• Journal of Oral Medicine and Pain
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• v.40 no.4
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• pp.155-162
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• 2015

Purpose: The association between pain and sleep is described as a vicious cycle and psychological distress is well known as comorbid condition in the patients with pain and sleep problems. The aim of the study was to evaluate the prevalence of self-reported sleep disturbance and its relationship to clinical and psychological profiles in temporomandibular disorder (TMD) patients. Methods: The sample consisted of 123 TMD patients (90 women and 33 men), with a mean age of $39.9{\pm}15.4years$. Self-report measures of sleep quality, pain and psychological profile were conducted via the Pittsburgh Sleep Quality Index (PSQI), the Brief Pain Inventory and the Symptom Checklist-90-Revision at the initial visit. The primary diagnosis of TMD were categorized as TMD with internal derangement without pain, TMD with joint pain, TMD with muscle pain and TMD with joint-muscle combined pain. The chi-square test, independent t-test, oneway ANOVA and multiple linear regression analysis were used for statistics. Results: The patients was grouped as good sleepers (n=32, scores of 5 and lower) and poor sleepers (n=91, scores of 6 and higher) according to the recommended cutoff point of the global PSQI score (>5). TMD patients with pain showed poor sleep quality than TMD patients with internal derangement without pain. Poor sleepers had high pain interference and elevated psychological distress. Among them, pain interference and depression were significant predictors to sleep quality. Conclusions: The results suggest that sleep disturbance is a prevalent complaint in TMD patients, and sleep problems in TMD patients are associated with pain and psychological distress.

• Journal of Preventive Medicine and Public Health
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• v.55 no.2
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• pp.173-181
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• 2022

Objectives: Anxiety disorder is among the most prevalent mental illnesses among adolescents. Early detection and proper treatment are important for preventing sequelae such as suicide and substance use disorder. Studies have suggested that sleep duration is associated with anxiety disorder in adolescents. In the present study, we investigated the association between sleep quality and anxiety in a nationally representative sample of Korean adolescents. Methods: This cross-sectional study was conducted using data from the 2020 Korea Youth Risk Behavior Web-based Survey. The Generalized Anxiety Disorder-7 questionnaire was used to evaluate anxiety. The chi-square test was used to investigate and compare the general characteristics of the study population, and multiple logistic regression analysis was used to analyze the relationship between sleep quality and anxiety. Results: In both sexes, anxiety was highly prevalent in participants with poor sleep quality (adjusted odds ratio [aOR], 1.56; 95% confidence interval [CI], 1.43 to 1.71 in boys; aOR, 1.30; 95% CI, 1.19 to 1.42 in girls). Regardless of sleep duration, participants with poor sleep quality showed a high aOR for anxiety. Conclusions: This study identified a consistent relationship between sleep quality and anxiety in Korean adolescents regardless of sleep duration.

• 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.

• Korean Journal of Psychosomatic Medicine
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• v.18 no.1
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• pp.30-39
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• 2010

Objectives：Assessment of sleep disturbance is an essential part of the diagnostic criteria used for several psychiatric disorders. Change in sleep patterns over time may indicate response to treatment. In clinical practice, sleep is usually evaluated subjectively by patient self-report. This study was aimed to compare subjective sleep assessment with objective sleep measurement by actigraphy in psychiatric inpatients. Methods：A total of 32 psychiatric inpatients were studied. Patients were asked to wear a wrist actigraphy for three consecutive days and nights and to fill out a sleep log each morning. The severity of depression and anxiety was evaluated according to Beck Depression Inventory and State-Trait Anxiety Inventory on the first day of the study. The subjective level of satisfaction with quality of sleep was also evaluated according to visual analog scale. Nurses assessed sleep at one hour interval between 10:00 PM and 6:00 AM for three consecutive nights. Results：There was statistically significant difference of sleep latency between patient's sleep log and acti-graphic measurement. Nursing reports were more consistent with actigraphic measurement than sleep log. Interestingly, subjectively poor sleepers show no significant difference in sleep parameters compared with those of good sleepers. Subjectively poor sleepers report longer sleep latency than that of actigraphic assessment. The discrepancy between subjective and objective assessment of sleep latency was significantly correlated with scores of Beck Depression Inventory and State-Trait Anxiety Inventory. Conclusion：These results show that there are discrepancies between subjective and objective assessment of sleep. The discrepancy of sleep assessment could be influenced by severe depression and anxiety. Especially objective sleep measurement is needed to assess sleep in psychiatric inpatients with severe depression or anxiety and the subjectively poor sleepers for more reliable measurements.

