• Sleep Medicine and Psychophysiology
• /
• v.1 no.2
• /
• pp.172-181
• /
• 1994

Obstructive sleep apnea syndrome(OSAS) is most frequently diagnosed in the sleep laboratories and its severity is objectively estimated. In terms of treatment, the most prevalent method is the continuous positive airway pressure(CPAP) application as of now. However, in Korea, CPAP is still not sufficiently known and it is attributable to the fact that sleep study facilities have not been popularized. In this article, the authors present their own experience with CPAP in nine subjects with OSAS. In this study, CPAP was found to decrease stage 1 sleep and to increase stage 2 sleep, with increasing mean oxygen saturation and decreasing lowest oxygen saturation during nocturnal sleep. Also, it tended to increase sleep continuity and generally to improve sleep architecture. Rebound slow wave and/or REM sleep stages during CPAP were also noted in 8 out of 9 cases. The authors suggest that CPAP should be considered as the primary mode of treatment for patients with obstructive sleep apnea syndrome and related educational programs for physicians should be developed and provided by sleep specialists.

• Sleep Medicine and Psychophysiology
• /
• v.17 no.1
• /
• pp.41-49
• /
• 2010

Unlike the case of adult obstructive sleep apnea syndrome (OSAS), there was no consistent finding on the changes of sleep architecture in childhood OSAS. Further understanding of the sleep electroencephalogram (EEG) should be needed. Non-linear analysis of EEG is particularly useful in giving us a new perspective and in understanding the brain system. The objective of the current study is to compare the sleep architecture and the scaling exponent (${\alpha}$) from detrended fluctuation analysis (DFA) on sleep EEG between OSAS and normal children. Fifteen normal children (8 boys/7 girls, 6.0${\pm}4.3$2.2 years old) and twelve OSAS children (10 boys/2 girls, 6.4${\pm}4.3$3.4 years old) were studied with polysomnography (PSG). Sleep-related variables and OSAS severity indices were obtained. Scaling exponent of DFA were calculated from the EEG channels (C3/A2, C4/A1, O1/A2, and O2/A1), and compared between normal and OSAS children. No difference in sleep architecture was found between OSAS and normal controls except stage 1 sleep (%) and REM sleep latency (min). Stage 1 sleep (%) was significantly higher and REM latency was longer in OSAS group (9.3${\pm}4.3$4.3%, 181.5${\pm}4.3$59.9 min) than in controls (5.6${\pm}4.3$2.8%, 133.5${\pm}4.3$42.0 min). Scaling exponent (${\alpha}$) showed that sleep EEG of OSAS children also followed the 'longrange temporal correlation' characteristics. Value of ${\alpha}$ increased as sleep stages increased from stage 1 to stage 4. Value of ${\alpha}$ from C3/A2, C4/A1, O1/A2, O2/A1 were significantly lower in OSAS than in control (1.36${\pm}4.3$0.05 vs. 1.41${\pm}4.3$0.04, 1.37${\pm}4.3$0.04 vs. 1.41${\pm}4.3$0.04, 1.37${\pm}4.3$0.05 vs. 1.41${\pm}4.3$0.05, and 1.36${\pm}4.3$0.07 vs. 1.41${\pm}4.3$0.05, p<0.05). Higher stage 1 sleep (%) in OSAS children was consistent finding with OSAS adults. Lower $'{\alpha}'$ in OSAS children suggests decrease of self-organized criticality or the decreased piling-up energy of brain system during sleep in OSAS children.

• The Journal of Internal Korean Medicine
• /
• v.43 no.3
• /
• pp.436-443
• /
• 2022

Objectives: This study examined the case of a 69-year-old man with a history of stroke and Alzheimer's disease who had been diagnosed with probable-rapid eye movement sleep behavior disorder (probable-RBD). Methods: The patient was treated with herbal medicine (Ukgan-san, Ukgansangayonggolmoryeo-tang, and powdered Gamisoyo-san extract), Western medicine (clonazepam, antiplatelet, psychotropic agents, antihypertensive drugs, and others), and acupuncture. Their effects were evaluated by the frequency and severity of sleep-related behavioral symptoms. Results: After treatment, the observed frequency and severity of sleep-related behavior decreased. Conclusion: The results suggest that using traditional Korean medicine with clonazepam can be effective in the treatment of patients with probable-RBD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.4 no.1
• /
• pp.173-178
• /
• 1993

Narcolepsy's age at onset is reported to be relatively homogeneous, occuring usually after the onset of puberty, although most cases are diagnosed when the patients are in their late teens to late 20s. It is very unusual for a patient to develop narcolepsy before 15 years of age or after 30 years of age. A 11-year old boy who has developed excessive daytime sleepiness since age of 7 and has all the four major features of narcolepsy by the time of evaluation is presented. On polysomnographic examination, the patient showed two sleep onset REM periods in the three latency test of the multiple sleep latency test and the nocturnal polysomnogram. In addition, the findings of typing HLA class I and II of the patient's family are presented. Reports of pediatric narcolepsy previously reported are reviewed.

