• The Journal of Korean Medicine
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• v.34 no.1
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• pp.179-191
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• 2013

Kleine-Levin syndrome is a rare disorder characterized by recurrent episodes of hypersomnia, hyperphagia, hypersexuality and delusion and hallucination with spontaneous recovery. A 17-year-old female suddenly showed hypersomnia, severe fatigue, and compulsive hyperphagia. She was diagnosed with suspected Kleine-Levin Syndrome. The precipitating factor was an upper respiratory tract infection that the patient had undergone 2 weeks prior. Past psychiatric history included somnambulism and ADHD; her symptoms of ADHD included attention deficit, impulsiveness, hyperactivity, and irritability. This was her third episode. Her hypersomnia was longer in duration but lower in frequency compared with usual KLS. Her low LF/HF ratio in heart rate variability measurement showed high parasympathetic nerve activity. A MMPI report showed some psychological problem. The patient was diagnosed of gastric fever by pattern identification. Her hypersomnia episode improved 6 weeks after onset. This is the first reported case of suspected Kleine-Levin Syndrome in the field of Oriental Medicine in Korea.

• Sleep Medicine and Psychophysiology
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• v.4 no.1
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• pp.89-95
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• 1997

The authors studied 5 cases of idiopathic CNS hypersomnia who visited Division of Sleep Studies, Seoul National University Hospital in 1995. Detailed medical history was taken and nocturnal polysomnography(NPSG), multiple sleep latency test(MSLT) and human leukocyte antigen(HLA) typing were performed. Neither cataplexy nor hypnagogic hallucination was reported in all cases and in NPSGs, there were tendencies of increased sleep period time and decreased slow wave sleep time. In MSLT, all the subjects showed average sleep latencies less than 8 minutes without sleep-onset rapid eye movement period(SOREMP). In HLA typing, some correlation between idiopathic CNS hypersomnia and HLA DR4 was observed. In contrast to previous reports, overall treatment response with methylphenidate was remarkable. Therefore, the authors suggest that patients suspected of idiopathic CNS hypersomnia be actively evaluated and treated with rather optimistic perspective.

• The Journal of Internal Korean Medicine
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• v.37 no.2
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• pp.189-195
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• 2016

Objective: This study evaluates the effects of traditional Korean medicine (including Guibi-tang) on a psychogenic urinary incontinence patient with hypersomnia disorder.Method: Herbal medicine, acupuncture, and moxibustion were carried out. The effect of the treatments was then evaluated via the Beck depression inventory (BDI), the Beck anxiety inventory (BAI), the symptom checklist-90-revised (SCL 90-R), the Epworth sleepiness scale (ESS), and the revised urinary incontinence scale (RUIS), as well as the number of urinations, incontinence levels, and sleeping times during the day.Results: After the treatments, both the urinary incontinence and hypersomnia symptoms showed improvement.Conclusion: This study suggests that traditional Korean medicine treatments are effective in caring for patients who suffer from psychogenic urinary incontinence with hypersomnia disorder.

• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.91-96
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• 1995

A 24-year-old woman complained of recurrent episodes of hypersomnia lasting on the average about 15 days with mild mood alternation such as depression and irritability. During interepisode interval, she was free of any symptoms. Depending on the absence of excessive eating and hypersexuality, she was clinically diagnosed as recurrent monosymptomatic hypersomnia or the incomplete form of Kleine-Levin syndrome. When nocturnal polysomnography and multiple sleep latency test were performed 10 days after her recovery from a hypersomnic episode, reduced slow wave sleep % and pathologic daytime sleepiness were still noted. The authors suggest that the clinical recovery in recurrent monosymptomatic hypersomnia precede electrophysiological normalization by several days.

• Sleep Medicine and Psychophysiology
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• v.5 no.2
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• pp.202-209
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• 1998

Authors report the findings of nocturnal polysomnography and multiple sleep latency test(MSLT) before and after morning light treatment in a winter depressive patient with hypersomnia. On polysomnographic recordings, the sleep pattern of this case before light treatment was similar to that of narcolepsy exhibited, sleep onset REM period(SOREMP). After treatment, the shortened REM latency changed to normal condition, but, deep sleep percentage did not changed, and stage 4 sleep percentage was decreased. Depressive symptoms were improved on clinical interview with Hamilton Depressive Rating Scale. Sleep log showed shortened sleep latency and reduced sleep duration. These findings suggest that although light treatment could alter the sleep structure in seasonal affective disorder with hypersomnia, it does not necessarily imply that antidepressant response of light treatment is result of change of sleep structure.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.383-390
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• 2004