• Journal of Oral Medicine and Pain
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• v.41 no.4
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• pp.188-194
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• 2016

Purpose: Burning mouth syndrome (BMS) is ambiguous and enigmatic oral condition. Sleep disturbance is one of the most prevalent complaints of patients with chronic pain. The aim of this study was to estimate general sleep characteristics and propensity in patients with BMS. Methods: A total of thirty BMS patients and thirty healthy control subjects were investigated. Self-reported measures of sleep quality were conducted using two widely used methods; the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Data were analyzed with one-way ANOVA, chi-square, Fisher's exact test, Kruskal-Wallis test, Holm method with 95% confidence interval and p<0.05 significant level. Results: BMS patients showed more poor sleepers than those in control subjects in both ESS and PSQI test. BMS patients also showed statistically significant poorer sleep quality compared with control subjects in both test. When BMS group were divided into three groups on the basis of numeric rating scale, the higher score subjects had, the more mean rank they had in the PSQI. Conclusions: BMS patients showed up poor sleep characteristics and propensity than control group, and they also showed the more severe the pain was, the worse the sleep quality was.

• Safety and Health at Work
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• v.10 no.1
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• pp.30-38
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• 2019

Background: Police officers' stress perception, frequency of stressful events (stressors), and police work characteristics may contribute to poor sleep quality through different mechanisms. Methods: We investigated associations of stress severity (measured by stress rating score) and frequency of stressors with sleep quality and examined the influence of police work characteristics including workload, police rank, prior military experience, and shift work on the associations. Participants were 356 police officers (256 men and 100 women) enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress Study from 2004 to 2009. A mean stress rating score and mean frequency of stressors occurring in the past month were computed for each participant from the Spielberger Police Stress Survey data. Sleep quality was assessed using the global score derived from the Pittsburgh Sleep Quality Index survey. Linear associations of the stress rating score and frequency of stressors with sleep quality (Pittsburgh Sleep Quality Index global score) were tested. Age, sex, race/ethnicity, and smoking status were selected as potential confounders. Results: The stress rating score was positively and independently associated with poor sleep quality (${\beta}=0.17$, p = 0.002). Only workload significantly modified this association (${\beta}=0.23$, p = 0.001 for high workload group; p-interaction = 0.109). The frequency of stressors was positively and independently associated with poor sleep quality (${\beta}=0.13$, p = 0.025). Only police rank significantly modified the association (${\beta}=0.007$, p = 0.004 for detectives/other executives; p-interaction = 0.076). Conclusion: Both police officers' perception of stress severity and the frequency of stressors are associated with poor sleep quality. Stress coping or sleep promotion regimens may be more beneficial among police officers reporting high workloads.

• Journal of Korean Biological Nursing Science
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• v.18 no.4
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• pp.203-212
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• 2016

Purpose: The purpose of this study was to identify the sleep patterns of nursing students using self-report questionnaire and physiologic measurement, to examine the factors influencing sleep patterns in based on Spielman's model. Methods: Participants were 119 nursing students who were in the clinical practice period. Self-report questionnaires and actigraphy were used to collect the data. Data were analyzed using descriptive statistics, correlation and regression by the SPSS/WIN 21.0 programs. Results: When sleep was measured by self-report questionnaire, 84 students (70.6%) showed poor sleep quality. The mean sleep efficiency was 82.6%, and 67 students(56.3%) showed low sleep efficiency (less than 85.0%). The factors affecting subjective sleep pattern measured by KMLSEQ were circadian sleep type (${\beta}=.28$, ${\rho}=.003$) and alcohol (${\beta}=.20$, ${\rho}=.031$). The factors affecting total sleep time were sedentary behavior (${\beta}=-.27$, ${\rho}=.003$) and daytime sleepiness (${\beta}=-.33$, ${\rho}$<.001). Conclusion: Many nursing students in their clinical practice period expressed sleep disturbance. Factors affecting the perceived sleep measured by the self-report questionnaire and objective sleep evaluated by physiologic measures were different. The evening type of students perceived poor sleep quality, however, sedentary life style and daytime sleepiness resulted in short sleep time. Therefore, more studies measuring the objective sleep characteristics are needed using subjective and objective characteristics.

