• 수면정신생리
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• 제17권1호
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• pp.11-15
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• 2010

Obstructive sleep apnea is a common sleep disorder that predominantly affects adult men than women. However, the prevalence in women increases with menopause dramatically. Menopause has long been described as a risk factor for obstructive sleep apnea. Recent large well-designed population studies support that menopause increases the risk for sleep-disordered breathing. The mechanism of that hypothesis is not yet clear. But, the decline in progesterone has been thought to influence the development of obstructive sleep apnea because progesterone is a respiratory stimulant and plays a protective role against sleep apnea. Increased visceral obesity and hypertension as major symptoms of metabolic syndrome are also associated with menopause and place women at increased risk for obstructive sleep apnea and other serious health problem. Hormone replacement therapy has been associated with a lower prevalence of sleep apnea. But, relative risk and benefits of hormone replacement therapy compared with other treatment options will require thorough consideration for each individual woman. Finally, attention should be drawn to the need for obstructive sleep apnea evaluation in perimenopausal and postmenopausal women.

• Safety and Health at Work
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• 제6권3호
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• pp.240-248
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• 2015

Background: Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work. Methods: Sixty-one male offshore employees-20 night workers, 16 swing shift workers, and 25 day workers-rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1-11) for 14 days after an offshore tour. After the two night-work schedules, differences on the $1^{st}$ day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis. Results: After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05-1.89) and swing shift workers (1.42, 95% confidence interval 1.03-1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found. Conclusion: After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the $1^{st}$ day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.

• Journal of Korean Biological Nursing Science
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• 제13권3호
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• pp.229-237
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• 2011

Purpose: The objective of this study was to investigate the relationships between sleep quality, fatigue, depression and health promoting behavior by shift-work patterns in university hospital nurses. Methods: A cross-sectional, descriptive survey was conducted using a convenient sample. The self-administered questionnaires were given to 165 nurses (shift workers 91, non-shift workers 74) employed in two university hospital located in Seoul and Gyeunggi-do. Data were collected from February to March, 2010. Results: The shift workers showed significantly lower sleep quality and health promoting behavior, and higher fatigue than non-shift workers. There were significant correlations between fatigue, depression and health promoting behavior in shift workers. There were significant correlations between sleep quality, fatigue, depression and health promoting behavior in non-shift workers. In multiple linear regression analysis, after controlling for total work experiences, predictor of health promoting behavior in shift workers was only fatigue (${\beta}$=-.29, p<.001). Predictors of health promotion behavior in non-shift workers were depression (${\beta}$=-.37, p=.002) and fatigue (${\beta}$=-.27, p=.023). Conclusion: This study failed to provide a clear explanation why sleep quality does not have a comparable effect on health promotion behaviors of shift-workers as well as non-shift workers. However, future research is needed to determine the various risk factors influencing on health promotion behaviors by which shift-work pattern exacerbates fatigue.

• Asian Pacific Journal of Cancer Prevention
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• 제16권11호
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• pp.4705-4710
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• 2015

Background: Though a large proportion of cancer survivors are assumed to be commonly affected by sleep disturbance, few studies have focused on short sleep problems and its correlates among Korean cancer survivors. The purpose of this study was to evaluate the prevalence of short sleep in adult cancer survivors from a nationwide population-based sample and to identify risk factors for short sleep duration. Materials and Methods: Based on the fourth and fifth Korea National Health and Nutrition Examination Surveys (2007-2012), 1,045 cancer survivors and 33,929 non-cancer controls were analyzed. The prevalence of short sleep was compared between these two groups. Associations between short sleep and its correlates were evaluated using multiple logistic regression among cancer survivors: odds ratios (ORs) and 95% confidence intervals (95%CIs) were estimated after adjusting for sociodemographic factors, lifestyle factors, psychological conditions, and cancer-related factors. Results: About 8.1% of cancer survivors slept for less than 5 hours per day (6.2% men and 9.3% women), whereas this was the case for only 3.7% of non-cancer controls. Cancer survivors who had the lowest household income level showed a significantly higher likelihood for short sleep (adjusted OR 2.82, 95%CI 1.06-7.54). Self-reported poor health and depressive symptoms were found to be associated with significantly increased likelihood for short sleep in cancer survivors (adjusted OR 3.60, 95%CI 1.40-9.26 and adjusted OR 2.00, 95%CI 1.17-3.42). Gastric cancer survivors had a 3.97-fold increased risk for short sleep (95%CI 1.60-9.90). Conclusions: The prevalence of short sleep occurs at a high rate among the Korean cancer survivors, which may indicate a poorer quality of life and a higher risk of future complications in survivorship. Targeted interventions that can assist cancer survivors to cope with sleep disturbances as well as ensuring psychological stability are warranted to reduce the latent disease burden.

