• 수면정신생리
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• 제9권1호
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• pp.9-13
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• 2002

Alzheimer's disease (AD) is one of the most common and devastating dementing disorders of old age. Most AD patients showed significant alternation of sleep structure as well as cognitive deficit. Typical findings of sleep architecture in AD patients include lower sleep efficiency, higher stage 1 percentage, and greater frequency of arousals. The slowing of EEG activity is also noted. Abnormalities in REM sleep are of particular interest in AD because the cholinergic system is related to both REM sleep and AD. Several parameters representing REM sleep structure such as REM latency, the amount of REM sleep, and REM density are change in patients with AD. Especially, measurements of EEG slowing during tonic REM sleep can be used as an EEG marker for early detection of possible AD. In addition, a structural defect in the suprachiasmatic nucleus is suggested to cause various chronobiological alternations in AD. Most of alternations related to sleep make sleep disturbances common and disruptive symptoms of AD. In this article, the author reviewed the alternation of sleep structure and circadian rhythm in AD patients.

• Journal of mucopolysaccharidosis and rare diseases
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• 제1권2호
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• pp.35-39
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• 2015

Sleep problems occur frequently among patients with Prader-Willi syndrome (PWS). The most common problem is excessive daytime sleepiness (EDS) that are closely related to of sleep-related breathing disorder (SRBD) such as obstructive sleep apnea (OSA) and congenital hypoventilation syndrome. Obesity, craniofacial dysmorphism and muscular hypotonia of patients with PWS may increase the risk of SRBD. Sleep apneas can interrupt the continuity of sleep, and these disruptions result in a decrease in both the quality and quantity of sleep. In addition to SRBD, other sleep disorders have been reported, such as hypersomnia, a primary abnormality of the rapid eye movement (REM) sleep and narcolepsy traits at sleep onset REM sleep. Patients with PWS have intrinsic abnormalities of sleep-wake cycles due to hypothalamic dysfunction. The treatment of EDS and other sleep disorders in PWS are similar to standard treatments. Correction of sleep hygiene such as sufficient amount of sleep, maintenance of regular sleep-wake rhythm, and planned naps are important. After comprehensive evaluation of sleep disturbances, CPAP or surgery should be recommended for treatment of SRBD. Remaining EDS or narcolepsy-like syndrome are controlled by stimulant medication. Bright light therapy might be beneficial for disturbed circadian sleep-wake rhythm caused by hypothalamic dysfunction.

• 수면정신생리
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• 제19권2호
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• pp.59-62
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• 2012

Borderline personality disorder (BPD) is characterized by identity and interpersonal problem, affective dysregulation and pervasive severe impulsivity. Although sleep disturbances are not primary symptoms of BPD, they are important aspects of this disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of BPD yet. Measured by nocturnal polysomnography, increased sleep latency as well as reduced total sleep time and sleep efficiency, and 'depression-like' REM abnormalities (i.e., reduced REM latency and increased REM density) are found in BPD patients. Co-morbid sleep disorders such as chronic insomnia, nightmare disorder or circadian rhythm sleep disorder associated with BPD have been reported. Clinicians should focus on the sleep complaints of BPD patients, and carefully manage such symptoms with sleep hygiene education, cognitive psychotherapy or light therapy.

• Tuberculosis and Respiratory Diseases
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• 제48권6호
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• pp.956-963
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• 2000

연구배경 : 폐쇄성 수면 무호흡증 환자 중 수평와위보다 측와위에서 호흡장애의 정도가 호전되는 체위성 폐쇄성 수면 무호흡증 환자의 신체계측인자와 수면단계 및 수면구조의 특성, 그리고 동맥혈산소포화도의 차이를 수면다원검사를 통하여 확인하고자 하였다. 대상 및 방법 : 1996년부터 1998년까지 수면장애로 영남대학병원에서 수면다원검사를 실시하여 폐쇄성 수면 무호흡증으로 진단된 환자 중 20세 이상으로 체질량지수(BMI) 20 이상, 호흡장애지수(RDI) 10 이상, 수평와위와 측와위로 각각 30분 이상 수면을 취했던 환자 50명을 대상으로 하였다. Cartwright 등의 기준에 따라 체위성, 비체위성 수면 무호흡증으로 구분하였다. 수면 다원 검사와 동맥혈 산소포도를 측정하였고 자동 체위감지 장치와 전문검사자의 관찰로 환자의 체위를 확인하였다. 결과 : 체위성 폐쇄성 수면 무호흡증 환자는 전체 폐쇄성 수면 무호흡증 환자의 30%를 차지하였다. 이들의 신체 계측의 특징은 비체위성 무호흡증 환자와 비교할 때 몸무게는 낮은 경향이 있었고(p>0.05), 체질량지수는 낮았다(p<0.05). 체위성 폐쇄성 수면 무호흡증 환자는 수면효율이 높고(p<0.05), 총 수면시간과 깊은 수면을 나타내는 3, 4 단계의 수면지속 시간은 길었으며(p<0.05), 무호흡지수는 유의하게 낮았다(p<0.05). 또한 수면 중 평균저산소포화도 및 평균산소 포화도, 그리고 최저산소포화도는 각각 87.7%, 92.7%, 78.3%로 비체위성 무호흡증 환자보다 유의하게 높았고(p<0.05), 동맥혈 산소 불포화도 지수는 체위성 무호흡증 환자가 훨씬 낮았다(p<0.05). 결과 : 폐쇄성 수면 무호흡증 환자는 체위에 따라 수면 중 발생하는 호흡장애정도나 무호흡 빈도의 차이가 크고, 체질량지수는 이러한 체위에 따른 호흡양상의 변화에 중요한 역할을 한다. 따라서 일부 폐쇄성 수면 무호흡증 환자의 호흡장애를 개선시키기 위하여 체위치료법과 비만도 조절이 중요하며, 수면다원검사를 시행할때 체위변동 관찰과 체위변동에 따른 수면구조의 변화에 대한 평가가 반드시 필요할 것으로 생각한다.