• 제목/요약/키워드: Enuresis

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소아신경정신 질환의 한.양방적 접근 방법론 연구 (A study of methods for Oriental.Western medical approach of Child Neuropsychiatric Disorders)

  • 김근우
    • 동의신경정신과학회지
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    • 제14권2호
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    • pp.15-25
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    • 2003
  • Objectives : This study aimed investigation of clinical development to child neuropsychiatry through the oriental western medical approach of child neuropsychiatric disorders Methods : As DSM-IV and ICD-10 set a standard for clinical expression. According to this standard and oriental medical diseases, child neuropsychiatric disorders are divided into six symptoms Results and Conclusion : 1. View point of oriental medicine, Psycho Somatic stroke(inclusive of the spasm) place under the category 'Epilepsy(癎)', 'Children's fit(驚風)' and 'Chi-Kyeung(?痙)'. 2. View point of oriental medicine, Mental Retardation place under the category 'Dementia(?)', 'Amnesia(健忘)' and 'Speech Disorder(語遲)' 3. View point of oriental medicine, Emotional Disorder place under the category 'Adjustment Disorder(客?)', 'Cry with anxiety at night(夜啼症)', 'Gi-Byung(?病)' and 'Child depressive Disorder(小兒癲症)' 4. View point of oriental medicine, Conduct development Disorder place under the category 'Physical frail of five part(五軟)' and 'Physical stiff of five part(五硬)'. 5. View point of oriental medicine, Childhood Psychosis place under the category 'Insanity(癲狂)'. 6. View point of oriental medicine, Somatoform Disorder place under the category 'Palpitation of the heart(驚悸)', 'Vomiting and Diarrhea(吐瀉)', 'Asthma(喘)', 'Headache(頭痛)' and 'Enuresis(遺尿)'

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일차성 야뇨증 아동에서 야간 수분 제한의 치료 효과 (Therapeutic Effect of Nocturnal Water Restriction in Children with Primary Nocturnal Enuresis)

  • 이수진;양재영;김혜순;이승주
    • Childhood Kidney Diseases
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    • 제5권1호
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    • pp.51-58
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    • 2001
  • 목 적 : 일차성 야뇨증의 치료는 민간 요법과 다양한 병인론에 근거한 각종 치료 방법이 개발 되어 있으나 가장 기본 치료인 야간 수분 제한의 치료 효과는 간과되어 왔다. 이에 저자들은 야뇨증의 일차적인 치료의 철저한 야간 수분 제한 효과만을 평가하고 성공 요인을 분석해 보고자 하였다. 대상 및 방법 : 1998년 10월부터 1999년 6월까지 이대목동병원 소아과 외래를 방문한 일차성 야뇨증 아동(주 3회 이상의 아뇨)중 2개월간의 야간 수분 제한에 순응도가 높은 41명(7.9${\pm}$2.3세)을 대상으로 하였다. 야간 수분 제한 전과 2개월 치료 후 매 2주마다 24시간 수분 섭취량과 요량을 (매주 1일이상) 기록하도록 하여 순응도를 평가하였다. 치료후 야뇨 횟수가 90$\%$이상 감소된 완전반응군, 50$\%$이상 9$\%$미만 감소된 부분반응군, 50$\%$이하로 감소된 무반응군으로 구분하여 치료율을 조사하였고, 치료에 대한 성공 요인으로 성별, 연령, 주간 배뇨 이상, 수분 섭취량, 요량, 최대 요량, 요농축능 등을 분석하였다. 치료 2개월 후 야간 요량, 최대 요량, 농축요삼투질 농도의 변화를 비교하였다. 결 과 : 야간 수분 제한 2개월 후의 반응률은 39.0$\%$ (l6/41)에서 완전반응, 43.9$\%$ (18/41)에서 부분반응, 17.1$\%$(7/41)에서 무반응을 보여 전체적으로 82.9$\%$ (34/41)에서 호전되었다. 야간 수분 제한의 치료 효과에 대한 예견 요인은 주간 배뇨 이상, 야간 수분 섭취량, 야간 요량, 방광 요인 등으로, 단증상 야뇨증 아동에서는 완전반응 50$\%$(13/26), 부분반응 46.2$\%$ (12/26)로 다증상 야뇨증 아동의 20$\%$ (3/15), 40$\%$ (6/15)에 비하여 유의하게 치료율이 높았다(P<0.05). 야간 수분 섭취량은 완전반응군 385${\pm}$109mL, 부분반응군 335${\pm}$105mL, 무반응군 233${\pm}$45 mL, 야간 다음은 각각 48.5$\%$(16/33), 42.4$\%$(14/33), 9.1$\%$(3/33)로 야간 수분 섭취량이 많을수록 유의하게 치료율이 높았다 (P<0.05). 야간 요량은 완전반응군 390${\pm}$62mL, 부분반응군 330${\pm}$136mL, 무반응군 140${\pm}$43mL, 야간 다뇨는 각각 59.3$\%$(16/27), 40.7$\%$(11/27), 0$\%$(0/27)로 야간 요량이 많을수록 유의하게 치료 효과가 좋았다(P<0.05). 일회 최대 요량은 완전반응군 236${\pm}$42 mL, 부분반응군 209${\pm}$56 mL, 무반응군 107${\pm}$36mL로 최대 요량이 많을수록 유의하게 치료 효과가 좋았다 (p<0.05). 연령, 성별, 일일 수분 섭취량, 다음, 일일 요량과 다뇨은 세 군간에 유의한 차이가 없었다. 야간 수분 섭취 제한 후 야간 요량의 감소 정도는 완전반응군 173${\pm}$56mL, 부분반응군 135${\pm}$83mL로 무반응군 28${\pm}$15mL에 비하여 유의하게 컸다 (P<0.05). 최대 요량의 증가도 완전반응군 88${\pm}$27mL, 부분반응군 79${\pm}$38mL로 무반응군 17${\pm}$13mL에 비하여 유의하게 컸다 (p<0.05). 농축요삼투질 농도의 증가 역시 완전반응군 190${\pm}$42mO느/kg, 부분반응군 254${\pm}$115mOsm/kg으로 무반응군 25${\pm}$32 mOsm/kg에 비하여 유의하게 컸다(p<0.05). 결 론 : 일차성 야뇨증은 야간 수분 섭취 제한만으로도 치료율이 높았고, 주간 배뇨 이상이 없고, 야간 다음, 야간 다뇨, 및 최대 방광용적이 높은 아동에서 치료 효과가 좋았다.

