• Title/Summary/Keyword: REM수면

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Basic Neurobiological Aspect of Dream (꿈의 신경생물학적 측면의 기초)

  • Kim, Seog-Ju
    • Sleep Medicine and Psychophysiology
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    • v.16 no.2
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    • pp.49-55
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    • 2009
  • This review aims to introduce the basic neurobiological aspects of dream. There have been long debates on whether the neurobiology of rapid eye movement (REM) sleep is identical to that of dream. However, many theories on dream are based on the findings of REM sleep. Bizarre cognition and intense emotion in dream have been suggested to derive from physiological (e.g. desynchronized gamma oscillation and postsynaptic inhibition), chemical (e.g. decreased noradrenalin and serotonin, increased acetylcholine and modulation of dopamine), anatomical (e.g. deactivation of dorsolateral prefrontal cortex and activation of limbic and paralimbic areas) change in REM sleep. In addition, dream has been suggested to play its neurobiological roles. Processing of negative emotion may be one of the functions of dream. Dream is also supposed to consolidate memory, especially semantic memory. Despite a number of hypotheses and debates, the neurobiological mechanism of dream generation has not been concluded.

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Excessive Daytime Sleepiness Case Confounding with Thyrotoxicosis (과도한 주간 졸림과 탈력발작을 주소로 내원한 환자에서 발견된 갑상선 중독증)

  • Chung, Jae-Kyung;Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.18 no.1
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    • pp.40-44
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    • 2011
  • Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

Relationship among Cognition, Sleep Patterns, Salivary Melatonin Level and Sleep Disorder Inventory of Older Adults in Nursing Homes (요양시설 입소 노인에서 인지, 수면양상, 타액 멜라토닌 농도 및 수면장애행동의 관련성)

  • Shim, Haeun;Sohng, Kyeong-Yae
    • Journal of Korean Biological Nursing Science
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    • v.23 no.2
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    • pp.151-158
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    • 2021
  • Purpose: The purpose of this study was to investigate sleep quality in older adults in nursing home with objective data collection. Methods: Participants included 74 older adults in nursing homes in Korea aged 65 years or above. Data were collected using a wearable device (Fitbit), salivary melatonin level and Sleep Disorder Inventory (SDI). The Pearson correlation coefficient was calculated to examine whether there was any correlation between sleep-related variables such as Total Sleep Time (TST), Rapid Eye Movement (REM) sleep, shallow sleep, deep sleep, salivary melatonin level and SDI. Results: There were distortion of sleep structure, as TST comprised short REM sleep (15.93±5.47%), long shallow sleep (74.18±8.08%) and short deep sleep (9.89±5.03%). Also, salivary melatonin levels were low (15.06±7.77 pg/mL). Moreover, we found than melatonin was significantly associated with TST (r = .251, p= .044), REM sleep (r= .294, p= .020) and deep sleep (r= .391, p= .002). But there was no correlation between SDI and other sleeprelated variables. Conclusion: These findings highlight that insufficient sleep structure is associated with the salivary melatonin level among older adults in nursing home. We suggest developing programs to promote sleep quality of older adults in nursing homes.

Comparison of Clinical Characteristics and Polysomnographic Findings between REM Sleep Behavior Disorder with and without Associated Central Nervous System Disorders (중추신경계질환 동반 여부에 따른 렘수면 행동장애의 임상 특성과 수면다원기록소견 소견 비교)

