• 수면정신생리
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• 제29권2호
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• pp.29-34
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• 2022

Coronavirus disease 2019 (COVID-19), which was a global pandemic caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), is still a serious public health problem. COVID-19 causes various symptoms not only in the respiratory system but also in various parts of the body and has a significant effect on sleep. Insomnia and poor sleep quality were observed at high rates in patients with COVID-19 as well as in the uninfected general population. Obstructive sleep apnea is also considered a risk factor in patients with severe COVID-19. Virus-induced central nervous system damage is likely to be the cause of many sleep disorders in COVID-19, but psychosocial influences also seem to have played a significant role. Sleep problems persisted at high rates for a considerable period after the infection phase was over. More attention and research on the effect of COVID-19 on sleep is needed in the future.

• 수면정신생리
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• 제24권1호
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• pp.32-37
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• 2017

목 적 : 폐쇄성 수면무호흡 증후군(obstructive sleep apnea syndrome, OSAS)에서 앙와위는 비앙와위보다 수면무호흡을 증가시키는 것으로 알려져 있다. 앙와위 자세시간(supine position time, SPT)과 OSAS의 무호흡-저호흡 지수(apnea-hypopnea index, AHI)의 관련성에 대해서 많은 연구가 있었으나, SPT가 OSAS에서 어떤 변수의 영향을 받는지는 알려져 있지 않다. OSAS에서 수면다원검사상 어떤 변수가 SPT과 관련이 있는지를 평가하였다. 방 법 : 수면다원검사로 진단된 치료받지 않은 365 명의 OSAS 남자 환자를 선정하였다. SPT($276.4{\pm}92.3$ 분)가 인구 통계학적 데이터, 수면구조 관련변수, OSAS 관련변수 및 심박변이도(Heart rate variability, HRV)와 상관관계가 있는지 분석했다. SPT에 영향을 주는 요인을 알아보기 위해 SPT에 대해 다중회귀분석을 시행하였다. 결 과 : 전체 대상군의 상관분석에서 SPT는 총수면시간(total sleep time, TST) (r = 0.443, p < 0.001)과 수면 효율(r = 0.300, p < 0.001)과 가장 유의한 상관관계가 있었고, 코골이 시간(r = 0.238, p < 0.001), 산소포화도 90 % 미만시간(r = 0.188, p < 0.001), AHI (r = 0.180, p = 0.001), 산소탈포화지수(oxygen desaturation index, ODI), (r = 0.149, p = 0.004), NN50 count(r = 0.137, p = 0.036)와 SPT 간에 유의한 상관관계가 있었다. 다중회귀분석 결과 SPT에 유의한 영향을 끼치는 요인으로 TST (t = 7.781, p < 0.001), 코골이 시간(t = 3.794, p < 0.001), AHI (t = 3.768, p < 0.001), NN50 count (t = 1.993, p = 0.047)가 있었다. 결 론 : SPT는 OSAS 관련변수보다 수면구조 관련변수와 더 높은 상관관계를 보였다. 특히 SPT는 TST과 AHI 뿐만 아니라 NN50 count와도 밀접하게 관련되어 있었다. 이것은 SPT가 OSAS의 심각도뿐만 아니라 수면구조와 심박변이도에 의해서도 결정될 가능성이 있음을 시사한다.

• 수면정신생리
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• 제18권2호
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• pp.76-81
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• 2011