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전립선 전용 전자쑥뜸 발열단자의 개발 (Development of the Special Heat Generating Terminal of Cauterizer for Prostate)

  • 조봉관;이윤호
    • Journal of Acupuncture Research
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    • 제26권2호
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    • pp.41-48
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    • 2009
  • Objectives : The conventional direct and indirect moxibustion therapies for prostate treatment could not been applied to the acupuncture point of $CV_1$(Conception Vessel Meridian 1, 會陰) because of its boring body region. The position of $CV_1$(會陰) is the back side of hard part between the anus and the genital organ. The conventional moxibustion methods have many troubles in operating to the acupuncture point of $CV_1$(會陰). In order to get rid of these problems, we have suggested the special heat generating terminal especially for prostate. The features of the special heat generating terminal for prostate are the low temperature infrared heater and the adhesive moxa-pad. These features are no burnt, no fiery and especially suitable for the point of $CV_1$(會陰). Methods: The heat generating terminal which is a part of the moxa-extract moxibustion cauterizer is composed of a PTC(Positive Temperature Coefficients) ceramic heater and the adhesive moxa-pad We had got the experimental demonstrations by the stimulating the acupuncture points which are $CV_1$(會陰), $BL_{28}$(Bladder Meridian 28, 膀胱兪), and $CV_3$(Conception Vessel Meridian 3, 中極) with the special heat generating terminal for the prostatitis and the benign prosthetic hypertrophy. And the stimulation level was 43$^{\circ}C$ infrared heat for one hour. The type of thermography is IRIS-5000. Results : With one subject suffering the prostatitis and another subject suffering the benign prosthetic hypertrophy, we cauterized the acupuncture points $CV_1$(會陰), $BL_{28}$(膀胱兪) and $CV_3$(中極) with the special heat generating terminal for prostate. We measured the temperature variations by the thermography before and after stimulations. Finally we estimated the tendency of temperature decreasing in the region of post-stroke urinary symptoms and the improvement of nocturnal enuresis after the stimulations. Conclusions : We suggest that the special heat generating terminal of moxa-extract moxibustion cauterizer proposed herein is effective for the treatment of prostate by NIH-CPSI and IPSS.