• 보건행정학회지
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• 제29권1호
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• pp.68-76
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• 2019

Background: This study investigates the association between sleep duration and diabetes mellitus (DM) in a large representative population-based survey in South Korea. Methods: The fourth (2007-2009), fifth (2010-2012), and sixth (2013) Korea National Health and Nutrition Examination Survey data sets were used. A total of 37,989 individuals were selected for the study. Chi-square tests and multivariate logistic regression analyses were used to analyze whether general characteristics, health status, and health risk behaviors were associated with DM. Results: After adjusting for confounders, the odds of DM in short sleepers (${\leq}5hr/day$) and long sleepers (${\geq}9hr/day$) were 1.033-times higher (95% confidence interval [CI], 0.913-1.169) and 1.334-times higher (95% CI, 1.140-1.562), respectively, compared with individuals who slept 7 hr/day. Subgroup analysis according to gender showed a U-shaped association for both genders, although it appeared stronger in men. Conclusion: This study identified a U-shaped association between sleep duration and the risk for DM. Additional studies should help clarify the important information in this study.

• 성인간호학회지
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• 제22권3호
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• pp.281-290
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• 2010

Purpose: This purpose of this study was to identify the factors related to the health related quality of life among institutionalized elders. Methods: The subjects were 247 elders institutionalized among one of the four nursing homes in Busan. Data were collected through interview with four standardized questionnaires from August to October, 2008. Questionnaires were related to health related quality of life (SmithKline Beecham's Quality of Life scale, SBQoL), quality of sleep(Pittsburgh Sleep Quality index, PSQI), activity of daily living (Katz ADL Index), and depression (Geriatric Depression Scale Short Form Korea, GDSSF-K). Data were analyzed for descriptive analysis, t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression by using SPSS/WIN 17.0 program. Results: The mean HRQoL in the subjects was $6.62{\pm}0.91$. Percentage of the respondents reporting sleep disorders were 72.5% and 27.1% reported being vulnerable to depression. The significant predictors of the HRQoL were sleep quality, activity of daily living (ADL), level of education, and depression. The factors accounted for 28.8% of variance in the health related quality of life of institutionalized elders. Conclusion: Sleep quality, activity of daily living, and depression need to be considered as the important control factors for improving the health related quality of life in the institutionalized elders.

• 대한간호학회지
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• 제43권1호
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• pp.81-90
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• 2013

Purpose: This study was done to test structural equation modeling of health-related quality of life (QOL) of men with obstructive sleep apnea in order to identify parameters affecting QOL and provide guidelines for interventions and strategies to improve QOL in these patients. Methods: Model construction was based on 'The conceptual model of patient outcome in health-related QOL' by Wilson and Cleary, using the variables; age, physiological factors, social support, cognitive appraisal, symptoms and QOL. Participants were 201 adult male patients recruited at a tertiary university hospital in Seoul. Data were collected via questionnaires, polysomnography, and clinical records. Results: Age and symptoms directly influenced QOL. Social support and cognitive appraisal about sleep did not have a direct influence on QOL, but indirectly affected it via symptoms. QOL was lower in patients who were younger and had more severe symptoms. Symptoms were more severe for patients with lower social support and more dysfunctional cognitive appraisal. When social support was lower, cognitive appraisal was more dysfunctional. Conclusion: These results suggest it is necessary to not only manage symptoms, but also apply interventions to increase social support and cognitive appraisal about sleep in order to increase QOL in patients with obstructive sleep apnea.

