• Dementia and Neurocognitive Disorders
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• v.16 no.3
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• pp.72-77
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• 2017

Background and Purpose Although sleep disturbances are common and considered a major burden for patients with Alzheimer's disease (AD), the fundamental mechanisms underlying the development and maintenance of sleep disturbance in AD patients have yet to be elucidated. The aim of this study was to examine the correlation between regional cerebral blood flow (rCBF) and sleep disturbance in AD patients using technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPECT). Methods A total of 140 AD patients were included in this cross-sectional study. Seventy patients were assigned to the AD with sleep loss (SL) group and the rest were assigned to the AD without SL group. SL was measured using the sleep subscale of the Neuropsychiatric Inventory. A whole-brain voxel-wise analysis of brain SPECT data was conducted to compare the rCBF between the two groups. Results The two groups did not differ in demographic characteristics, severity of dementia, general cognitive function, and neuropsychiatric symptoms, with the exception of sleep disturbances. The SPECT imaging analysis displayed decreased perfusion in the bilateral inferior frontal gyrus, bilateral temporal pole, and right precentral gyrus in the AD patients with SL group compared with the AD patients without SL group. It also revealed increased perfusion in the right precuneus, right occipital pole, and left middle occipital gyrus in the AD with SL group compared with the AD without SL group. Conclusions The AD patients who experienced sleep disturbance had notably decreased perfusion in the frontal and temporal lobes and increased rCBF in the parietal and occipital regions. The findings of this study suggest that functional alterations in these brain areas may be the underlying neural correlates of sleep disturbance in AD patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.5
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• pp.335-340
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• 2020

Objectives: This study sought to evaluate the efficacy of injecting botulinum toxin into the masseter and temporal muscles in patients with temporomandibular myofascial pain and sleep bruxism. Materials and Methods: The study was conducted based on a clinical record review of 44 patients (36 females and eight males; mean age, 35.70±12.66 years). Patients who underwent the injection of botulinum toxin into the masseter and temporal muscles for the management of temporomandibular myofascial pain and sleep bruxism were included in the study. Patients were diagnosed based on the Diagnostic Criteria for Temporomandibular Disorders. Sleep bruxism was diagnosed according to the criteria defined by the American Academy of Sleep Medicine. The values of the visual analogue scale (VAS) and range of jaw motion, including unassisted maximum mouth opening (MMO), protrusion, and right and left laterotrusion, were observed preoperatively and postoperatively at one-, three-, and six-month follow-up visits. Results: MMO, movements of the right and the left laterotrusion, and protrusion increased significantly (P<0.05), while VAS ratings decreased significantly at the three follow-up points relative to baseline values (P<0.05). Conclusion: Botulinum toxin is an effective treatment for patients with temporomandibular myofascial pain and sleep bruxism.

• Sleep Medicine and Psychophysiology
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• v.14 no.1
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• pp.20-25
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• 2007

The present study compared the actigraphic indices between both wrist actigraphies (WATGs), and the sleep estimates between each WATG and nocturnal polysomnography (NPSG) to assess their differences and consistencies. We studied 22 right-handed subjects (mean age $43.9{\pm}13.3\;years$, M：F=14：8) with untreated primary sleep disorders (primary insomnia=8, simple snorer=2, obstructive sleep apnea=12) undergone by overnight both WATGs and NPSG, simultaneously. Comparison and correlation were analyzed between right and left wrist actigraphic data. In the sleep estimates of both WATGs and NPSG, each WATG was compared and correlated with NPSG in sleep period time (SPT), total sleep time (TST), sleep latency (SL), sleep efficiency (SE) and wake time (WT). Sleep indices between both WATGs showed significant positive correlations with no correlations in SL and fragmentation index (FI). There were no differences in sleep indices between both WATGs. SPTs of both WATGs, SL of left WATG, and TST of right WATG showed positively significant correlations, and SE of right WATG did negatively significant correlation in sleep indices between each WATG and NPSG. As each WATG was compared to PSG, SPTs of both WATGs and WT of right WATG were decreased, and TST and SE of right WATG and SL of left WATG were increased. Inconsistent SL and FI between both WATGs indicate that the activities between both WATGs can differentially happen during wake or arousal. Inconsistent sleep estimates between each WATG and NPSG may indicate the limited usefulness in measuring and analyzing one-night sleep by using WATG.

