• 제목/요약/키워드: Rem

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렘수면행동장애와 악몽 (REM Sleep Behavior Disorder and Nightmares)

  • 윤인영
    • 수면정신생리
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    • 제2권1호
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    • pp.3-12
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    • 1995
  • In the International Classification of Sleep Disorders(ICSD), REM sleep behavior disorder(RBD) and nightmares are classified as 'parasomnias usually associated with REM sleep'. RBD can be defined as the intermittent absence of REM sleep EMG atonia and the appearance of the elaborate motor activity associated with dream mentation. Bilateral pontine tegmental lesions in cats induce RBD-like behavior, but in human cases, more than 60% are idiopathic. Polysomnograpy shows characteristic findings in REM sleep and treatment with clonazepam is highly effective. With nightmares as long, frightening dream decreasing with age, their persistence or apperance in adults is related with certain drugs, trauma, personality and psychotic episode. Psychotherapy, behavior techniques or medication is used for treatment, but all of nightmares do not require treatment.

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렘수면 의존성 수면무호흡증과 비렘수면 의존성 수면무호흡증의 특징 (The Characteristics of REM Sleep-Dependent Obstructive Sleep Apnea and NREM Sleep-Dependent Obstructive Sleep Apnea)

  • 서민철;최재원;주은정;이규영;방수영;김의중
    • 수면정신생리
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    • 제24권2호
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    • pp.106-117
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    • 2017
  • 목 적 : 폐쇄성 수면무호흡증(obstructive sleep apnea)은 수면 시 호흡을 하려고 하는 노력에도 불구하고 기도의 부분적/완전 폐색이 반복되는 수면 관련 호흡 질환이다. 일반적으로 렘수면에서 근긴장도의 저하가 나타나게 되므로 렘수면에서 수면무호흡증의 악화가 예상되지만 많은 경우에 있어 비렘수면에서의 무호흡/저호흡 지수(apnea-hypopnea index, AHI)가 렘수면에서의 AHI보다 높은 경우가 관찰되었다. 그러나 그런 현상의 분명한 이유는 밝혀져 있지 않았기에 렘/비렘수면 의존성 수면무호흡증에 대한 특징을 종합적으로 알아보고자 하였다. 방 법 : 560명의 성인 수면무호흡증 환자를 대상으로 후향적 연구를 진행하였다. 모든 환자는 렘 수면시의 AHI (REM-AHI), 비렘수면시의 AHI (NREM-AHI)의 비율에 따라 세군으로 분류하였다. 렘수면 의존성 수면무호흡증(REM sleep dependent OSA, REM-OSA)는 REM-AHI/NREMAHI > 2, 비렘수면 의존성 수면무호흡증(NREM sleep dependent OSA, NREM-OSA)는 NREM-AHI/REM-AHI > 2, 수면 단계 비의존성 수면무호흡증(Sleep stage independent OSA, IND-OSA)로 분류하였다. 수면다원검사 이외에도 주관적인 수면의 질, 낮시간 졸림, 정서와 연관된 설문지를 함께 시행하였다. 카이제곱 검정, 일원배치분산분석, 공분산분석을 시행하였다. 결 과 : 세 군 사이에서 연령의 차이는 보이지 않았다. REM-OSA는 대체로 경도의 수면무호흡증 환자가 많았고 여성의 비율이 가장 높았다. 또한 주관적인 수면의 질이 가장 저하되어 있다고 느꼈으며 기분 상태 평가 척도인 K-POMS의 점수는 가장 높았다. IND-OSA는 BMI, 목둘레(neck circumference, NC), 복부 둘레(abdominal circumfefence)가 REM-OSA에 비해 높았고 주간 졸림의 호소는 세군 중 가장 컸고, 무호흡 관련 변인의 값이 가장 높아 중증도가 심한 군이었다. 공변량을 통제하고 시행한 공분산 분석의 결과에서 NREM-OSA는 앙와위에서의 AHI가 가장 높았고 수면 중 측와위의 비율이 가장 컸다. 또한 수면 효율이 가장 떨어졌고 렘수면 잠복기가 가장 길었으며 입면 후 각성 시간의 비율이 가장 컸다. 결 론 : REM-OSA는 여성이 많고 부정적인 정서를 가장 많이 호소하는 군으로, 경도의 수면무호흡증을 가장 많이 포함하였고 IND-OSA는 중증의 수면무호흡증을 반영하였다. NREM-OSA는 자세 변화와 가장 밀접한 관련은 지니고 있었으며 수면 효율이 가장 떨어졌다. 세 군의 수면무호흡증이 일련의 중중도 차이만이 아닌 또 다른 특성을 반영하는 것으로 보이고 이를 통해 폐쇄성 수면무호흡증의 이해를 넓힐 수 있을 것이다.

