• Journal of Korean Biological Nursing Science
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• v.13 no.3
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• pp.211-219
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• 2011

Purpose: The study compared the rest-activity rhythm and sleep pattern of elderly with young group. Methods: The subjects were 22 over than 65 years old and 23 under 65 years old. An actigraph, sleep diary, Pittsburgh Sleep Quality Index and Insomnia Severity Index scale were used as measurement tools for this study. The data were analyzed with $x^2$, Lamda test, t-test and correlation with SPSS 15.0 program. Results: The elderly had lower curve than the young group in rest-activity rhythm on each time zone. In particular, the elderly group had lower rest-activity rhythm curve of 8, 9, 14, 18, 19, 20, 21, 22 and 23 time zone than those of young group. Sleep pattern had statistical difference in the total sleep time, PSQI and insomnia. Total sleep time of elderly had lower score and PSQI and Insomnia had higher score than young group. Age had correlation with rest-activity rhythm, sleep efficiency, PSQI and insomnia. Conclusion: Rest-activity rhythm of the elderly showed an increase in activity in the early morning because of earlier get up than the young group and an decrease in activity in the afternoon because of taking a nap at this time. Elderly sleep was that total sleep time increased but sleep efficiency decreased and insomnia intensified. This sleep pattern was related to age and rest-activity rhythm.

• Journal of Korean Academy of Nursing
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• v.37 no.1
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• pp.5-13
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• 2007

Purpose: The purpose of this study was to identify the relationship between physical activity and sleep patterns of the elderly. Methods: The subjects of this study were 154 elderly who visited a community senior center in Korea. Data was collected by an interview and a self reported questionnaire, during the period from June to October, 2006. Physical activity was measured by IPAQ Korean version(2006), and sleep pattern by Korean Sleep Scale A developed by Oh et al.(1998). Results: The prevalence of chronic illness in the subjects was 73.4 %. The mean time of vigorous activity was $6.62{\pm}31.27$ minutes/day during the past week. Moderate activity time was $28.85{\pm}50.31$ minutes/day and walking time was $28.85{\pm}50.3$ minutes/day. The total sleep time was $397.63{\pm}111.53$ minutes/day. Physical activity of the elderly significantly correlated with sex, chronic illness, job, and sleep patterns of the elderly. Stepwise multiple regression analysis revealed that the most powerful predictor of sleep pattern was the satisfaction of sleep. A combination of the number of chronic illnesses, moderate physical activities(MET), and total time of sleep accounted for 44.4% of the sleep pattern. Conclusions: Moderate physical activity is more effective than vigorous physical activity for improving the sleep quality of the elderly.

• Korean Parent-Child Health Journal
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• v.3 no.2
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• pp.18-24
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• 2000

The purpose of this research is to investigate Sleep/Activity pattern of normal neonate in Kangwon area. The subjects of this research were 23 normal neonate who visited pediatric clinic of kangneung general hospital from Jun 15, 1999 to August 10, 2000. The instrument of this research was the NCASA. The results of this research were as follows: 1. The mean time of daytime sleep was 8.21 hours. The mean time of nighttime sleep was 5.70 hours. The mean time of total daily sleep was 13.92 hours. The mean time of longest sleep period was 5.02 hours. The mean time of regularity of sleep were daytime 46.59%, nighttime 74.43%, total daily sleep 55.88%. The mean frequency of nighttime wakening was 2.03 times. 2. The each mean time of activity were daytime 7.72 hours, nighttime 2.28 hours, daily total activity 9.99 hours. The mean time of the longest activity period was 6.16 hours. The mean times of feeding frequency were daytime feeding 4.53, nighttime feeding 1.92, total daily feeding 6.45. The mean of regularity of feeding frequency was 65.71%.

• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.422-432
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• 2009

Purpose: In this study rest-activity rhythm, sleep pattern and quality of life of patients with restless legs syndrome were compared with those of a normal group. Methods: The participants in this study were 36 patients with restless legs syndrome diagnosed by a neurologist and 36 participants in the normal group. An actigraph, sleep diary, Pittsburgh Sleep Quality Index and Insomnia Severity Index scale were used as measurement tools for the study. Chi-square test, Lamda test, t-test and Kendall's correlation with SPSS 12.0 program were used to analyze the data. Results: Patients with restless legs syndrome had a higher rest-activity rhythm curve of Least 5 hr's activity(L5) and Most 10 hr's activity(M10) than those of normal group and sleep problems included decreased sleep efficiency and increased sleep latency, wake time and number of awakenings. The scores for the subscales of quality of life in patients with restless legs syndrome were lower than the normal group for general health, physical functioning, role limitations due to emotional problems, role limitation due to physical problems, social functioning, bodily pain, vitality and mental health. Conclusion: The results suggest that further studies are needed to identify rest-activity rhythm according to symptom severity and to develop nursing interventions which consider rest-activity rhythm.

