• 수면정신생리
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• 제8권2호
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• pp.113-120
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• 2001

배 경 : 폐쇄성 수면무호흡증은 다양하고 심각한 임상 증상과 합병증을 유발하는 질환으로 국내에서도 흔히 진단되고 있다. 그러나 현재까지 수면다원기록법을 사용해 폐쇄성 수면무호흡증을 확진한 환자들의 대규모 국내 연구를 찾아 볼 수 없었다. 본 연구에서는 종래의 연구에서보다 더 큰 집단을 대상으로 수면다원기록법을 사용해 폐쇄성 수면무호흡증으로 확진된 한국인 환자의 임상적 특성과 수면 양상에 관해 조사하였다. 방 법 : 서울대학교병원 수면다원검사실에 의뢰된 환자들 중 수면다원검사 결과 폐쇄성 수면무호흡증으로 진단된 환자 801명을 대상으로 하였다. 중추성 무호흡증, 주기성 사지운동증, 기면병, 렘수면관련행동장애, 그리고 외국인 환자는 제외하였다. 연구 대상 군의 임상적 특징을 조사하였으며 수면 변인들을 연령, 성별에 따른 정상치와 비교하였다. 그리고 호흡장애지수가 수면변인에 미치는 영향을 분석하였다. 결 과 : 전체 연구대상자 801명 중 남자가 83.4%, 여자가 16.4%이었고 평균 연령은 46.6세였다. 평균 비만정도 지수는 25.8이었고 비만한 환자가 22.8%를 차지하였다. 전체 대상 중 6.2%가 벤조디아제핀계 약물을 복용 중이었다. 연구 대상군에서 정상치에 비해 입면잠복시간은 증가되었고 수면효율, 렘수면 분율, 그리고 서파수면 분율은 감소하였다. 서파수면 분율과 렘수면 분율은 각각 호흡장애지수와 음의 상관성을 보였으나 수면효율과 입면잠복시간은 모두 호흡장애지수와 유의한 상관관계가 없었다. 결 론 : 본 연구에서 다수의 폐쇄성 수면무호흡증 환자가 비만과 무관하였다. 또한 6.2%의 폐쇄성 수면무호흡증 환자가 벤조디아제핀계 약물을 복용하고 있었다. 폐쇄성 수면무호흡증의 발병은 수면효율도 낮추고 서파수면과 렘수면 분율을 감소시키나 호흡장애지수가 커져도 서파수면과 렘수면 분율이 감소할 뿐 수면효율은 별 다른 변화가 없었다. 즉, 수면효율보다는 수면 구조의 변화가 수면 중 호흡장애의 정도에 더 관련되었음을 알 수 있었다.

• 수면정신생리
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• 제24권1호
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• pp.38-45
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• 2017

목 적 : 불면 증상을 나타내는 수면 장애는 고령화 현상과 더불어 매우 급격히 증가중인 질환이다. 3년간 추적 관찰한 우리나라 농촌의 60세 이상 노인 코호트를 대상으로 수면 장애의 유병률과 이를 예측하는 요인을 알아보고자 하였다. 방 법 : 한국인의 사회적 삶, 건강과 노화에 대한 2012년과 2014년의 조사를 통해 두 번 데이터를 얻었다. 뇌졸중, 심근경색증, 협심증, 관절염, 폐결핵, 천식, 백내장, 녹내장, B형 간염, 요실금, 전립선 비대, 암, 골다공증, 고혈압, 당뇨, 고지혈증, 대사증후군에 대한 진단 여부를 물었다. 치매선별용 간이정신상태검사를 이용하여 인지 기능을 평가하였고 역학연구 우울척도를 이용하여 우울 증상을 평가하였다. 2015년에는 이 중 235명에게 DSM-IV의 제1축 장애의 구조화된 임상적 면담을 시행하였고 피츠버그 수면 질 척도로 불면증의 정도, 즉 수면 장애를 평가하였다. 또한, 지각된 스트레스 척도와 상태-특성 분노표현 척도를 시행하였다. 수면장애를 예측하기 위하여 성별, 나이, 교육, 첫 번째와 세 번째 주기의 우울 점수, 공존 질환의 개수, 그리고 현재의 분노 억제 점수와 지각된 스트레스 정도를 설명 변인으로 삼아 로지스틱 회귀분석을 시행하였다. 결 과 : 조사 대상의 27%가 수면 장애를 가지고 있었다. 회귀 분석 결과, 3년 전의 공존 질환 수, 1년 전의 우울 점수 및 현재 지각된 스트레스 정도가 수면 장애를 유의하게 예측하였다. 결 론 : 3년 전 측정한 공존 질환과 1년 전 평가한 우울증상이 현재의 수면 장애를 예측할 수 있었다. 공존 질환 및 우울 증상의 치료가 수면 장애를 호전시킬 수 있는지 추가적 연구가 필요하다.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.324-329
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• 2000