Do Earnings Manipulations Matter Differently in Different Markets of China? Cost of Capital Consequences

  • Sohn, Byungcherl Charlie;Shim, Hoshik
    • Asia Pacific Journal of Business Review
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    • 제4권1호
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    • pp.1-34
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    • 2019
  • This study investigates whether and how a firm's cost of equity capital is influenced by the extent of a firm's real earnings management (REM). Using a large sample of Hong Kong and Chinese firms over the 9-year period 2009-2017, we find that our implied cost of equity estimates are positively associated with both the extent of REM and the extent of accrual-based earnings management (AEM), but the positive association is stronger for REM than for AEM. We also provide evidence suggesting that the effect of AEM and REM on the cost of equity is more pronounced for Hong Kong firms than Chinese firms, and within Chinese firms, it is less pronounced for the state-owned enterprises (SOEs). Collectively, our results suggest that while both REM and AEM exacerbate the quality of earnings used by outside investors, REM does so to a greater extent than AEM, and thus the market demands a higher risk premium for REM activities than for AEM activities and that this cost of capital-increase effect is more prominent in a developed market like Hong Kong and mitigated by state ownership in China because of investors' expectations for a lower level of detriments to firm fundamentals by REM due to government's protection in a less developed market like China.

렘수면 행동장애 유사 수면장애에 대한 고찰 (A Review on Sleep Disorders Similar to REM Sleep Behavior Disorder)

  • 이은영;송지혜;배희원;최하연
    • 수면정신생리
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    • 제29권2호
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    • pp.35-39
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    • 2022
  • 렘수면 행동장애는 렘수면에서 과도한 근전도 활동과 관련된 불쾌한 꿈과 격렬한 행동이 특징인 사건수면이다. 이는 특발성으로 나타날 수 있고, 다른 신경학적 또는 의학적 상태에 이차적으로 나타날 수 있는 등 여러 이질적인 기저 질환이 있을 수 있다. 특발성으로 나타나는 렘수면 행동장애는 대부분 시누클레인 병증으로 인한 신경퇴행성 질환이 나타날 가능성을 의미하므로, 정확한 진단이 예후를 예측하는데 중요하다. 렘수면 행동장애의 진단을 위해서는 수면다원검사에서 나타나는 무긴장증이 없는 렘수면이 필수적이다. 노인 환자에서 수면 중 꿈을 꾸면서 행동을 보이는 질환으로는 폐쇄성 수면 무호흡증, 외상 관련 수면 장애, 수면 중 격렬한 주기적인 다리 운동 등이 알려져 있다. 렘수면 행동장애를 모방할 수 있는 다른 수면장애가 동반되어 나타날 수 있음을 고려하여 신중한 병력 청취와 수면다원검사 등을 이용하여 수면장애의 감별 진단 및 치료가 중요하겠다.