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

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.77-89
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• 1996

Data collected to date indicate that sleep apnea syndrome is a risk factor in the development of cardiovascular dysfunction such as systemic hypertension, cardiac arrhythmias, pulmonary hypertension, right heart failure, angina, myocardial infarction, and stroke. Several reports suggest that untreated patients with sleep apnea syndrome have a higher long-term mortality than treated patients and than normal subjects. But there are many controversies concerning the treatment of sleep apnea syndrome, and there is no universally accepted standard for effective treatment. We reviewed the current approaches and options in the medical treatment of sleep apnea syndrome.

• Sleep Medicine and Psychophysiology
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• v.8 no.2
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• pp.129-137
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• 2001

Objectives: The purpose of this study is to investigate the effects of 38-hour sleep deprivation on fine motor performance. The Motor Performance Series (MPS) in the Vienna Test System (computerized neurocognitive function tests) was used in this study. Methods: Twenty four subjects participated in this study. Subjects had no past history of psychiatric disorders and physical illness. Subjects had normal sleep-waking cycle without current sleep disturbances and were all right-handed (Annett's Hand Preference Questionnaire: above +9 points). To minimize the learning effects, familiarization with the Vienna Test System was performed one day before the study. Subjects were to get up at 6:00 in the morning after getting enough sleep according to his or her usual sleep-wake cycle. After awakening, subjects remained awake for 38 hours under continuous surveillance. During two consecutive study days, the subjects tested MPS at 7 AM and 7 PM each day, which means the MPS was done four times in total. During the experiment, anything that could affect the subjects' sleep such as coffee, tea, alcohol, a nap, tiring sports, and all medications were prohibited. Results: In MPS, the fine motor functions of both hands decreased after 38 hours of sleep deprivation. The decrement in motor performance was prominent in the dominant right hand. In the right hand, the total number of tapping was reduced (p<.005), and the number of misses (p<.05) and the length of misses (p<.05) of line tracking, the total length of inserting a short pin (p<.01), the total length of inserting a long pin (p<.05), and the number of misses in aiming (p<.05) increased. Such performance decrement was distinct in the morning sessions. Conclusions: These results suggest that fine motor performance decrement during sleep deprivation is predominant in the right hand, which exerts maximal motor function. The finding of decrement in motor function in tapping during sleep deprivation also suggested that the time required for exhaustion of muscles is shortened during sleep deprivation. More deterioration of motor performance was shown in the morning, which could be explained as circadian rhythm effects.

• Clinical and Experimental Pediatrics
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• v.61 no.12
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• pp.392-396
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• 2018

Purpose: Adenotonsillar hypertrophy (ATH) that causes upper airway obstruction might lead to chronic hypoxemic pulmonary vasoconstriction and right ventricular (RV) dysfunction. We aimed to evaluate whether adenotonsillectomy (T&A) in children suffering from obstructive sleep apnea (OSA) due to severe ATH could improve RV function. Methods: Thirty-seven children (boy:girl=21:16; mean age, $9.52{\pm}2.20years$), who underwent T&A forsleep apnea due to ATH, were included. We analyzedthe mean pulmonary artery pressure (mPAP), the presence and the maximal velocity of tricuspid regurgitation (TR), the tricuspid annular plane systolic excursion (TAPSE), and the right ventricular myocardial performance index (RVMPI) with tissue Doppler echocardiography (TDE) by transthoracic echocardiography pre- and post-T&A. The follow-up period was $1.78{\pm}0.27years$. Results: Only the RVMPI using TDE improved after T&A ($42.18{\pm}2.03$ vs. $40{\pm}1.86$, P=0.001). The absolute value of TAPSE increased ($21.45{\pm}0.90mm$ vs. $22.30{\pm}1.10mm$, P=0.001) but there was no change in the z score of TAPSE pre- and post-T&A ($1.19{\pm}0.34$ vs. $1.24{\pm}0.30$, P=0.194). The mPAP was within normal range in children with ATH, and there was no significant difference between pre- and post-T&A ($19.6{\pm}3.40$ vs. $18.7{\pm}2.68$, P=0.052). There was no difference in the presence and the maximal velocity of TR (P=0.058). Conclusion: RVMPI using TDE could be an early parameter of RV function in children with OSA due to ATH.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.600-607
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• 2018