Objective : Psychological factors may have a major influence on the outcome of treatment for back pain. We investigated the relationship between the outcome and some psychological factors, such as self-reported pain intensity, disability, sleep disturbance and fatigue. Method : The study was conducted as a survey using a questionnaire and telephone interviews. The survey included consecutive 294 patients who visited the neurosurgical out-patient department complaining of low back pain and contacted by telephone on average seven months after the first visit. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. Results : The outcome of treatment for back pain was recovered in 36.7%, improved in 30.6%, almost same in 28.6%, and aggravated in 4.1%. Overall rate of improvement was 67.3%. The rate of improvement was related to the duration, patterns and intensity of the symptom, and Waddell index. It was not influenced by the doctors, special studies, and methods of treatment. When the duration was more than 6 months, there were the symptoms of both back and legs, and the self-reported Waddell index was 1-3, the rate of improvement was relatively low. Although the intensity of the pain and disability was closely related to the degree of sleep disturbance, fatigue, appetite, or indigestion, the outcome of treatment for back pain was not always bad in patients with high psychological stress. Actually the outcome of the patients who complained severe pain and disability was better than the outcome of the others. Conclusion : The outcome of the back pain can be predicted by the duration, patterns and intensity of the symptom, and Waddell index. The multidisciplinary treatment will be necessary for the patients whose expected outcome is not good to reduce not only the physical symptoms but also the psychological stress.

• 수면정신생리
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• 제17권2호
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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.

• 한국자연치유학회지
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• 제9권2호
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• pp.57-61
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• 2020

목적: 본 연구는 갱년기 증상이 있는 50대 여성 대상자들이 족욕을 하였을 때 갱년기 증상 및 수면장애에 미치는 효과를 연구하는 것이 목적이었다. 방법: 12주간 주 3회 족욕요법을 실시한 후에 갱년기 증상의 사전 및 사후 변화를 조사하였다. 결과: 안면홍조, 심장 불편감, 수면 문제, 우울감, 과민성, 불안감, 신체 및 정신적 피로, 성적인 문제, 배뇨문제, 질 건조감, 관절 및 근육 불편감이 있는 대상자는 사전보다 사후에 모두 유의성이 있게 개선되었다(p < .001). 족욕 후에 주관적 수면의 질, 수면 잠복기, 수면 기간, 수면 방해점수, 수면 약물 이용 및 수면 기능장애는 사전보다 사후가 유의하게 감소하였다(p < .001). 습관적 수면 효율성 유의하게 증가하였다. 결론: 대상자들이 족욕 후에 갱년기 증상과 수면의 질이 전반적으로 개선된 것으로 나타났다. 따라서 족욕요법은 갱년기 증상 및 수면 개선에 적합한 자연치유적 요법이라 평가한다.

• 대한간호학회지
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• 제36권1호
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• pp.136-143
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• 2006

Purpose: The purpose of this study was to explore the effects of the lavender fragrance on sleep and depression in women college students, Method: Forty-two women college students who complained of insomnia were studied during a four-weekprotocol( control treatment week, $60\%$ lavender fragrance treatment week, washout week, $100\%$ lavender fragrance treatment week), All subjects were in the department of nursing in 'K' college and the study was a single blind repeated measurements experiment For the duration of the study, weekly evaluations of sleep, patterns of sleep disturbance, severity of insomnia scale, self satisfaction with sleep, and severity of depression were performed. Result: Among sleep variables, length of time taken to fall asleep, severity of insomnia, and self satisfaction with sleep were improved for the $60\%$(p=.000, p=.000, p=.000) and $100\%$(p=.000, p=.000, p=.000) week while the severity of depression was improved only for the $100\%$(p=.002)week. Conclusion: According to the study results, it can be concluded that the lavender fragrance had a beneficial effect on insomnia and depression in women college students. Repeated studies are needed to confirm effective proportions of lavender oil and carrier oil for insomnia and depression.