목 적 : 본 연구는 폐쇄성 수면무호흡증후군 환자에서 수면무호흡지수, 수면관련 척도, 기분관련 척도, 그리고 수면중 신체활동도 간의 연관성을 보고자 하였다. 방 법 : 폐쇄성 수면무호흡증후군을 보이는 122명(평균연령 $43{\pm}11$세)의 남자환자를 선정하였다. 폐쇄성 수면무호흡증후군 진단은 수면무호흡지수>5인 경우로 하였고, 수면무호흡지수의 평균은 $39.6{\pm}26.0$이였다. 수면관련척도로 Stan-ford Sleepiness Scale(SSS), Epworth Sleepiness Scale(E-SS), Pittsburg Sleep Quality Index(PSQI), Morningness-Ev-eningness Scale(MES)이 사용되었고, 기분관련척도로 Beck Depression Inventory(BDI), Beck Anxiety Inventory(BAI), State-Trait Anxiety Inventory(STAI) I, II, Profile of Mood States(POMS)가 사용되었다. 수면중 활동도를 측정하기 위해 양측 손목에 손목 액티그라프(wrist actigraphy, WATG)를 착용한 채 1일밤 야간수면다원검사(nocturnal polysom-nography, NPSG)를 시행하였다. WATG에서 산출된 지수는 총활동도(total activity score), 평균활동도(mean activity score) 및 분절지수(fragmentation index)였다. 수면무호흡지수, 수면 및 기분관련척도, 수면중 활동도 간의 상관관계를 분석하였다. 결 과 : ESS는 PSQI, BDI, BAI, STAI I, II와 각각 유의한 양의 상관관계를 보였다(p<0.01). SSS는 PSQI, BAI와 유의한 양의 상관관계를 보였다(p<0.05, p<0.01). BAI는 총활동도, 평균활동도 및 분절지수(fragmentation index)와 유의한 양의 상관관계를 보였다(p<0.05, p<0.01, p<0.05). 수면중 총활동도는 ESS, BAI와 각각 유의한 양의 상관관계를 보였다(p<0.05). 수면 분절지수는 ESS, PSQI, BAI와 유의한 양의 상관관계를 보였다(p<0.05, p<0.01, p<0.05). 수면무호흡지수는 수면 및 기분관련 척도와 유의한 상관관계를 보이지 않았다. 결 론 : 주간 졸리움을 호소하는 정도가 수면무호흡증의 심한 정도와 연관이 있기 보다는 오히려 야간수면 만족도, 우울 및 불안의 정도, 수면중 활동도와 더 연관성이 있었다.

• 수면정신생리
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• 제16권2호
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• pp.74-78
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• 2009

목 적: 천식에서 수면무호흡증이 흔하다고 알려져 왔으나 야간 수면다원검사를 이용한 체계적인 연구는 거의 이루어지지 않았다. 본 연구의 성격은 천식 환아들에서 수면 중 무호흡-저호흡지수와 폐기능과의 연관성을 밝히기 위한 예비연구이다. 방 법: 천식으로 진단받은 19명의 남아와 12명의 여아들을 대상으로 하였으며 대상자들의 연령은 평균 8.2세였다. 야간 수면다원검사와 폐기능검사가 대상자들에게 시행되었다. 결 과: 31명의 천식 환아들 중에 21명(67.7%)이 소아의 수면무호흡증의 진단기준을 만족하였고, 평균 무호흡-저호흡지수는 시간당 1.7회였다. 무호흡-저호흡지수가 높을수록 폐기능이 저하되는 소견을 보였다($FEV_1$/FVC ratio: p=0.002, $FEV_1$%pred: p=0.047). 결 론: 본 연구의 결과는 소아 천식 환아들에서 수면무호흡증의 빈도가 매우 높을 가능성이 있으며 수면무호흡증의 중증도와 폐기능의 정도가 연관성이 있다는 것을 제시한다. 그러나, 향후 대조군과 천식군의 비교연구를 통하여 이에 대한 확인이 필요하다.

• 대한치과의사협회지
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• 제53권4호
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• pp.238-248
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• 2015

Sleep related breathing disorders(SRBDs) are a group of diseases accompanied by difficulties in respiration and ventilation during sleep. Central sleep apnea, obstructive sleep apnea(OSA), sleep-related hypoventilation, and hypoxemia disorder are included in this disease entity. OSA is known to be the most common SRBDs and studies show its significant correlation with general health problems including hypertension, arrhythmia, diabetes, and metabolic syndrome. The diagnostic process of OSA is composed of physical examinations of the head and neck area and also the oral cavity. Radiologic studies including cephalography, CT, MRI, and fluoroscopy assist in identifying the site of obstruction. However, polysomnography(PSG) is still considered the gold standard for the diagnosis of OSA since it offers both qualitative and quantitative recording of the events during a whole night's sleep. The dentist who is trained in sleep medicine can easily identify patients with the risk of OSA starting from simple questions and screening questionnaires. Diagnosis is the first step to treatment and considering the high rate of under-diagnosis for OSA the dentist may play a substantial role in the diagnosis and treatment of OSA which will eventually lead to the well-being of the patient as a whole person. So the objective of this article is to assist dental professionals in gaining knowledge and insight of the diagnostic measures for OSA including PSG.

• 수면정신생리
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• 제8권1호
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• pp.18-21
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• 2001

The change of sleep pattern is one of the most often altered normal physiological functions in elderly people. Besides normal change of sleep, insomnia and sleep apnea syndrome (SAS) are (one of) the main complaints. In addition, parasomnia is also frequent in this age group. Several parasomnias frequently found in the elderly are reviewed. Periodic limb movements in sleep (PLMS), restless legs syndrome (RLS), and REM sleep behavior disorder are the most frequent parasomnias in old age. Most parasomnias could be diagnosed by polysomnography, and be treated easily. Therefore, early and precise diagnosis and management for parasomnia in aging people are needed.