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Clozapine으로 치료 중인 만성 정신분열병 환자의 수면양상 (Sleep Patterns in Chronic Schizophrenic Patients Treated with Clozapine)

  • 신일선;이승현;윤보현;윤진상
    • 생물정신의학
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    • 제6권2호
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    • pp.246-252
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    • 1999
  • Objectives : Daytime drowsiness or sedation and changes in night sleep are commonly seen in patients treated with clozapine. There is, however, very limited information on their degree and nature during the course of treatment. The purpose of this study was to understand the sleep patterns in chronic schizophrenic patients with clozapine treatment over a period of 24 weeks. Method : The sleep pattern was evaluated using a set of 5-point scale questionnaire, to record subjective impressions of the night sleep induction, maintenance and quality, and daytime drowsiness and fatigue. In addition, unusual experiences associated with night sleep were recorded. The sleep questionnaire was repeatedly administered at baseline and at 1, 2, 4, 8, 12 and 24 weeks of drug treatment. At present, data on 12 patients has been collected. Results : All the components of night sleep were significantly improved in the 1st through the 12th week after treatment with clozapine. Daytime drowsiness was significantly higher in the 1st to the 2nd week after the treatment and fatigue was also significantly higher in the 1st to the 4th week after the treatment. Eight patients experienced noticeable increases in salivation during night sleep, and of these, one also reported frequent nocturnal urination and even enuresis. However, all these adverse factors did not affect the major sleep patterns. Conclusions : These findings suggest that the beneficial effects of clozapine on night sleep might last much longer than the undesirable effect of daytime drowsiness and fatigue. In other words, tolerance of the hypnotic action of clozapine might develop late and tolerance of the daytime drowsiness and fatigue might be evident earlier.

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여성의 요실금 빈도와 관련 요인에 대한 조사 연구 (Incidence and Correlates of Urinary Incontinence in Women)

  • 윤혜상;노유자
    • 대한간호학회지
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    • 제27권3호
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    • pp.683-693
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    • 1997
  • Urinary incontinence is defined as the involuntary and inappropriate loss of urine to failure to emit normal responses as the bladder fills, or inability to reach the bathroom in sufficient time. This study was undertaken to estimate the incidence of urinary incontinence and to determine the correlates of urinary incontinence among women. Subjects of this survey consisted of 408 women, 26 to 83 years old in Incheon. The results of this study are as follows. 1. Of the subjects 50.7% reported urine loss once or twice per year and 28.5% reported incontinence on a regular basis at least once per month. 2. 40.5% of women reported small volume accidents of only 1 to 2 drops, 31.4% ; 1 t-spoon, 16.9% : 1 T-spoon, while 10.1% of women couldn't estimate the volume of urine loss. 3. The volume of urine loss was great enough to require a change of garment (undergarments or outer garments) in 73%. But only 3.8% of those used some type of pads. 4. 56.5% of incontinent women didn't talk about their urinary incontinence with other persons because they felt that urinary incontinence was shameful(38.4%), was not a disease(31.6%), was incurable in spite of treatment(27.4%) and was fearful of being uncured (2.6%). 5. Only 15.5% of urinary incontinent women had sought treatment. 6. The incidence of urinary incontinence was significantly higher in women who had more pariety and uterine-ovarian disease, older age, worrying about where toilets were when they visited new places or voiding anxiety, nocturia and frequency, but was significantly lower in women who had coffee intake. The incidence of urinary incontinence was not related to smoking and enuresis. The results indicate that urinary incontinence is common among young and middle-aged women. That few seek treatment for urinary incontinence suggests a need for more information about women's attitudes toward urinary incontinence and more attention to this problem by health care providers.

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소아(小兒) stress에 관한 문헌적(文獻的) 고찰(考察) (A study on stress in Children)

