• 수면정신생리
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• 제27권1호
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• pp.8-15
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• 2020

Sleep disorder in chronic obstructive pulmonary disease (COPD) is common and typically is associated with oxygen desaturation. The mechanisms of desaturation include hypoventilation and ventilation to perfusion mismatch. Despite the importance of sleep in patients with COPD, this topic is under-assessed in clinical practice. Impaired sleep quality is associated with more severe COPD and may contribute to worse clinical outcomes. Recent data have indicated that specific respiratory management of patients with COPD and sleep disordered breathing improves clinical outcomes. Clinicians managing patients with COPD should pay attention to and actively manage symptoms of comorbid sleep disorders. Management of sleep-related problems in COPD should particularly focus on minimizing sleep disturbance.

• 수면정신생리
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• 제20권1호
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• pp.10-14
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• 2013

Sleep disturbances are commonly encountered problems in cancer patients. Sleep has a role in maintenance of immunity, metabolism, and quality of life but little has been known about the prevalence, risk factors, and effects on prognosis of sleep disturbances in patients with cancer. Also little attention has been made on proper assessment and management of sleep disorders in these patients. Recently, there have been some reports that sleep disorders are related with development of many cancers such as breast, colorectal, prostate, and endometrial cancers. An intermittent hypoxia and a disruption of circadian rhythm are considered as one of the possible mechanisms of cancer developments. More aggressive evaluation and meticulous management of sleep disturbances in cancer patients are essential to improve quality of life as well as prognosis.

• 수면정신생리
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• 제16권1호
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• pp.22-27
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• 2009

Regulation of respiration differs significantly between wakefulness and sleep. Respiration during wakefulness is influenced by not only automatic control but also voluntary and behavioral control. Sleep is associated with definite changes in respiratory function. With the onset of sleep, voluntary control of ventilation that overrides automatic control during wakefulness becomes terminated. Also ventilatory response to various stimuli including hypoxemia and hypercapnia is decreased. With these reasons respiration during sleep becomes fragile and unstable so that marked hypoxemia can be happened in patients with lung disease especially during REM sleep. Obstructive sleep apnea may also be developed if upper airway resistance is increased in addition to these blunted ventilatory responses.

• 한국직업건강간호학회지
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• 제31권1호
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• pp.11-21
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• 2022

Purpose: This study aimed to identify the relationship among musculoskeletal problems, sleep problems, and self-rated mental health of home-care workers. Methods: Data were collected from 447 home-care workers spanning three occupation types: life supporters for the elderly, home-visit caregivers, and life supporters for the disabled. Musculoskeletal problems, sleep problems, and self-rated mental health were assessed using structured questionnaires. Factors affecting self-rated mental health were analyzed using multiple regression. SPSS was used to test the mediating effects of sleep problems on musculoskeletal problems and self-rated mental health. Results: Among the general characteristics, the variables that showed significant differences in musculoskeletal problems were monthly income level, caring-related career duration, weekly working hours, and occupation type; and the variable that showed significant differences in self-rated mental health was occupation type. Among the occupation types, supporters for the disabled had the most musculoskeletal problems and the lowest self-rated mental health. Musculoskeletal problems among home-care workers had a direct negative effect on self-rated mental health and indirect negative effects on sleep problems. Conclusion: Measures are needed to reduce the differences in working conditions and health status among the occupation types of home-care workers. Considering the relevance between the health issues of home-care workers, the development of a carefully designed health promotion strategy is required.

• 근관절건강학회지
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• 제27권2호
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• pp.169-176
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• 2020

Purpose: This study aims to investigate the factors affecting fatigue of care helpers in long-term care facilities. Methods: The subjects consisted of 131 care helpers at six long-term care facilities in Chungcheongnam-do. A survey was conducted between July and September 2019 to collect data, which were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis.Results: An increase in fatigue of care helpers owing to taking care of over 10 patients a day, increase in emotional labor and sleep disturbance, and a decrease in economic status was observed. Their fatigue decreased when there was an increase in their subjective health status and job satisfaction. Work-related stress (β=.37, p<.001), emotional labor (β=.21, p=.014), and sleep disturbance (β=.18, p=.026) significantly predicted fatigue. These factors explained 37% of the total variance in fatigue (F=10.48, p<.001).Conclusion: In addition to improving the work environment, interventions that alleviate emotional labor and improve sleep quality, are needed to lower the fatigue of care helpers.

• 수면정신생리
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• 제24권1호
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• pp.5-11
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• 2017

The use of alcohol is associated with the development and worsening of sleep disorder. Alcohol is generally known to have a sedative effect, but it has an arousal or sedative effect depending on the timing and drinking dose and directly affects REM sleep physiology. Alcohol acts on the central nervous system (CNS) to interfere with the sleep-wake cycle and to affect sleep-related hormone secretion. In addition, the ingestion of alcohol pre-sleep is associated with deterioration and development of sleep related breathing disorders (SBD). The increase in resistance of the upper respiratory tract and the decrease in sensitivity of the CNS respiratory center and the respiratory muscles are major mechanisms of alcohol-induced SBD, and result in snoring or apnea in healthy men or aggravating apnea in patients with OSA. Sleep-related restless leg syndrome and circadian rhythm disorders are common in alcohol use disorder patients. This review provides an assessment of scientific studies that investigated on the impact of alcohol ingestion on nocturnal sleep physiology and sleep disorders.