Objective : It has been reported in recent studies that 50-80% of patients with cervical disc hernia have concomitant sleep disorders. The aim of this study was to evaluate the quality of sleep before and after surgical treatment in patients with cervical disc hernia and to assess the effects on treatment. Methods : The study included 32 patients performed discectomy and fusion with an intervertebral cage through the right anterior cervical approach. Oswestry Disability Index (ODI), Visual Analog Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were applied to all patients preoperatively and at one month postoperatively. Results : The postoperative PSQI total points and all the PSQI subscale points, the ODI and VAS scores were significantly reduced compared to the preoperative values. A positive correlation was determined between the preoperative ODI points and the PSQI total points and sleep duration, sleep latency and daytime functional loss subscale points. A positive correlation was also found between preoperative ODI points and VAS points. A positive correlation was determined between the preoperative VAS points and and the PSQI total points and sleep duration, and sleep latency subscale points. A negative correlation was determined between the postoperative ODI and the daytime functional loss subscale points. Conclusion : The results of the study showed that in patients with cervical disc hernia, sleep quality and daytime functionality were negatively affected by severity of pain that limited daily activities. Bringing the pain under control with surgical treatment was observed to increase sleep quality. It can be concluded that when planning treatment for these patients, it should be taken into consideration that there could be a sleep disorder in addition to the complaints and symptoms such as pain, hypoestesia and loss of strength.

• Journal of Life Science
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• v.22 no.8
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• pp.1077-1084
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• 2012

This study investigated the effects of Origanum majorana essential aroma therapy on electrical activity in the brain as evaluated by an electroencephalogram (EEG). The subjects were 29 healthy female young adults, and their sleep quality was assessed by using the Pittsburgh Sleep Quality Index. EEG electrodes were attached at the frontal, temporal, occipital, and parietal lobes according to the international 10-20 system. Subjects were exposed to organic Origanum majorana essential aroma (50 ${\mu}l$) for a period of 3 minutes each before, during, and after aromatherapy. Subjects with good sleep quality showed that Origanum majorana essential aroma increased the theta power at the frontal and temporal lobes of both cerebral hemispheres, the left parietal lobe, and the right occipital lobe. Furthermore, Origanum majorana essential aroma decreased the alpha power at the left occipital lobe and the beta power at the right temporal lobe. On the other hand, subjects with poor sleep quality showed an increase in the theta power at the temporal lobe of both cerebral hemispheres and a decrease in the alpha power at the left parietal lobe by Origanum majorana essential aroma therapy. It is concluded that Origanum majorana essential aroma therapy diminishes the state of wakefulness in the brain; alpha and beta powers were both decreased in the subjects with good sleep quality, but only alpha power was decreased in the subjects with poor sleep quality. Moreover, Origanum majorana essential aroma therapy has a sleep-inducing effect in both subjects with good sleep quality and poor sleep quality.

• Sleep Medicine and Psychophysiology
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• v.4 no.2
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• pp.129-139
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• 1997

The data collected to date indicate that sleep-related breathing disorders, including sleep-disordered breathing(sleep apnea) and underlying respiratory system diseases, are one of the important risk factors for cardiovascular dysfunction. Sleep-disordered breathing(sleep apnea) is now recognized as one of the leading causes of systemic hypertension, cardiac arrhythmias, coronary heart disease, pulmonary hypertension, right heart failure, and stroke. Sleep may exert a profound effect on breathing in patients with underlying respiratory system disease including bronchopumonary diseases, chest wall abnormalities, central alveolar hypoventilation syndromes or respiratory neuromuscular disorders. Chronic hypoxia and hypercapnia in these patients may accelerate the development of long term cardiovascular complications such as cardiac arrhythmias, pulmonary hypertension, and right heart failure(cor pulmonale). Several recent studies reported that sleep-related breathing disorders are associated with long-term cardiovascular morbidity and mortality. Careful assessment of respiratory and cardiovascular function in these patients is critical. Aggressive and highly effective treatment of sleep-related breathing disorders using tracheostomy, mechanical ventilation, nasal continuous positive airway pressure therapy(nCPAP), intercurrent oxygen therapy or other interventions can reduce the prevalence of cardiovascular dysfunction and the long-term mortality.