  • Lee, Yu-Jin;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.58-63
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    • 2005
  • Objectives: REM sleep behavior disorder (RBD), characterized by excessive motor activity during REM sleep, is associated with loss of muscle atonia. In recent years, it has been reported that RBD has high co-morbidity with CNS disorders (especially, Parkinson's disease, dementia, multiple system atrophy, etc.). We aimed to assess differences in clinical and polysomnographic findings among RBD patients, depending on the presence or absence of central nervous system (CNS) disorders. Methods: The medical records and polysomnographic data of 81 patients who had been diagnosed as having RBD were reviewed. The patients were classified into two groups: associated RBD (aRBD, i.e., with a clinical history and/or brain MRI evidence of CNS disorder) and idiopathic RBD (iRBD, i.e., without a clinical history and/or brain MRI evidence of CNS disorder) groups. Twenty-one patients (25.9%) belonged to the aRBD group and 60 patients (74.1%) belonged to the iRBD group. The clinical characteristics and polysomnographic findings of the two groups were compared. Results: Periodic limb movement disorder (PLMD), i.e., PLMI (periodic limb movement index)>5, was observed more frequently in the aRBD group than in the iRBD group (p<0.001, Fisher's exact test). Also, obstructive sleep apnea syndrome (OSAS), i.e., RDI (respiratory disturbance index)>5, was found more frequently in the aRBD group (p=0.0042, Fisher's exact test). The percentages for slow wave sleep and sleep efficiency were significantly lower in the aRBD group than in the iRBD group. Conclusion: We found that 1 out of 4 RBD patients had associated CNS disorders, warranting more careful neurological evaluation and follow-up in this category of RBD. In this category of RBD patients, we also found more frequent PLMD and OSAS. These patients were also found to have lower slow wave sleep and sleep efficiency. In summary, RBD patients with associated CNS disorders suffer from more disturbed sleep than those without them.

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Effects of exercise on sleep EEG following caffeine administration (카페인 투여 후 운동이 수면에 미치는 효과)

  • 윤진환;이희혁
    • Journal of Life Science
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    • v.12 no.4
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    • pp.375-382
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    • 2002
  • The purpose of this experiment was to examine influence of acute exercise on nocturnal sleep which had been disrupted by caffeine(400mg$\times$3) thought the daytime. Six healthy young males aged 21.0$\times$0.2 yr with a history of low caffeine use. Subjects completed three conditions in a within-subject. At three conditions Sleep EEG were investigated: (1) nocturnal following quiet rest, (2) nocturnal sleep following the consumption of 1200mg of caffeine (3) nocturnal sleep following cycling at 60 min of 60% V $O_{2peak}$ with 1200mg of caffeine consumption. Sleep data were calculated for REM sleep, REM latency, sleep onset latency, sleep efficiency, sleep stages, SWS. Those data were analyzed using repeated-measures ANOVA of change scores. A main effect to, drug(caffeine) indicated that caffeine elicited sleep disturbance that is, TST and sleep onset latency increase and sleep efficiency and stage 4 decrease. The effects of exercise on sleep following caffeine intake generally improve sleep that is, stage 2, 3 and SWS increase and sleep onset latency decrease. A condition effect for sleep indicated sleep improvement after exercise Therefore The data supported a restorative theory of slow-wave sleep and suggest that acute exercise may be useful in promoting sleep and reducing sleep disturbance elevated by a high dose of caffeine.

Sleep and Panic (수면의 공황증)

  • Kim, Young-Chul
    • Sleep Medicine and Psychophysiology
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    • v.4 no.1
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    • pp.49-56
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    • 1997
  • Nocturnal panic involves sudden awakening from sleep in a state of panic characterized by various somatic sensation of sympathetic arousal and intense fear. Many(18-71%) of the spontaneous panic attacks tend to occur from a sleeping state unrelated to the situational and cognitive context. Nocturnal panickers experienced daytime panics and general somatic sensation more frequently than other panickers. Despite frequent distressing symptoms, these patients tend to exhibit little social or occupational impairment and minimal agoraphobia and have a high lifetime incidence of major depression and a good response to tricyclic antidepressants. Sleep panic attacks arise from non-REM sleep, late stage 2 or early stage 3. The pathophysiology and the similarity of nocturnal panic to sleep apnea, dream-induced anxiety attacks, night terrors, sleep paralysis, and temporal lobe epilepsy are discussed.