• Tuberculosis and Respiratory Diseases
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• 제86권3호
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• pp.203-215
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• 2023

Background: Surgical resection is the standard treatment for early-stage lung cancer. Since postoperative lung function is related to mortality, predicted postoperative lung function is used to determine the treatment modality. The aim of this study was to evaluate the predictive performance of linear regression and machine learning models. Methods: We extracted data from the Clinical Data Warehouse and developed three sets: set I, the linear regression model; set II, machine learning models omitting the missing data: and set III, machine learning models imputing the missing data. Six machine learning models, the least absolute shrinkage and selection operator (LASSO), Ridge regression, ElasticNet, Random Forest, eXtreme gradient boosting (XGBoost), and the light gradient boosting machine (LightGBM) were implemented. The forced expiratory volume in 1 second measured 6 months after surgery was defined as the outcome. Five-fold cross-validation was performed for hyperparameter tuning of the machine learning models. The dataset was split into training and test datasets at a 70:30 ratio. Implementation was done after dataset splitting in set III. Predictive performance was evaluated by R² and mean squared error (MSE) in the three sets. Results: A total of 1,487 patients were included in sets I and III and 896 patients were included in set II. In set I, the R² value was 0.27 and in set II, LightGBM was the best model with the highest R² value of 0.5 and the lowest MSE of 154.95. In set III, LightGBM was the best model with the highest R² value of 0.56 and the lowest MSE of 174.07. Conclusion: The LightGBM model showed the best performance in predicting postoperative lung function.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2609-2619
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• 2015

본 연구는 노인요양시설 노인들의 우울과 건강상태, 일상생활수행능력, 수면상태의 관련성을 파악하고자 실시하였다. 연구대상자는 노인요양시설에서 거주하는 만 65세 이상의 노인을 대상으로 하였다. 노인요양시설 노인들의 우울 관련성은 시력상태, 치아상태, 수면의 질, 수면상태 등과 관련이 있었으며, 시력상태가 나쁜 군, 치아상태가 나쁜 군, 수면의 질이 나쁜 군, 수면장애가 있는 군에서 높게 나타났다. 우울과의 상관관계에서는 우울과 연령과는 음의 상관관계로 나타났고, 치아상태, 수면의 질 등이 양의 상관관계가 있는 것으로 나타났다. 노인요양시설 노인들의 우울에 영향을 미치는 요인으로 시력상태, 치아상태, 수면상태, 청력상태 등이 관련성이 높게 나타났다. 결론적으로, 노인요양시설 노인들의 우울과의 관련성은 개인이 인지하는 건강상태와 관련이 높으며, 건강관리와 간호중재도 개인별 건강상태에 세심한 관심과 시력상태, 치아상태가 낮은 노인관리가 중요하다고 하겠다.

• 한국의료질향상학회지
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• 제1권1호
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• pp.124-131
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• 1994

Polysomnography is an essential methodology for diagnosing and following up sleep disorders and doing researches on human sleep. Sleep medicine, mainly with the utilization of polysomnographic techniques, has developed itself as one of the promising fields in the 21st century medicine. Korea is not an exception in importing and developing sleep medicine into the conventional medicine. However, it still remains to be clarified what polysomnography is for and how it should be done, considering the relatively recent introduction of sleep medicine into Korea. The author, being a board-certified sleep medicine specailist, having experienced spreading out sleep medicine within Korea for the past four years, and having recently set up a major sleep study facility in Korea at Seoul National University Hospital, attempts in this introductory critical article to review the essential issues related to quality assurance in polysomnographic study of human sleep. Also, unconditional introduction of "automated" sleep scoring system, which has been found to have significantly reduced reliability in various studies including the author's own, is critically reviewed. The author suggests that quality assurance and training program should be initiated and established by a responsible sleep medicine-related organization such as the Korean Association of Sleep Medicine and Psychophysiology.

• 수면정신생리
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• 제24권1호
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• pp.19-23
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• 2017

Obstructive sleep apnea is a common disorder in which respiratory flow decreases or disappears despite respiratory effort due to occlusion of the upper respiratory tract during sleep. Oxidative stress and systemic inflammatory reaction induced by the obstruction cause complications such as hypertension, coronary artery disease, and diabetes and increase cancer incidence. Furthermore, in patients with interstitial lung disease, obstructive sleep apnea has a very high prevalence and is thought to have a close pathophysiological and clinical correlation. In other words, obstructive sleep apnea could be the cause or a complication of interstitial lung disease ; when these two afflictions coexist, the prognosis of the patient is worse. In patients with interstitial lung disease with obstructive sleep apnea, CPAP treatment significantly improved sleep and quality of life, as well as improved morbidity and mortality in a recent study. Therefore, early diagnosis and treatment of obstructive sleep apnea in patients with interstitial lung disease are very important, and additional studies designed to include patients with idiopathic pulmonary fibrosis as well as patients with advanced interstitial lung disease should be performed.