• Korean Parent-Child Health Journal
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• v.3 no.2
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• pp.41-48
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• 2000

The sleep is the most important problem for new parents. However, there were very rare the study about sleep of normal neonates and early infants in Korea. So we attempted pilot survey study of neonates' sleep pattern. The purpose of this study was to investigate the sleep pattern of normal neonates in Seoul and Kyungki area and to provide for basis for nursing intervention for parents of them. The subjects of this study were 37 normal full-term neonates of 2~3weeks of age who were visited by researcher or assistant at postpartum care unit, health care clinic, outpatient clinic located in Seoul and Kyungki area from April 20, 1999 to March 15, 2000. This study was descriptive survey study under the convenient sampling method. The instrument of this study was the NCASA translated by Korean Parent Child Health Academic Association. The collected data were coded as 1/4hour unit, and analyzed by MS Office Excel program. The result of this study were as followed: 1. The mean amount of total sleep was 15.1hours. The mean amount of daytime sleep was 9.5hours. The mean amount of nighttime sleep was 5.7 hours. The mean amount of longest sleep was 2.9hours. The mean amount of shortest sleep was 0.6hour. 2. The mean amount of total activity was 8.9hours. The mean amount of daytime activity was 6.5 hours. The mean amount of nighttime activity was 2.3hours. The frequency of feeding was 10.4 times a day. The frequency of daytime feeding was 7.3 times. The frequency of nighttime feeding was 3.1 times. It is suggested that various subjects and more data according to age, and comparative study among different cultures are needed for further study in the future.

• Korean Parent-Child Health Journal
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• v.3 no.1
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• pp.46-59
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• 2000

The purpose of this study is to determine whether the NCASA (Nursing Child Assessment Sleep/Activity Record) would be suitable to evaluate and to provide the basic resources for a Korean model of sleep/activity patterns during the first 6 months Korean infants' lives and to provide a basis for nursing intervention for mothers of early infants. The subjects of this study were 94 normal infants from birth to 6 months of age who visited the postpartum care center and two general hospitals located in Pusan from February 1 to April 28, 2000. The method of data collection was through convenient sampling. The instrument of this study was the NCASA translated by the Korean parent Child Health Academic Association. The collected data were analysed by mean, standard deviation, frequency percentage and ANOVA, Post Hoc test by use of SPSS/PC. The conclusions obtained from this study are summarized as follows: 1. The mean amount of daytime sleep was 8.06 hours. The mean amount of nighttime sleep was 6.31 hours. The mean amount of total daily sleep was 14.37 hours. The mean of the longest sleep period was 5.20 hours. The mean regularity of daytime sleep was 25.84%. The mean regularity of nighttime sleep was 77.69%. The mean regularity of total daily sleep was 42.60%. The mean frequency of nighttime wakenings was 2.33 times. 2. The mean amount of daytime activity was 8.25 hours. The mean amount of nighttime activity was 1.39 hours. The mean amount of daily total activity was 9.64 hours. The mean of the longest activity period was 3.80 hours The mean frequency of daytime feeding was 5.69 times. The mean frequency of nighttime feeding was 2.08 times. The mean frequency of total daily feeding was 7.74 times. The mean frequency regularity of feeding was 54.62%. The mean frequency of wakenings was 5.14 times. The mean frequency of crying was 1.90 times. 3. According to an analysis of sleep patterns based on an infant's age, there were some significant differences in the following factors: amount of daytime sleep(p<.001), amount of night time sleep(p<.05), amount of total daily sleep (p<.001), longest sleep period(p<.001), regularity of daytime sleep(p<.001), regularity of nighttime sleep(p<.01), regularity of total daily sleep(p<.001), frequency of nighttime wakenings(p<.001). 4. According to an analysis of activity patterns based on an infant's age, there were some significant differences in the following factors: amount of daytime activity(p<.001), amount of nighttime activity(p<.01), amount of total daily activity(p<.001), longest activity period(p<.05), frequency of nighttime feeding(p<.01), frequency of wakenings(p<.001). 5. The mean amount of a mother's day time was 16.30 hours. The mean amount of a mother's night time was 7.70 hours. In conclusion, the initial irregular sleeping and activity patterns of the early infant became regurized as the infant grew older and estabilished firmer patterns of sleeping and of activity.