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Narcolepsy Variant Presented with Difficult Waking (각성장애로 발현한 기면증의 변종)

  • Lee, Hyang-Woon;Hong, Seung-Bong
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.115-119
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    • 2000
  • Objectives Summary: A 20-year-old man was presented with a history of difficult waking for 10 years. He suffered from morning headache, chronic fatigue and mild daytime sleepiness but had no history of irresistible sleep attack, cataplexy, hypnagogic hallucination or sleep paralysis. Methods: Night polysomnography (PSG), multiple sleep latency test (MSLT) and HLA-typing were carried out. Results: The PSG showed short sleep latency (4.0 min) and REM latency (2.5 min), increased arousal index (15.7/hour), periodic limb movements during sleep (PLMS index=8.1/hr) with movement arousal index 2.1/hr and normal sleep efficiency (97.5%). The MSLT revealed normal sleep latency (15 min 21 sec) and 4 times sleep-onset REM (SOREM). HLA-typing showed DQ6- positive, that corresponded at the genomic level to the subregion DQB1*0601, which was different from the usual locus in narcolepsy patients (DQB1*0602 and DQA1*0102). Conclusion: Differential diagnosis should be made with circadian rhythm disorder and other causes of primary waking disorder. The possibility of a variant type of narcolepsy could be suggested with an unusual clinical manifestation and a new genetic marker.

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Review about effects of sleep disturbances on Burning mouth syndrome (수면장애가 구강작열감 증후군에 미치는 영향에 대한 고찰)

  • Lim, Hyun-Dae;Lee, You-Mee
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.313-318
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    • 2013
  • The aim of this study was to the relationship between sleep disturbances and Burning mouth syndrome(BMS). BMS presents as a chronic burning sensation in the oral mucous membrane that is frequently associated with sleep disturbances. BMS is considered neuropathic pain condition with dysfunction of small diameter afferent sensory fiber. A review of the studies reveals, BMS suggested peripheral and cental nervous system changes. Sleep disruption or Rem sleep deprivation cause an inhibition of opioid protein synthesis and a reduced affinity of ${\mu}$ and ${\delta}$ opioid receptors. Let me say that sleep disturbances suggest a risk factor For BMS and support to evaluate as a part of BMS treatment. Further study will be required to ascertain the relationship between distruption of sleep continuity or Rem sleep deprivation and BMS and the evidence of altered neurochemical degeneration of BMS.

Improvement of Sleep Environment using Intelligent Context Awareness System (지능형 상황인식 시스템을 통한 수면 환경 개선)

  • Shin, Seong-Yoon;Baek, Jung-Uk;Rhee, Yang-Won
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2010.07a
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    • pp.129-132
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    • 2010
  • 작금의 현대 사회 사람들은 바쁜 일상생활로 인해 짧아진 수면과 불면증 등의 각종 수면장애를 겪고 있으며, 여러 가지의 요소로 인하여 수면의 방해를 받게 되면, 여러 질병 및 생활 장애를 겪을 수 있어 수면의 중요성은 날로 주목받고 있다. 본 논문에서는 수면을 이루는 침실의 수면 환경 데이터를 수집하여 얻어진 조건 데이터들과 수면간의 관계를 분석하고 이를 바탕으로 시뮬레이션 모델을 추출하여 개개인에 따른 최적의 환경을 제공할 수 있다. 따라서 수면 과정에 따라 신체의 감각 및 자극에 대한 반응을 알고, 사람의 신체 상황에 따른 차이점 및 안정적인 패턴 및 조건을 정의하며 수면 패턴을 분석 및 솔루션 제공을 할 수 있다. 또한 차후에는 수면의 특정 상황만 아니라 식사, 출근, 등과 같은 유기적인 생활(유비쿼터스 환경)의 한 부분에도 상황에 따른 적절한 실내 환경 변화를 제공해주어서 좀 더 쾌적한 일상생활을 영위할 수 있도록 도움을 주게 되는 측면으로 확대 하려한다.

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