The most common causes of severe sleepiness beginning or progressively worsening in adults are SLEEP APNEA and RELATED BREATHING DISORDERS DURING SLEEP. Idiopathic hypersomnia is excessive sleeping without obvious cause. Idiopathic hypersomnia diagnosis can be explained as follows: One could be chronically sleepy due to either something wrong with sleep that makes it non-refreshing, or a problem with the brain mechanisms which normally should keep one alert whether caused by primary problems within the brain or its chemistry, or by other factors (such as sedating medications or thyroid problems). A 71-year-old male who had suffered from excessive sleeping was admitted to our department for oriental treatment on 7th of July, 2003. He was diagnosed as an idiopathic hypersomnia for excessive sleeping without obvious cause. Initial treatment modalities with administration of "SoonHwanGi1HoBang(循環器1號方)" were not effective. However, after administration of "YukMiGiHwangTang(六味地黃湯)" desirable effects were seen.

• Sleep Medicine and Psychophysiology
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• v.10 no.1
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• pp.12-19
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• 2003

Sleepiness, or hypersomnia, is a relatively common complaint and one of the main problems of modern society. Accurate evaluation and diagnosis of sleepiness are important. The methods used for evaluating sleepiness are subjective measures or self-evaluations, performance decrease measures, sleep propensity measures, and arousal decrease measures. A clear and detailed history is important in differential diagnosis of sleepiness because symptoms of sleepiness may be expressed in terms of 'tiredness' or 'fatigue' that do not directly denote sleepiness. Comprehensive diagnostic evaluation is also invaluable because these symptoms may result from a variety of causes ranging from medical disorders to insufficient nocturnal sleep.

• 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.

• Journal of Physiology & Pathology in Korean Medicine
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• v.26 no.3
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• pp.376-380
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• 2012

This study was designed to evaluate the effects of traditional korean herbal medicine(Jaumkunbi-tang) therapy on a hyperthyroidism patient. Clinical data was analyzed on a patient with hyperthyroidism whose main symptoms were fatigue, palpitation, up flame, hyperhidrosis, hypersomnia and dyspepsia. The patient visited our hospital 9 times from November 10, 2011 and remianed until January 30, 2012. He was treated with Jaumkunbi-tang, the traditional korean herbal medicine. After treatment, improvement was seen in clinical symptoms(such as fatigue, palpitation, up flame, hyperhidrosis, hypersomnia and dyspepsia) and thyroid function test. The study suggests that Jaumkunbi-tang, one of traditional korean herbal medicines, could be effective on the treatment of hyperthyroidism.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.65-76
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• 1996

Natural sleep pattern and its physiology in childhood are much different from those in adulthood. Several aspects of clinical evaluation for sleepiness in childhood are more difficult than in adulthood. These difficulties are due to several factors. First, excessive sleepiness in childhood do not always develop functional impairments. Second, objective test such as MSLT may not be reliable since it is hard to be certain that the child understand instructions. Third, sleepiness in children is often obscured by irritability. paradoxical hyperactivity, or behavioral disturbances. Anseguently, careful clinical evaluation is needed for the sleepy children. Usual causes of sleepiness in children are the disorders that induce insufficient sleep such as sleep apnea syndrome, schedule disorder, underlying medical and psychiatric disorder, and so forth. After excluding such factors, we can diagnose the hypersomnic disorders such as narcolepsy, Kleine-Levin syndrome, and idiopathic central nervous system hypersomnia. Among the variety of those causes of sleepiness, I reviewed the clinical difference of narcolepsy and obstructive sleep apnea syndrome in childhood compared with in adulthood. Recognition of the childhood narcolepsy is difficult because even severely sleepy children often do not develop pathognomic cataplexy and associated REM phenomena until much later. Since childhood narcolepsy give srise to many psychological, academical problem. Practicers should be concerned about these aspects. Childhood obstructive sleep apnea syndrome is different from adult obstructive sleep apnea syndrome too. Several aspects such as pathophysiology. clinical feature, diagnostic criteria, complication, management, and prognosis differ from those in the adult syndrome. An important feature of childhood obstructive sleep apnea syndrome is the variety of severe complications such as behavioral disorders, cognitive impairment, cardiovascular symptoms, developmental delay, and ever death. Fortunately, surgical interventions like adenotosillectomy or UPPP are more effective for Childhood OSA than adult form. CPAP is a "safe, effective, and well-tolerated" treatment modality too. So if early detection and proper management of childhood OSA were done, the severe complication would be prevented or ever cured.