  • 김기봉;김장현
    • 대한한방소아과학회지
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    • 제16권1호
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    • pp.105-124
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    • 2002
  • With the progress of civilization, the disorders due to the stress, which derived from the social-structural complexity and diversity, are on an increasing trend in our times. Accordingly, the accurate diagnosis and appropriate treatment for them are required. Especially in the current years, children's disorders delivered by the emotional problems keep increasing. In this research, the researcher tried to figure out the cause of the children's stress and its treatment, studied the theories of the stress in the modem medicine and the sever emotions in oriental medicine, and came to the conclusion as follows: 1. The stress can be defined as the combination of the reaction to noxious stimuli and its defense mechanism of the body, In oriental medicine, it is considered as pathological notions which includes seven emotions as the internal factor, six evils as the external factor and other foods, expectoration, ecchymoma as the non-internal/external factors. 2. Children usually get stressed by various reasons in a growth process such as schooling, relationship with friends, the opposite sex of family, or change of surroundings, and these can cause the various disorders. 3. In the study of the children's stress symptoms, it is found that the silent reaction is uncommon. It usually appeared in both reactions: firs, physical reactions such as stomachache, vomiting, headache, neural frequent urination, bronchial asthma or excessive respiration and/or, second, behavioral reactions such as a decline of performance, alimentary disorder, e.g. anorexia nervosa or bulimia, sleep disorder, e.g. nightmare or panic in sleep, anthrophobia, refusal to a school attendance or hyperactiveness. Besides, the peculiar mental disorder such as paroxysm of anger, tic, autism, nocturnal enuresis, lack of attentiveness, impediment in linguistic development, learning difficulty, intellectual decline, etc. can be appeared, and the heavy stress during the babyhood can cause the regression of behavior or the immaturity of formation of character. 4. The appropriate treatments for the children's stress are Osteopathy, Manpulation, Aroma Therapy, Alexander Technique, Autonomic Never Control Treatment, Biofeedback, Chiropractic, Dance Therapy, Feldenkrasis Technique, Gravity Therapy, Homepathy, Aquatherapy, Hypnotherapy, Naturopathy and Meditation.

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소아설사(小兒泄瀉)에 대한 가감전씨백출산(加減錢氏白朮散)의 임상효능(臨床效能)에 관한 연구(硏究) (The clinical effect of Gagamjeonsibaekchul-san on child diarrhea)

  • 김장현
    • 대한한방소아과학회지
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    • 제18권2호
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    • pp.1-9
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    • 2004
  • Objectives: The objective of this study is to assess the clinical effect of Gagamjeonsibaekchul-san on child diarrhea. Methods: This clinical study was carried out with 42 cases(31male, 11female) of children aged 0 to 14 years old who visited the Department of Pediatrics, Dongguk University Bundang Oriental Hospital and were diagnosed as the diarrhea. Assessments were made with reference to sex, age, the duration of symptoms and physical history. To assess the impact of Gagamjeonsibaekchul-san, the complicated signs, the duration of treatment, the correlation between the use of Gagamjeonsibaekchul- san, san and the duration of symptom were examined before and after the treatment. Results: There were 31 males and 11 females in the incidence by sex. It showed that males were more than females. The most numerous age group was 0-2(19) followed by 3-7 (11) and 9-12 (12). According to the duration of symptom, 12 children have symptom for 0-7 days, 10 for 8-14 days, 11 for 15-20 days, 4 for 22-28 days and 5 over 28 days. With regard to the physical history of the sample, 5 children had atopic dermatitis, 3 children had enteritis, 3 children had rhinitis, 2 children had tonsillitis, 1 child had otitis media, 1 child had asthma and 1 child had pneumonia. The children also had the complicated signs: 22 children had anorexia, 17 children had abdominal pain, 13 children had vomiting and 8 children had nausea in digestive organ. In addition 11 children had dizziness, 7 children had general weakness, 1 child had enuresis and 1 child had sweat in general symptoms. For the duration of the treatment, 14 children were treated for 7 days, 13 for 8-10 days, 8 for 11-14 days, 3 for 15-21 days, 2 for 22-28 days and 2 for 29-40 days. No distinct relationship between the use of Gagamjeonsibaekchul-san and the duration of the symptom was found. Conclusion: Gagamjeonsibaekchul-san is effective in the treatment of intestine mucous membrane and improves the function of digestive system. It is also an effective short-term treatment for child diarrhea.

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소아설사(小兒泄瀉)에 대한 가감전씨백출산(加減錢氏白朮散)의 임상효능(臨床效能)에 관한 연구(硏究) (The clinical effect of Gagamjeonsibaekchul-san on child diarrhea)

