• Journal of Korean Biological Nursing Science
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• 제14권1호
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• pp.1-7
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• 2012

The purpose of this study is to investigate the level of fatigue, depression and sleep disorders and to find the correlation between them in patients with chronic liver disease. Methods: The participants consisted of 130 patients with chronic liver disease who visited the C University Hospital in Daegu, Korea from July to August, 2011. Data were collected by a self-reporting questionnaire of the Revised Piper Fatigue Scale, Depression Inventory (BDI) and Sleep Scale. Collected data were analyzed by using PASW Statistics 18.0 program for descriptive statistics, T-test, one-way ANOVA and Correlation Analysis. Results: There were significant differences in fatigue scores (t=8.415, $p$=.004) and depression scores (t=10.08, $p$=.002) between subjects with symptoms of liver disease and those with no symptoms. There was no significant difference in sleep disorder scores. In addition, there is a significant correlation between fatigue and depression (r=.641), linking fatigue and sleep disorders (r=.578), and between depression and sleep disorders (r=.572). Conclusion: It is necessary to develop multidisciplinary intervention programs to relieve patientsuffering.

• Journal of Oral Medicine and Pain
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• 제43권3호
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• pp.61-69
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• 2018

Obstructive sleep apnea (OSA) is a relatively common, but greatly underdiagnosed sleep-related breathing disorder, characterized by recurrent collapse of the upper airway during sleep. OSA has been associated with a variety of cardiometabolic disease, such as hypertension, coronary artery disease, cardiac arrhythmia, cerebrovascular disease and metabolic dysfunction. Neurocognitive impairment, including excessive daytime sleepiness, increased risk of motor vehicle accidents, is also related to OSA. Sleep fragmentation and related arousals during sleep lead to intermittent hypoxia, sympathetic activation, oxidative stress, systemic inflammation and metabolic dysregulation which provide biological plausibility to this pathologic mechanism. Extensive studies demonstrated that OSA is a modifiable risk factor for the above mentioned diseases and oral appliances (OAs), although continuous positive air pressure (CPAP) is a first-line therapy of OSA, are not inferior to CPAP at least in mild OSA, and may be an alternative to CPAP in CPAP-intolerant subjects with OSA. The goal of this article is to provide a current knowledge of pathologic link between OSA and cardiovascular disease, focusing on intermittent hypoxia, sympathetic activation, oxidative stress and metabolic dysregulation. Then, previous epidemiologic studies will be reviewed to understand the causal relationship between OSA and cardiovascular disease. Finally, the effects of OAs will be updated via recent metaanalyses compared to CPAP.

• 대한한방내과학회지
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• 제44권4호
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• pp.603-620
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• 2023

Objectives: This study reviewed randomized controlled trials (RCTs) investigating the efficacy of herbal medicine on sleep disorders associated with Parkinson's disease and suggests a better research process. Methods: We searched for RCTs for herbal medicine treatments for sleep disorders related to Parkinson's disease on July 31, 2023 using eight databases (PubMed, Embase, the Cochrane library, China National Knowledge Infrastructure [CNKI], the Research Information Service System [RISS], Science ON, the Oriental Medicine Advanced Searching Integrated System [OASIS], and the Korea Citation Index [KCI]). Cochrane's risk of bias tool was used to assess the quality of the RCTs. Results: A total of 16 RCTs met all the inclusion criteria, and in most reports, the treatment group showed a significant improvement in sleep disorders compared to the control group. Total effective rate (TER), Pittsburgh Sleep Quality Index (PSQI), Unified Parkinson's Disease Rating Scale (UPDRS), TCM Symptom Score (TSS), Parkinson's Disease Sleep Scale (PDSS), etc., were used as evaluation indicators. Conclusion: Herbal medicine is a potential treatment for sleep disorders associated with Parkinson's disease. However, the selected RCTs were of poor quality, and it is necessary to perform more systematic studies.

• 동서간호학연구지
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• 제7권1호
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• pp.105-111
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• 2002

The purpose of this study was to investigate the effect of hand massage program on total sleep hours at night and satisfaction of sleep in clients with ischemic heart disease. The design utilized for this study was quasi-experimental with a nonequivalent control group non-synchronized design. The subjects were fifty-four patients, twenty-eight for the experimental and twenty-six for the control group, who were admitted with ischemic heart disease at cardiac intensive care unit in K medical center of K university. This study was carried out from May, 1999 to March, 2000. Hand massage was carried out at $8{\sim}9$ PM, once a day for 3 days. Total sleep hours at night were measured from 9 PM through 6AM next morning. Sleep hours of subjects were observed 30 minutes interval. Satisfaction of sleep was measured by Visual Analogue Scale(VAS) at 7 AM next morning. The collected data were processed by using the SPSS PC program and analyzed using $X^2$-test and repeated measures of ANOVA. The result of this study are as follows : 1. The total sleep hours at night of the experimental group were not higher than those of the control group. 2. The satisfaction of sleep of the experimental group was not higher than that of the control group. In conclusion, hand massage did not promoted sleep in ICU clients with ischemic heart disease.

