sleepiness had independent influence of perceived errors. More studies are warranted to achieve more reliable conclusion.

• Journal of Rhinology
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• v.25 no.2
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• pp.69-74
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• 2018

Background and Objectives: Sleep disturbances and excessive daytime sleepiness (EDS) are the major symptoms of obstructive sleep apnea (OSA). This study aimed to investigate clinical implications of insomnia and EDS in patients with OSA using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Materials and Method: We evaluated 131 subjects with suspected OSA who were undergoing polysomnography (PSG) and performing the PSQI and ESS surveys. OSA was diagnosed when the apnea-hypopnea index was five or more. EDS was defined when ESS score was 11 points or higher. Detailed history and questionnaire were used to categorize insomnia. We compared clinical variables and PSG results in subgroups with or without insomnia and EDS. Results: There were no significant differences of PSQI and ESS score between controls and OSA. OSA with insomnia had significantly increased total score (p<0.001) and decreased total sleep time (p=0.001) and sleep efficiency (p=0.001) on the PSQI compared to those without insomnia. OSA with EDS showed significantly increased PSQI score (p=0.022) and decreased total sleep time (p=0.018) on PSG compared to those without EDS. Neither PSQI nor ESS score had a correlation with respiratory variables such as AHI and oxygen saturation. Total sleep time had a significant effect on both insomnia and EDS in patients with OSA. Conclusion: Decreased total sleep time had important effects on subjective symptoms of OSA and comorbid insomnia. Therefore, restoration of decreased sleep time is important in the management of OSA.

• Journal of the Korean Applied Science and Technology
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• v.41 no.1
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• pp.96-106
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• 2024

This study aimed to examine the effects of non-face-to-face sleep program combined with aroma necklace on quality of sleep, daytime sleepiness, depression, and stress in insomnia with college students. A nonequivalent control group pre-post test design was used. The experimental group(n=21) underwent non-face-to-face sleep program combined with aroma-necklace while the control group(n=21) received a sleep booklet. Sleep quality, daytime sleepiness, depression, and stress were measured to identify the effectiveness of the program. Data were analyzed using descriptive statistics, Fisher's exact test, χ²-test, and independent t-test with the SPSS 24.0 program. In the homogeneity test of the general characteristics and study outcome variables there were no significant differences between the two groups. Significant group differences were found in sleep quality (t=-5.87, p<.001), daytime sleepiness(t=-4.28, p<.001), and depression(t=-4.40, p<.001). No differences were found in the stress. Non-face-to-face sleep improvement program combined with an aroma-necklace was effective in improving insomnia in college students. Nurses can contribute to improving sleep and depression by applying this program to college students experienced insomnia living in various environments.

• Sleep Medicine and Psychophysiology
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• v.6 no.2
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• pp.97-101
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• 1999

Sleep disorders are relatively common occurrence after traumatic brain injury. Sleep disturbances often resulted in difficulties in sleep onset and sleep maintenance, nonrestorative after sleep, poor daytime performances and poor individual sense of wellbeing. Unfortunately, there has been minimal attention paid to this common and disabling sequela of brain injury. Better undertanding about problem, pathophysiology and treatment of sleep disorder after traumatic brain injury will improve the cognitive function, social adjustment and rehabilitation for injured patients. Also it may be helpful to reduce traumatic brain injury in patients with sleep apnea.

• Anxiety and mood
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• v.12 no.2
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• pp.97-102
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• 2016

Objective : This study aimed to quantify the degrees of insomnia, depression and anxiety felt by employees, and to understand which components of insomnia affect depression and anxiety. Methods : One thousand employees who had medical checkups from January to December 2014 in the Workplace Mental Health Institute of Kangbuk Samsung Medical Center were selected randomly. Sleep quality, depression, and anxiety were rated using the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression scale (CES-D), and the Beck Anxiety Inventory (BAI), respectively. Good and poor sleepers were divided into two groups according to their total PSQI score : ${\leq}5$ for good sleepers or >5 for poor sleepers. Results : Of 998 employees, 742 (74.35%) had PSQI total scores below 5, and 256 (25.65%) had scores over 5. Multivariate linear regression analysis using the 7 components of PSQI versus BAI, and CES-D scores revealed that subjective sleep quality, daytime dysfunction, sleep disturbance, sleep latency and sleep duration components were significantly associated with both BAI and CES-D. Conclusion : Among the components of insomnia, subjective sleep quality and daytime dysfunction were most strongly associated with depression and anxiety.

• The Journal of the Korean dental association
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• v.53 no.1
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• pp.47-56
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• 2015

Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences Untreated OSAS can cause various problems such as hypertension, diabetes, stroke, cardiac disease, daytime sleepiness. Various treatments are available, including non-surgical treatment such as medication or modification of life style, surgical treatment, continuous positive airway pressure (CPAP) and oral appliance (OA). Oral appliance is known to be effective in mild to moderate OSA, also genioglossus muscle advancement (GA) or maxillomandibluar advancement (MMA) is a good option for OSA patients with muscular or skeletal problems. Although the prevalence of OSA is increasing, the proportion of the patient treated by dentist is still very law. Dentists need to understand the mechanism of OSA and develop abilities to treat OSA patients with dental problems. The purpose of this paper is to give a brief overview about OSA and the dentist's role in OSA patients.

• Sleep Medicine and Psychophysiology
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• v.7 no.1
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• pp.5-9
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• 2000

Several nonpharmacological treatment methods of insomnia and their effects were reviewed. A long-term use of most hypnotics may produce tolerance, dependence, cognitive and psychomotor impairments at daytime, shallow sleep, and rebound insomnia on drug withdrawal. To reduce hypnotic abuse, nonpharmacological strategies have been developed to correct disordered behavioral and cognitive factors. These treatments aim at modifying maladaptive sleep habits, lowering physiological and cognitive arousal levels, and correcting dysfuctional beliefs and attitudes about sleep. These non-pharmacological or cognitive behavior treatments include stimulus control, sleep restriction, relaxation training, sleep hygiene education, cognitive therapy, and light therapy. Among them the stimulus control therapy has been demonstrated most effective as a single treatment or in combination with other treatments. Through nonpharmacological treatments, sleep latency was most significantly reduced and wake time after sleep onset was also reduced. About 50% of insomniacs reported clinical improvements in terms of nearly normalized sleep latency, awakening time, sleep efficiency, and reduction of hypnotic use. Compared to the hypnotic therapy, nonpharmacological treatments are more cost-effective and more readily accepted by patients, and their effects last longer.