• Korean Parent-Child Health Journal
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• v.2
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• pp.83-110
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• 1999

The purpose of this study was to identify the sleep/activity patterns of neonates and to provide a baseline data for the development effective mother-infant relationship. Subjects of this study were 36 newborns aged 1-21 days and stayed in Postpartum Care Center in Taejon during the period of October 28th, 1999 to February 10th, 2000. The data were collected using NCASA developed by Barnard et al. and were analyzed with SPSS 7.5 for window program. The results of this study were as follows: 1. An average day sleep of neonates was 8.0 hours, night sleep was 3.6 hours, and total sleep was 11.6 hours. A longest period of day sleep was 3.8 hours and a longest period of night sleep was 3.4 hours. The regularity of day sleep was 22.1%, night sleep was 23.3%, and total was 22.1%. 2. The frequency of daytime feeding was 6.9, nighttime fee ding was 3.4, resulting in total of 10.3. The regularity of feeding was 37.4%, and the frequency of night awakening was 2.4. 3. Associations among variables related to neonate's sleep/activity records were as follows : - The regularity of total sleep was positively correlated with the frequencies of day sleep(r=.57, P=.00), night sleep (r=.40, P=.01), and total sleep(r=.65, P=.00). - The frequency of total feeding was negatively correlated with the frequencies of day sleep(r=-.29, P=.04), night sleep(r=-.39, P=.02), and total sleep(r=-.42, P=.00), as well as longest day sleep(r=-.50, P=.00). - The regularity of feeding was negatively correlated with the frequency of night sleep(r=-.35, P=.02), longest period of day sleep(r=-.32, P=.04), and longest period of night sleep(r=-.30. P=.04), whereas positively correlated with frequencies of daytime feeding (r=.29, P=.02) and nighttime feeding (r=.32, P=.05). - The frequency of night awakening was negatively correlated with amount of night sleep(r=-.39, P=.02) and frequency of daytime feeding(r=-.42, P=.01) while positively correlated with frequencies of nighttime feeding(r=.68, P=.00) and total feeding(r=.50, P=.00). 4. Although there was no statistical significant difference between sleep pattern and infant's age, following tendency was noted: - As baby gets older, total amount of sleep and longest period of day sleep decreased while longest period of night sleep increased. - As baby gets older, the regularity of day sleep decreased while the regularity of night sleep and total sleep slightly increased. - The frequencies of daytime and total feedings increased while the frequency of nighttime feeding decreased. In conclusion, the author found that the neonates of this study showed less amount of sleep, more night awakening, and more night time feedings than NCAST sample. There was a certain sleep/activity pattern existed: If babies were fed more frequently, daytime or nighttime sleeping hours became shorter, and if babies had longer daytime sleep, frequent nighttime awakenings were noted. This pattern illustrated the significant influence of feeding and sleep periods on each other. Awakening in the night is natural and normal patterns in the newborn period. The result of this study will provide information to parents about what to expect their infants.

• Korean Parent-Child Health Journal
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• v.3 no.2
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• pp.25-40
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• 2000