Linalool Ameliorates Memory Loss and Behavioral Impairment Induced by REM-Sleep Deprivation through the Serotonergic Pathway

  • Lee, Bo Kyung;Jung, An Na;Jung, Yi-Sook
    • Biomolecules & Therapeutics
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    • 제26권4호
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    • pp.368-373
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    • 2018
  • Rapid eye movement (REM) sleep has an essential role in the process of learning and memory in the hippocampus. It has been reported that linalool, a major component of Lavandula angustifolia, has antioxidant, anti-inflammatory, and neuroprotective effects, along with other effects. However, the effect of linalool on the cognitive impairment and behavioral alterations that are induced by REM-sleep deprivation has not yet been elucidated. Several studies have reported that REM-sleep deprivation-induced memory deficits provide a well-known model of behavioral alterations. In the present study, we examined whether linalool elicited an anti-stress effect, reversing the behavioral alterations observed following REM-sleep deprivation in mice. Furthermore, we investigated the underlying mechanism of the effect of linalool. Spatial memory and learning memory were assessed through Y maze and passive avoidance tests, respectively, and the forced swimming test was used to evaluate anti-stress activity. The mechanisms through which linalool improves memory loss and behavioral alterations in sleep-deprived mice appeared to be through an increase in the serotonin levels. Linalool significantly ameliorated the spatial and learning memory deficits, and stress activity observed in sleep-deprived animals. Moreover, linalool led to serotonin release, and cortisol level reduction. Our findings suggest that linalool has beneficial effects on the memory loss and behavioral alterations induced by REM-sleep deprivation through the regulation of serotonin levels.

PVDF 필름 기반 센서를 이용한 정상인 및 폐쇄성 수면 무호흡증 환자에서의 무구속적인 렘 수면 모니터링 (Unconstrained REM Sleep Monitoring Using Polyvinylidene Fluoride Film-Based Sensor in the Normal and the Obstructive Sleep Apnea Patients)

  • 황수환;윤희남;정다운;서상원;이유진;정도언;박광석
    • 대한의용생체공학회:의공학회지
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    • 제35권3호
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    • pp.55-61
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    • 2014
  • In sleep monitoring system, polysomnography (PSG) is the gold-standard but previous studies revealed that attaching numerous amount of sensors disturb sleep during the test which is the fundamental disadvantage of PSG. We suggest an unconstrained rapid-eye-movement (REM) sleep monitoring method measured with polyvinylidene (PVDF) film-based sensor for the normal and the obstructive sleep apnea (OSA) patients. Nine normal subjects and seventeen OSA patients have participated in the study. During REM sleep, rate and variability of respiration are known to be greater than in other sleep stages. Based on this phenomena, respiratory signals of participants were unconstrainedly measured using the PVDF-based sensor with the PSG and REM sleep were extracted from the average rate and variability of respiration. In epoch-by-epoch REM sleep detection, proposed method classified REM sleep with an average sensitivity of 72.3%, specificity of 92.5%, accuracy of 88.9%, and kappa statistic of 0.60 compared to the results of PSG. Student's t-test showed no significant difference between the results of normal and OSA group. This method is potentially applicable to REM sleep detection in homing environment or ambulatory monitoring.

Kleine-Levin Syndrome의 수면 다원 검사 소견 (Polysomnographic Findings in Kleine-Levin Syndrome)

  • 이성훈
    • 수면정신생리
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    • 제3권1호
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    • pp.79-84
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    • 1996
  • Kleine-Levin syndrome is a disorder characterized by recurrent episodes of hypersomnia, hyperphagia and hypersexuality that typically occur weeks or months apart. A 17-years-old male showed these episodes and took nocturnal polysomnography(NPSG) and multiple sleep latency test(MSLT). As results of NPSG, sleep latency was 82.5min, sleep efficiency was 82.5min, sleep efficiency was 82.5%, latency and percentage of REM sleep were 106.5min and 14.6% and percentage of slow wave sleep was 12.7%. In 4 times MLST, average of sleep latency and REM latency were 8min 7sec and 5min 20sec with 3 times sleep onset REM period(SOREMP). These findings are consistent with these of Keine-Levin syndrome. And the possible causes and classification of this syndrome were discussed.