• 기본간호학회지
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• 제18권2호
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• pp.186-194
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• 2011

Purpose: The purpose of this study was to investigate factors of sleep disturbance and sleep patterns of elderly hospitalized women patients between young-old (65-74 years), old (76-84 years) and old-old (85 years and above). Methods: The questionnaire included the environmental disturbance factors (Paik, 2000), degree of pain (Wang & Kim,1995), disease symptoms (Paik, 2000), depression (Kee, 1996) and sleep patterns (Oh, Song, & Kim, 1998). Data were analyzed using frequencies, means, ${\chi}^2$-test, t-test, ANOVA, Scheffe, Pearson correlation coefficients and multiple regression (SPSS 14.0). Results: The middle, and oldest group's environmental disturbance factors of degree of pain, disease symptoms, depression and sleep patterns were higher than those of the younger group. The younger, middle, and oldest group's sleep pattern had a significant negative correlation with environmental disturbance factors, degree of pain, disease symptoms and depression. The model including variables related to environmental, physical and psychological disturbance factors, explained the following variances in sleep pattern: 26.8% for the youngest group, 27.6% for the middle group and 40.7% for the oldest group. Conclusion: The result of this study offer basic data for the development of nursing intervention programs to improve sleep patterns for hospitalized women patients according to age differences.

• Journal of Yeungnam Medical Science
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• 제38권4호
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• pp.267-274
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• 2021

Sleep plays a critical role in homeostasis of the body and mind. Insomnia is a disease that causes disturbances in the initiation and maintenance of sleep. Insomnia is known to affect not only the sleep process itself but also an individual's cognitive function and emotional regulation during the daytime. It increases the risk of various neuropsychiatric diseases such as depression, anxiety disorder, and dementia. Although it might appear that insomnia only affects the nervous system, it is also a systemic disease that affects several aspects of the body, such as the cardiovascular, endocrine, and immune systems; therefore, it increases the risk of various diseases such as hypertension, diabetes mellitus, and infection. Insomnia has a wide range of effects on our bodies because sleep is a complex and active process. However, a high proportion of patients with insomnia do not seek treatment, which results in high direct and indirect costs. This is attributed to the disregard of many of the negative effects of insomnia. Therefore, we expect that understanding insomnia as a systemic disease will provide an opportunity to understand the condition better and help prevent secondary impairment due to insomnia.

• 수면정신생리
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• 제28권2호
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• pp.43-52
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• 2021

Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is a sleep disorder characterized by sensorimotor symptoms such as unpleasant sensations before sleep, akathisia, and periodic limb movements during sleep. It is also closely related to hyperarousal and is often accompanied by insomnia. Although the mechanism is not clear, the understanding of etiology and pathophysiology has greatly expanded through recent advances in genetic and neurobiological research. The most important pathophysiology of RLS/WED is brain iron deficiency. Such iron deficiency in the brain is caused by complex interactions between several genetic factors and various environmental factors, including comorbidities. Iron deficiency in the brain results in dysfunction of several neurotransmitters. A decrease in adenosine activity appears first, followed by an increase in the activity of glutamate and dopamine. A decrease in adenosine activity and an increase in glutamate activity stimulate the brain arousal system, resulting in hyperarousal. In addition, overproduction of dopamine and glutamate leads to dysfunction of the cortical-striatal-thalamic circuit, resulting in symptoms such as akathisia and periodic limb movements during sleep.

• 수면정신생리
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• 제7권2호
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• pp.102-108
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• 2000