• 수면정신생리
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• 제5권2호
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• pp.210-215
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• 1998

OSA(Obstructive Sleep Apnea) is a condition with repeated obstruction of the upper airway while sleeping. This obstruction of the upper airway may result if sleep-induced physiologic change in muscle activity is superimposed on various structural defects of the upper airway. Macroglossia, micrognathia, retrognathia, and decreased airway lumen have all been implicated in OSA. There are a variety of surgical and nonsurgical treatment modalities currently available for OSA. Recently the uvulopalatopharyngoplasty has achieved widespread use, but success rates vary and long-term effects are still unknown. Current nonsurgical treatment methods can be cumbersome and uncomfortable with variable responses. For this case. we diagnosed as OSA by using polysomnographic analysis and cephalometric analysis, and delivered intraoral removable appliance which is more conservative, reversible and easy to use for patient. And we got results that Apnea Index(AI) decreased from 14.4 to 3.1, Total Respiratory Disturbance Index(Total RDI) decreased from 18.1 to 7.0 and removal of chronic headache in daytime.

• 수면정신생리
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• 제18권2호
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• pp.63-66
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• 2011

It has been controversial whether upper airway resistance syndrome (UARS) is a distinct syndrome or not since it was reported in 1993. The International Classification of Sleep Disorders classified UARS under obstructive sleep apnea syndrome (OSAS) in 2005. UARS can be diagnosed when the apnea-hypopnea index (AHI) is fewer than 5 events per hour, the simultaneously calculated respiratory disturbance index (RDI) is more than 5 events per hour due to abnormal non-apneic non-hypopneic respiratory events accompanying respiratory effort related arousals (RERAs), and oxygen saturation is greater than 92% at termination of an abnormal breathing event. Although esophageal pressure measurement remains the gold standard for detecting subtle breathing abnormality other than hypopnea and apnea, nasal pressure transducer has been most commonly used. RERAs include phase A2 of cyclical alternating patterns (CAPs) associated with EEG changes. Symptoms of OSAS can overlap with UARS, but chronic insomnia tends to be more common in UARS than in OSAS and clinical symptoms similar with functional somatic syndrome are also more common in UARS. In this journal, diagnostic and clinical differences between UARS and OSAS are reviewed.

• 근관절건강학회지
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• 제18권1호
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• pp.28-38
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• 2011

Purpose: This paper was aimed to investigate the effect of laugher therapy on the pain, depression and sleep disturbance in elderly patients who admitted in long term care facility. Method: This study used a nonequivalent control group pretest-posttest design. A sample of 40 elderly patients (20: experimental group, 20: control group, 65 or older) were recruited. Visual analogue scale was used to measure level of pain level, Geriatric Depression Scale Short Form Korea Version (GDSSF-K) for depression. Sleep Scale for sleep. The laugher therapy was given twice a week for four weeks (8 times). Each therapy consists of preparatory, action and finishing stage. Data were analyzed by PASW 18.0. Results: The pain score in experimental group was significantly different from that in control group (t=4.17, p<.001). The level of depression in experimental group was significantly different from that in control group (Z=4.12, p<.000). The level of sleep in experimental group was not significantly different from that in control group (Z=-1.43, p<.152). Conclusion: A laugher therapy is expected to be practical used an efficient method of a nursing intervention to elderly patients in long term care facility.

• 성인간호학회지
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• 제14권3호
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• pp.378-389
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• 2002

Purpose: The purpose of this study was to identify the relationship of fatigue and quality of sleep in patients with cancer. Method: The data was collected from January to February 2001. Study objects were recruited K university hospital in Busan, Korea. Their fatigue was measured using the Revised Piper Fatigue Scale developed by Piper et. al(1998), and quality of sleep was measured using Quality of Sleep Questionare by Oh et. al(1998). Result: 1) The fatigue score was mean $114.80{\pm}34.88$(range: 22-220). The sub dimension that showed behavior/severity score at $33.70{\pm}13.89$, affective score at $24.23{\pm}3.33$, sensory score at $27.74{\pm}12.51$, and cognitive/mood score at $29.11{\pm}3.71$. And sleep quality score was mean $37.32{\pm}8.18$. 2) There was a significant difference in religion(F=4.157, P= .008), present therapy(F=2.536, P= .043), past therapy(F=6.625, P= .000), major caregiver(F=3.133, P= .028), and change of weight(F=7.965, P=.006), according to general characteristics in the fatigue in patients with cancer. 3) There was a significant difference in present pain(t=-2.103, P= .037) and change of weight(F=5.484, P=.005), according to general characteristics in the sleep quality in patients with cancer. 4) There was a significant negative correlation between fatigue and quality of sleep(r=- .340, P= .000). Conclusion: Patients with cancer experience in fatigue. Increase in fatigue are associated with decreases in quality of sleep. Nurses must provide patients with nursing care about the occurrence of fatigue and interventions to deal with sleep disturbance.