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2014 베니스 비엔날레 건축전에 나타난 환유적 리얼리즘 (The Metonymic Realism of the 2014 Venice Biennale of Architecture)

  • 박영태
    • 한국실내디자인학회논문집
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    • 제25권1호
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    • pp.13-23
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    • 2016
  • 2014 Venice Biennale of Architecture, presented by general director Rem Koolhaas, has shown the distinct difference between his present displays and past displays. Under the theme of FUNDAMENTALS and ABSORBING MODERNITY, Rem Koolhaas has developed his own unique way which is a research-oriented display technique to explain the difference at the exhibition. The purpose of this study is to define a research-oriented display technique as realism rhetoric for the opened dialectic and identify its aspect of a methodic approach. This report investigated not only Rem Koolhaas's thought and theoretical approach through his work but also the comparison of between his present and past displays. His display is based on the constellation of Central Pavilion, National Pavilions, and Arsenale display and reflected the reality of architecture in self-deception through the metonymical interaction of various facts and records. Rem Koolhaas called it the composition of contradiction. In his work, the spatial situation which is the present has been made with the intervention of historical events and has revived the reality of architecture. Also, the present is a montage of the strict control of architecture, the isolation from the architecture itself, and the autonomic communication with other fields. Finally, as a result of his work, Rem Koolhaas has shown that his display is not the end of phase but a phase of creation.

수면다원기록(睡眠多元記錄)으로 확인(確認)된 급속수구운동수면(急速眼球運動睡眠) 행동장애(行動障碍) 1례(例) (A Case of REM Sleep Behavior Disorder Confirmed with Polysomnography)

  • 정도언;윤인영
    • 수면정신생리
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    • 제1권1호
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    • pp.99-106
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    • 1994
  • The authors report a case of REM sleep behavior disorder which occurred in a 69-year-old business man. He began experiencing episodic "acting out" behavior of his dream at the age of 66. The episodes tended to be associated with dream contents, mainly being chased or threatened. Before that, his sleep was relatively quiet despite occasional nightmares, midsleep arousal, and shallowness. Injuries resulted from leaping out of bed, jumping onto furnitures, and grabbing and biting the spouse's arm. Most recent dream-incurred laceration of chin required 5 sutures. Medical and psychiatric history revealed no significant findings except that he had been overanxious all his life within himself with others' reputation of himself as pleasant and easy-going. A nocturnal polysomnogram showed repeatedly intermittent increase of chin and/or leg muscle tones during otherwise characteristic REM sleep period. The overnight video recording revealed head lifting and limb movements during REM sleep periods. Brain MRI and EEG were normal. Job-related stress was presumed to be an etiological possibility. Clonazepam 0.25-0.5mg nightly almost completely relieved the symptoms.

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REM 수면 의존성 폐쇄성 수면무호흡증후군 1례 (A Case of REM-Dependent Obstructive Sleep Apnea Syndrome)

  • 이주영;정도언
    • 수면정신생리
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    • 제12권1호
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    • pp.68-71
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    • 2005
  • 저자들은 렘수면에서만 주로 발생한 폐쇄성 수면무호흡증 1례를 경험하고 이를 보고하면서 그 의미를 고찰하고자 하였다. 증례는 55세 여자 환자였으며 수면클리닉에 와서 만성불면증을 호소하였다. 야간수면다원검사에서 호흡장애지수는 13.8, 혈중산소포화도가 90% 미만인 시간은 5.0%로 전반적으로는 경한 정도의 폐쇄성 수면무호흡증 소견을 보였다. 그러나 흥미롭게도 무호흡과 산소포화도저하가 주로 렘수면에서만 나타났고 렘수면단계에서만 산출한 호흡장애지수는 38.1, 그리고 혈중산소포화도의 저하소견도 더 심해져 90% 미만에 해당하는 시간의 비율이 13.9%로 중증의 수면무호흡증에 해당되었다. 이 증례에서 얻는 교훈은 다음과 같다. 첫째, 만성불면증의 일부에서는 폐쇄성 수면무호흡증을 앓고 있으며 야간수면 다원검사 없이는 단순한 불면증으로 오진할 가능성이 있다는 것이다. 둘째, 치료적 측면에서 렘수면 의존성인 폐쇄성수면무호흡증의 치료는 여러 수면단계에 걸쳐 나타나는 무호흡증의 치료와 달리 약물학적 치료, 특히 렘수면에 관여하는 약물을 이용한 치료법 개발의 좋은 모델이 될 가능성이 있다.

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