목 적 : 파킨슨병 환자의 상당수에서 아침에 일어났을 때 수면이득으로 알려진 운동성 기능의 일시적인 호전을 보고 한다. 파킨슨병 환자에서의 수면이득이 수면과 관련되는 현상임에도 불구하고 수면다원검사 등의 객관적인 방법을 이용한 연구는 드물다. 본 연구의 목적은 수면이득이 있는 환자 군과 없는 환자 군의 임상특징 및 수면다원검사 소견을 비교하는데 있다. 방 법 : 33명의 일차성 파킨슨병 환자(남 14, 여 19)를 대상으로 하였다. 모든 환자들은 수면이득의 여부를 확인하기 위하여 면담을 하였고, 의무 기록지를 통하여 임상적 자료를 얻었고, 수면검사실에서 하룻 밤의 수면다원검사를 실시하였다. 결 과 : 수면이득이 있는 환자가 16명(48.5%), 없는 환자가 17명(51.5%)이었다. 수면이득이 있는 환자들이 없는 환자들에 비하여 더 젊었고(p<0.02), 수면효율이 더 좋았고 (p<0.05), 그리고 수면잠복기가 더 짧았다(p<0.02). 그러나 수면이득은 유병기간, 레보도파 일일 복용 용량, 운동기능의 장애 등과 관련되지 않았고, 특정 수면단계와도 관련되지 않았다. 두 군 모두에서 렘수면행동장애 등의 수면장애의 빈도가 높았으나 일차성 코골이를 제외하고는 두 군간에 차이는 없었다. 결 론 : 본 연구의 결과는 수면이득이 젊은 나이, 좋은 수면효율, 짧은 수면잠복기와 관련됨을 시사한다.

• 중환자간호학회지
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• 제16권2호
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• pp.15-27
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• 2023

Purpose : This study aimed to examine the relationship between sleep quality and its influencing factors in patients with coronary artery disease (CAD). Methods : This descriptive correlational study included 130 patients with CAD admitted to the cardiology department of a general hospital in B City between September 2019 and February 2020. Data were collected using structured questionnaires and research instruments to measure sleep quality, anxiety, depression, chronotype, and daytime sleepiness. Results : The mean scores for sleep quality, daytime sleepiness, anxiety, and depression were 7.59±3.45, 6.45±3.46, 6.58±3.88, and 7.74±4.05, respectively. In terms of chronotypes, 10.8%, 48.5%, and 40.7% of the participants had evening-, intermediate-, and morning-type patterns, respectively. Sleep quality was significantly correlated with anxiety (r=0.38, p<.001), depression (r=.37, p<.001), and daytime sleepiness (r=.26, p =.002). Factors associated with sleep quality in patients with CAD included anxiety (β=.29), heart failure (β=.22), daytime sleepiness(β=.21), and sleeping alone (β=.19). Collectively, these factors had an explanatory power of 23.1% for sleep quality variance. Conclusion: Patients with CAD often experience poor sleep quality owing to various factors such as anxiety, daytime sleepiness, heart failure, and sleeping alone. It is recommended that healthcare providers objectively evaluate sleep and identify factors that influence sleep quality. This will enable the development of effective methods for sleep management as part of nursing care.

• 수면정신생리
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• 제6권1호
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• pp.19-25
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• 1999

Sleep alters both breathing pattern and the ventilatory responses to external stimuli. These changes during sleep permit the development or aggravation of sleep-related hypoxemia in patients with respiratory disease and contribute to the pathogenesis of apneas in patients with the sleep apnea syndrome. Fundamental effects of sleep on the ventilatory control system are 1) removal of wakefulness input to the upper airway leading to the increase in upper airway resistance, 2) loss of wakefulness drive to the respiratory pump, 3) compromise of protective respiratory reflexes, and 4) additional sleep-induced compromise of ventilatory control initiated by reduced functional residual capacity on supine position assumed in sleep, decreased $CO_2$ production during sleep, and increased cerebral blood flow in especially rapid eye movement(REM) sleep. These effects resulted in periodic breathing during unsteady non-rapid eye movement(NREM) sleep even in normal subjects, regular but low ventilation during steady NREM sleep, and irregular breathing during REM sleep. Sleep-induced breathing instabilities are divided due primarily to transient increase in upper airway resistance and those that involve overshoots and undershoots in neural feedback mechanisms regulating the timing and/or amplitude of respiratory output. Following ventilatory overshoots, breathing stability will be maintained if excitatory short-term potentiation is the prevailing influence. On the other hand, apnea and hypopnea will occur if inhibitory mechanisms dominate following the ventilatory overshoot. These inhibitory mechanisms include 1) hypocapnia, 2) inhibitory effect from lung stretch, 3) baroreceptor stimulation, 4) upper airway mechanoreceptor reflexes, 5) central depression by hypoxia, and 6) central system inertia. While the respiratory control system functions well during wakefulness, the control of breathing is commonly disrupted during sleep. These changes in respiratory control resulting in breathing instability during sleep are related with the pathophysiologic mechanisms of obstructive and/or central apnea, and have the therapeutic implications for nocturnal hypoventilation in patients with chronic obstructive pulmonary disease or alveolar hypoventilation syndrome.