• Sleep Medicine and Psychophysiology
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• v.2 no.2
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• pp.171-179
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• 1995

Objectives : This study was carried out to determine whether the state anxiety may affect sleep on the night before surgery. Methods : The researcher examined the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day and then had semistructural interview with patients. In addition Spielberger's State Anxiety Inventory(1972), presleep questionnaire and postsleep questionnaire were administered to the patients. One hundred patients who responded to the questions were divided into three groups based on the state anxiety scores; low(n=35), middle(n=27) and high(n=38). Demographic and clinical characteristics of patients, some possible factors affecting sleep, daytime status and nighttime sleep before surgery were compared among three groups. Results : 1) There was no significant difference in demographic characteristics and some possible factors affecting sleep on the night before surgery among three groups. 2) In terms of clinical characteristics, the expectancy of surgical result was significantly different among three groups. More patients in low anxiety group than in middle and high anxiety groups, predicted surgical results as good, while more patients in middle and high anxiety groups than in low anxiety group could not predict their surgical results. 3) For daytime status, high anxiety group felt more tired compared to low anxiety group, but there was no significant difference in daytime nap among three groups. 4) For nighttime sleep before surgery, high anxiety group expected poor sleep and in fact, waked more frequently during sleep than low anxiety group. However there was no difference in bed time, sleep latency, rise time, total sleep time, sleep depth and sleep quality among three groups. 5) The need for hypnotics was higher before bedtime and also after rise in high anxiety group compared to low anxiety group. Conclusions : These results indicate that the individuals with high state anxiety before surgery have poor sleep and furthermore suggest that anxiolytics and/or hypnotics may be required to decrease anxiety and improve sleep for those with high state anxiety.

• Korean Journal of Adult Nursing
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• v.29 no.1
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• pp.87-97
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• 2017

Purpose: The purpose of this study was to investigate the relationship among sleep quality, heart rate variability (HRV), fatigue, depression, and anxiety reported by Korean adults. Methods: A cross-sectional study of 208 adults aged 20~60 years was conducted using a short-term HRV analysis and self-reported questionnaires of Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale, Beck Depression Inventory, and State Trait Anxiety Inventory. Results: Subjects with good sleep quality (PSQI $score{\leq}5$) had higher HRV total power (t=2.03, p=.043) and high-frequency (t=2.04, p=.043) with lower fatigue (t=-4.08, p<.001), depressive mood (t=-3.66, p<.001), and trait anxiety (t=-3.84, p<.001) than subjects with poor sleep quality. Poor sleep quality was negatively correlated with HRV total power (r=-.17, p=.016), high-frequency (r=-.14, p=.049), and positively fatigue (r=.39, p<.001), depression (r=.44, p<.001), state anxiety (r=.23, p=.001) and trait anxiety (r=.34, p<.001). Conclusion: The results indicated that sleep quality is correlated with HRV which reflects the activities of the autonomic nerve system, fatigue, depression, and anxiety in adults.

• Sleep Medicine and Psychophysiology
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• v.7 no.2
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• pp.79-83
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• 2000

Sleep disturbances are frequently associated with neurological disorders. Sleep disorders interfere with rehabilitation of patients with neurological disorders such as stroke and may increase the severity of their symptoms and recurrence rate of stroke. The treatment of sleep apnea syndrome is particularly important in managing patients with cerebral infarction of whom 50-80% have moderate to severe sleep apnea. Sleep apnea produces not only poor quality sleep but also excessive daytime sleepiness, fatigue and lack of energy. Sleep problems frequently found in patients with dementia are sleep-wake cycle abnormality, fragmentation of sleep, nocturnal insomnia, decreased slow wave sleep and REM sleep, and sleep disordered breathing. The management of sleep disturbances is very important for controlling symptoms such as nocturnal wandering and sundowning syndrome in patients with dementia. Parkinson's disease and epilepsy are other neurological disorders that may have sleep disturbances.