  • 김장현
    • 대한한방소아과학회지
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    • 제18권2호
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    • pp.11-11
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    • 2004
  • Objectives: The objective of this study is to assess the clinical effect of Gagamjeonsibaekchulsan on child diarrhea. Methods: This clinical study was carried out with 42 cases(31male, 11female) of children aged 0 to 14 years old who visited the Department of Pediatrics, Dongguk University Bundang Oriental Hospital and were diagnosed as the diarrhea. Assessments were made with reference to sex, age, the duration of symptoms and physical history. To assess the impact of Gagamjeonsibaekchulsan, the complicated signs, the duration of treatment, the correlation between the use of Gagamjeonsibaekchul- san and the duration of symptom were examined before and after the treatment. Results: There were 31 males and 11 females in the incidence by sex. It showed that males were more than females. The most numerous age group was 0-2(19) followed by 3-7 (11) and 9-12 (12). According to the duration of symptom, 12 children have symptom for 0-7 days, 10 for 8-14 days, 11 for 15-20 days, 4 for 22-28 days and 5 over 28 days. With regard to the physical history of the sample, 5 children had atopic dermatitis, 3 children had enteritis, 3 children had rhinitis, 2 children had tonsillitis, 1 child had otitis media, 1 child had asthma and 1 child had pneumonia. The children also had the complicated signs: 22 children had anorexia, 17 children had abdominal pain, 13 children had vomiting and 8 children had nausea in digestive organ. In addition 11 children had dizziness, 7 children had general weakness, 1 child had enuresis and 1 child had sweat in general symptoms. For the duration of the treatment, 14 children were treated for 7 days, 13 for 8-10 days, 8 for 11-14 days, 3 for 15-21 days, 2 for 22-28 days and 2 for 29-40 days. No distinct relationship between the use of Gagamjeonsibaekchul-san and the duration of the symptom was found. Conclusion: Gagamjeonsibaeichul-san is effective in the treatment of intestine mucous membrane and improves the function of digestive system. It is also an effective short-term treatment for child diarrhea.

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Obstructive sleep apnea syndrome in children: Epidemiology, pathophysiology, diagnosis and sequelae

  • Chang, Sun-Jung;Chae, Kyu-Young
    • Clinical and Experimental Pediatrics
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    • 제53권10호
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    • pp.863-871
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    • 2010
  • The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. Adenotonsillar hypertrophy is the most common cause of OSAS in children, and obesity, hypotonic neuromuscular diseases, and craniofacial anomalies are other major risk factors. Snoring is the most common presenting complaint in children with OSAS, but the clinical presentation varies according to age. Agitated sleep with frequent postural changes, excessive sweating, or abnormal sleep positions such as hyperextension of neck or abnormal prone position may suggest a sleep-disordered breathing. Night terror, sleepwalking, and enuresis are frequently associated, during slow-wave sleep, with sleep-disordered breathing. Excessive daytime sleepiness becomes apparent in older children, whereas hyperactivity or inattention is usually predominant in younger children. Morning headache and poor appetite may also be present. As the cortical arousal threshold is higher in children, arousals are not easily developed and their sleep architectures are usually more conserved than those of adults. Untreated OSAS in children may result in various problems such as cognitive deficits, attention deficit/hyperactivity disorder, poor academic achievement, and emotional instability. Mild pulmonary hypertension is not uncommon. Rarely, cardiovascular complications such as cor pulmonale, heart failure, and systemic hypertension may develop in untreated cases. Failure to thrive and delayed development are serious problems in younger children with OSAS. Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions.

대구지역 일개 초등학교를 대상으로 한 소아 수면문제에 대한 예비연구 (Preliminary Study of Children's Sleep Problems in an Elementary School in Daegu)

  • 서완석;구본훈;김민지;노영환;성형모;신지현
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제19권3호
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    • pp.156-161
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    • 2008
  • Objectives: The purpose of this study was to investigate the prevalence of sleep problems in Korean elementary school children and the differences in sleep problems elated to their school grade and gender. Methods : One public elementary school in Dae-gu, Korea as randomly selected. And, parents who agreed to participate this study were asked to complete a modified version of Tucson Children's Assessment of Sleep Apnea screening questionnaire (TuCASA). Results: The most common sleep problem was 'falling asleep in vehicle (44.2%)' and the prevalence rate of this problem differed by school grade. The prevalence rate of falling asleep while watching TV before 8 P.M. (8.0%), daytime fatigue (21.9%) and nocturnal enuresis during the past 6 months (5.3%) were significantly differed by school grade. The prevalence rate of falling asleep while doing home work, falling sleep during a lesson, snoring and bruxism were 12.6%, 1.0%, 26.7% and 13.2% respectively. Although these rates did not show any differences between grades, snoring as more in boys and daytime fatigue was more in girls. Conclusion: This study demonstrates that many elementary school children may have various sleep problems. Lower grade elementary schoolers had sleep problems which related to euro-developmental factors, whereas higher grade elementary schoolers had sleep problems related to sleep deprivation and stress. Finally, more female schooler showed signs of fatigue or sleepiness than male schoolers.

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