The purpose of this study is to identify the sleep/activity patterns of neonates and to provide a baseline data in developing an effective maternal-child nursing intervention strategies. The subjects of this study were 57 normal newborn babies from birth to 4 weeks of age, who visited the Postpartum Care Center and two General Hospitals and One Local clinic in Taejon. The data were collected from October 28th, 1999 to April 28th, 2000. The instrument used in this study was NCASA developed by Barnard and validated by the Academic Society of Parent-Child Health. The data were analyzed with the SPSS PC+ 7.5 for window program using means, standard deviation, one-way ANOVA. The results of this study were as follows: 1. The mean amount of daytime sleep was 7.45 hours, nighttime sleep was 4.27 hours, and the total daily sleep was 11.72 hours. The mean amount of longest sleep period was 4.32 hours. The mean regularity of daytime sleep was 35.55%, the nighttime sleep was 44.82%, and the total daily sleep was 39.02%. The mean frequency of nighttime awakenings was 2.44 times. 2. The mean amount of daytime awake periods was 8.54 hours, the nighttime awake periods was 3.72 hours, and the daily total awake periods was 12.27 hours. The mean amount of the longest awake period was 3.98 hours. 3. The mean frequency of daytime feeding was 5.18 times, the nighttime feeding was 2.50 times, and the total daily feeding was 7.49. The mean of regularity of total daily feeding was 61.34%. 4. According to an analysis of sleep patterns based on newborn's age, there were some statistically significant differences noted in the following factors ; amount of nighttime sleep (F=7.65, p=.002), longest sleep period(F=5.84, P=.006). 5. According to an analysis of activity patterns based on newborn's age, there were some statistically significant differences noted in the following factors ; amount of nighttime activity (F=7.64, P=.002), longest activity period (F=4.34, P=.020), frequency of nighttime feeding(F=3.89, p=.029), frequency of total daily feeding(F=3.76, P=.033), and regularity of daily feeding(F=4.66, P=.016). In conclusion, the newborn baby slept more during the daytime than nighttime and more active during the daytime. And there were some irregular sleep/activity pattern noted during 1 to 2 weeks of newborn baby. The results of this study will contribute to maternal-child health nursing practice and nursing research, and provide an information to parents about what to expect their newborn baby.

• Sleep Medicine and Psychophysiology
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• v.17 no.2
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• pp.75-84
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• 2010

The cyclic alternating pattern (CAP) is a periodic EEG activity in NREM sleep, characterized by sequences of transient electrocortical events that are distinct from background EEG activities. A CAP cycle consists of two periodic EEG features, phase A and subsequent phase B whose durations are 2-60 s. At least two consecutive CAP cycles are required to define a CAP sequence. The CAP phase A is a phasic EEG event, such as delta bursts, vertex sharp transients, K-complex sequences, polyphasic bursts, K-alpha, intermittent alpha, and arousals. Phase B is repetitive periods of background EEG activity. The absence of CAP more than 60 seconds or an isolated phase A is classified as non-CAP. Phase A activities can be classified into three subtypes (A1, A2, and A3), based on the amounts of high-voltage slow waves (EEG synchrony) and low-amplitude fast rhythms (EEG desynchrony). CAP rate, the percentage of CAP durations in NREM sleep is considered to be a physiologic marker of the NREM sleep instability. In insomnia, the frequent discrepancy between self-reports and polysomnographic findings could be attributed to subtle abnormalities in the sleep tracing, which are overlooked by the conventional scoring methods. The conventional scoring scheme has superiority in analysis of macrostructure of sleep but shows limited power in finding arousals and transient EEG events that are major component of microstructure of sleep. But, it has recently been found that a significant correlation exists between CAP rate and the subjective estimates of the sleep quality in insomniacs and sleep-improving treatments often reduce the amount of CAP. Thus, the extension of conventional sleep measures with the new CAP variables, which appear to be the more sensitive to sleep disturbance, may improve our knowledge on the diagnosis and management of insomnia.

• Child Health Nursing Research
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• v.13 no.2
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• pp.147-156
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• 2007

Purpose: The purpose of this study was to investigate the sleep/activity patterns of premature babies. Method: The subjects were 55 premature babies who were hospitalized in the Neonatal Intensive Care Unit (NICU) of one University Hospital in Daejeon from September 1, 2004 to March 31, 2006. The sleep/activity patterns of the premature babies were observed for 24 hours a day for 7 days. The observations were made and recorded by the researcher and 5 trained research assistants using NCASA records developed by Barnard et al. (1979). For statistical analysis, frequency, average, t-test, and Pearson correlation coefficients were used. Results: The infants slept more and had less awake periods during daytime than full-term infants. As the hospital stay of the premature babies increased, the amount of daytime sleep and total daily sleep decreased, and the amount of daytime awake periods increased. Conclusions: The findings suggest that the level of physical and physiological maturity of premature babies is one of the major variables that affect their sleep/activity patterns. Furthermore, the findings of this study will provide information about the sleep/activity patterns of premature babies, and present baseline data to develop the nursing intervention programs which support optimum development for the premature babies.