• 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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• 제11권2호
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• pp.84-88
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• 2004

목 적：폐쇄성 수면 무호흡증은 병력청취, 이학적 검사, 방사선학적 검사, 수면다원검사로 진단할 수 있는데 이를 임상적으로 검사할 때에는 편도의 비대와 좁아진 구인두의 관찰에 초점을 두어야 한다. 이 연구에서는 폐쇄성 수면무호흡증의 심한 정도를 예측하는데 있어 변형 Mallampati 지수(MMG)와 편도지수(TG)의 유용성을 알아보고자 하였다. 방 법：MMG와 TG는 심한정도에 따라 각각 4군 및 5군으로 나뉜다. 2002년 3월부터 2004년 4월까지 계명대학교 동산의료원에서 코골이와 수면무호흡증으로 수면다원검사와 이비인후과적 검진을 받은 94례를 대상으로 이들의 의무기록을 후향적으로 분석하였다. 환자들은 무호흡-저호흡지수(AHI)에 따라 비교군(n=24)과 수면무호흡군(n=70)으로 나누었다. 결 과：변형 Mallampati 지수(MMG)와 편도지수(TG)가 높을수록 높은 AHI 값을 가지며 TG와 MMG 모두 AHI와 통계적으로 유의한 연관성을 보였다. 결 론：MMG와 TG는 수면무호흡증을 진단하는데 신뢰할만한 예측인자이며 치료방법을 결정하는데 유용한 척도가 될 수 있다.

• 수면정신생리
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• 제18권2호
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• pp.67-71
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• 2011

Schizophrenia is a chronic, currently incurable, and devastating syndrome. Although sleep disturbances are not primary symptoms of schizophrenia, they are important aspects of schizophrenia. Difficulties initiating or maintaining sleep are frequently encountered in patients with schizophrenia. Many schizophrenics report low subjective sleep quality. Measured by polysomnography, increased sleep latency as well as reduced total sleep time, sleep efficiency, slow wave sleep, and rapid eye movement sleep latency (REM latency), are found in most patients with schizophrenia and appear to be an important aspect of the pathophysiology of this disorder. Some literatures suggest that worsening sleep quality precedes schizophrenic exacerbations. Co-morbid sleep disorders such as obstructive sleep apnea (OSA) and restless legs syndrome (RLS), and sleep-disrupting behaviors associated with schizophrenia may lead to sleep disturbances. Clinicians should screen the patient with sleep complaints for primary sleep disorders like OSA and RLS, and carefully evaluate sleep hygiene behaviors of all patients with schizophrenia who complain of sleep disturbances.

• 대한임상검사과학회지
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• 제39권2호
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• pp.141-146
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• 2007

Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a disorder characterized by the repetitive collapse of the pharyngeal airway during sleep, which leads to oxygen desaturation, sleep fragmentation, daytime sleepiness, and increased risk for hypertension and stroke. We investigated the clinical factors related to the severity of OSAHS. Polysomnography was performed in three hundred and ninety five consecutive adult patients with clinical symptoms of obstructive sleep apnea syndrome. All patients completed the sleep questionnaire and the Epworth Sleepiness Scale before polysomnography. Patients were classified into four groups based on the severity of their polysomnographic data: Non-OSA group, characterized by Apnea-Hypopnea Index (AHI) < 5; mild OSA group, by AHI 5-15; moderate OSA group, by AHI 16-30; and severe OSA group, by AHI > 30. Neck circumference was also measured at the cricothyroid level. A total of 395 patients (336 men and 59 women) were studied. In the non-OSA group, there were 55 patients; their mean neck circumference was $39.63{\pm}4.24cm$ and mean BMI was $24.48{\pm}3.53$. In the mild group, there were 101 patients; their mean neck circumference was $41.93{\pm}3.75cm$ and mean BMI was $25.33{\pm}2.94$. In the moderated group, there were 93 patients; their mean neck circumference was $43.27{\pm}3.50cm$ and BMI was $25.90{\pm}2.88$. In the severe group, there were 146 patients; their mean neck circumference was $44.94{\pm}3.93cm$ and mean BMI was $26.81{\pm}3.76$. Men had significantly larger neck circumference than women ($Mean{\pm}SD$, $43.72{\pm}3.83$ vs $39.17{\pm}4.30$, p < 0.001), and higher AHI than women ($29.12{\pm}22.65$ vs $14.63{\pm}14.11$, p < 0.001). Multiple regression analysis revealed that neck circumference was the most significant predictor of AHI. Neck circumference and BMI were positively correlated with the severity of OSAHS. The severity of OSAHS was greater in men than in women.