• PNF and Movement
• /
• v.6 no.3
• /
• pp.19-28
• /
• 2008

Purpose : The objective of this study was to determine efficacy of sleep-dependent motor learning. Methods : This is a literature study with books and internet. We searched the PubMed, Science Direct, KISS and DBpia. Key words were Sleep-dependent, motor learning, RAM and LTP. Results : Procedural memory, like declarative memory, undergoes a slow, time-dependent period of consolidation. A process has recently been described wherein performance on some procedural task improves with the mere passage of time and has been termed "enhancement". Some studies have reported that the consolidation/enhancement of perceptual and motor skill is dependent on sleep. Specially, rapid-eye-movement(REM) sleep seems to benefit procedural aspects of memory. Conclusion : Motor learning is very important for CNS injury patients. And also distribution of practice sessions is important because REM sleep is to benefit procedural aspects of memory consolidation.

• Sleep Medicine and Psychophysiology
• /
• v.5 no.1
• /
• pp.111-117
• /
• 1998

Objectives : 'First-night effect' has been a well-known concept since 1960's. It is important because it is one of the major factors to be considered in assessing the reliability of polysomnographic data. However, 'reverse first-night effect' has also been described, resulting in the inconsistency of conceptualization. We attempted to investigate on the first-night effect in adults by having each of them take two nights of polysomnography in a controlled environment. Young healthy adult volunteers were chosen as subjects in order to rule out age- or health-related confounders. Methods : Polysomnography was performed on eight male medical students (mean $age=23.5\;{\pm}\;0.9$) for two nights with Grass model 78 polysomnograph. We scored manually under the standard protocol each epoch of the sleep records. Sleep variables were obtained and compared between the two nights. Results : Sleep period time(SPT) and total sleep time(TST) of the third fraction of night were significantly longer on the first night than on the second night (p<0.05). However, other sleep variables such as percentage of each sleep stage, sleep latency, REM sleep latency, number of waking, and sleep efficiency were not different between the two nights. Conclusion : We could not confirm the existence of first-night effect in this study. In healthy young male adults, it may not happen at all or may happen to a very negligible degree. Young healthy adults may have more adaptability to a new sleep environment. Also, the provision of a reasonably comfortable sleep environment could have helped them with abolition of first-night effect.

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

• Korean Journal of Air-Conditioning and Refrigeration Engineering
• /
• v.18 no.7
• /
• pp.535-540
• /
• 2006

This study was performed In evaluate sleep efficiencies and conditions for comfortable sleep based on the analysis of Physiological signals under variations in thermal conditions. Five female subjects who have similar life cycle and sleep patterns were participated for the sleep experiment. It was checked whether they had a good sleep before the night of experiment. EEGs were obtained from C3-A2 and C4-A1 electrode sites and EOGs were acquired from LOC (left outer canthus) and ROC (right outer canthus) for REM sleep detection. Sleep stages were classified, then TST (total sleep time), SWS (slow wave sleep) latency and SWS/TST were calculated for the evaluation of sleep efficiencies on thermal conditions. TST was defined as an amount of time from sleep stage 1 to wakeup. SWS latency was from light off time to sleep stage 3 and percentage of SWS over TST was calculated for the evaluation of sleep quality and comfort sleep under thermal conditions. As result, the condition which raise a room temperature provided comfortable sleep.

• Journal of Korean Living Environment System
• /
• v.19 no.4
• /
• pp.479-488
• /
• 2012

This study investigated the influence of the indoor CO₂concentration level on sleep quality by polysomnography(PSG). One healthy female subject was selected among several subjects based on RI(Risk Indicator) value and BMI(Body Mass Index) value to evaluate judging the risk level of obstructive sleep apnea hypopnea. To get the impact of the indoor carbon dioxide concentration to sleep quality, both CO₂concentration levels were set up using ventilating form with 700~800 ppm and 2000~3000 ppm. Other environments were controlled in the comfortable sleep scope by previous researches. To measure the sleep quality, measurements have carried on polysomnography(PSG). In conclusion, it have shown that high carbon dioxide concentration leads arousal effect about central nervous system and to sustaining dreams and excited condition by bring about REM sleep split phenomenon.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.6
• /
• pp.956-963
• /
• 2000

Backgrounds : Obstructive sleep apnea syndrome(OSA) can divided into two groups, positional(PP) and non-positional(NPP) obstructive sleep apnea syndrome, according to the body position while sleeping. In this study, we evaluated the differences of anthropometric data and polysomnographic recordings between the two types of sleep apnea syndrome. Materials : Fifty patients with OSA were divided two groups by Cartwright's criteria. The supine respiratory disturbance index (RDI) was at least two times higher than the lateral RDI in the PP group, and the supine RDI was less than twice the lateral RDI in the NPP group. This patients underwent standardized polysomnographic recordings. The anthropometric data and polysomnographic data were analyzed, statistically. Results : Of all 50 patients, 30% were found to be positional OSA. BMI was significantly higher in the PP group(p<0.05). Total sleep time was significantly longer in the PP group (350.6$\pm$28.2min, 333.3$\pm$46.0min, (p<0.05). Sleep efficiency was high in the PP group(89.6$\pm$6.4%, 85.6$\pm$9.9%, p<0.05). Deep sleep was significantly higher and light sleep was lower in the PP group than in the NPP group but no difference was observed in REM sleep between the two groups. Apnea index(AI) and RDI were significantly lower( 17.0$\pm$10.6, 28.5$\pm$13.3, p<0.05) and mean arterial oxygen saturation was higher in the PP group(92.7$\pm$1.8%. p<0.05) than in the NPP group. Conclusion : Body position during sleep has a profound effect on the frequency and severity of breathing abnormalities in OSA patients. A polysomnographic evaluation for suspected OSA patients must include monitoring of the body position. Breathing function in OSA patients can be improved by controlling their obesity and through postural therapy.