• Safety and Health at Work
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• 제7권2호
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• pp.120-123
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• 2016

Background: To assess in a laboratory setting the ability to stay awake in a sample of workers of an Italian hospital and to investigate the association between that ability and the risk of occupational injury. Methods: Nine workers at the University Hospital of Udine who reported an occupational injury in the study period (cases), and seven noninjured workers (controls) underwent a polysomnography and four 40-minute maintenance of wakefulness tests (MWT). Differences in sleep characteristics and in wakefulness maintenance were assessed using Wilcoxon's rank sums tests and Fisher's exact tests. Results: Controls had greater sleep latency, lower total sleep time, fewer leg movements, and a higher percentage ratio of cycling alternating pattern, were more likely not to fall asleep during the MWT and were less likely to have two or more sleep onsets. Although not all the differences reached statistical significance, cases had lower sleep onset times in Trials 1-3. Conclusion: In the literature, the evidence of an association between MWT results and real life risk of accidents is weak. Our results suggest a relationship between the MWT results and the risk of injury among hospital workers.

• 생물정신의학
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• 제21권2호
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• pp.74-80
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• 2014

Objectives More than half of the elders suffer from chronic sleep disturbances. Moreover, sleep disturbances are more prevalent in patients with depressive disorder than in community dwelling elderly. In this study, we aim to estimate the risk factors of poor sleep quality and its effect on quality of life in patients with late life depression. Methods This study included 159 depressive patients aged 65 years or older who completed Pittsburgh Sleep Quality Index (PSQI). A global PSQI score of 5 or greater indicates a poor sleeper. Structural diagnostic interviews were performed using the Korean version of Mini International Neuropsychiatric Interview (MINI). Depression was evaluated by the Korean form of Geriatric Depression Scale (KGDS). Global cognition was assessed by Mini-Mental State Examination in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment packet. Quality of life was evaluated by the Korean version of Short-Form 36-Item Health Survey (SF-36). Results The frequencies of poor sleepers were 90.5% in major depressive disorder, 71.8% in minor depressive disorder, 47.1% in subsyndromal depressive disorder, and 73.0% in all types of depressive disorders. Multivariate logistic regression analysis indicated that female [odds ratio (OR) = 2.83, 95% confidence interval (CI) = 1.20-6.67] and higher KGDS score (OR = 1.13, 95% CI = 1.05-1.21) were risk factors of poor sleep quality in patients with late life depression. In the analysis of ANCOVA adjusted for age, gender, education and KGDS score, the mean scores of vitality mental health and mental component summary of SF-36 were lower in poor sleepers than in good sleepers. Conclusions Poor sleepers among patients with late life depression are very common and are associated with female and higher KGDS scores. Poor sleep quality causes a significant negative effect on mental health quality. So researchers and clinicians should be more vigilant in the evaluation and treatment of sleep disturbances in patients with late life depression.

• Safety and Health at Work
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• 제15권1호
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• pp.53-58
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• 2024

Background: As social distancing persists and interest in work-life balance grows, more companies are adopting flexible work policies. While there have been studies on sleep disorders associated with different types of work, such as shift work, research exploring the relationship between flexible work schedules and sleep disorders is still limited, particularly among Korean workers. Methods: We performed a secondary analysis of the 6th Korean Working Conditions Survey, focusing on 31,243 paid workers out of a total of 50,538 participants. We defined flexible workers as those who set their own working hours. Sleep disorders were divided into three categories: 'difficulty falling asleep,' 'frequent waking during sleep,' and 'waking up feeling exhausted and fatigued.' Using scores derived from three specific symptoms, the Minimal Insomnia Symptoms Scale (MISS) was calculated to assess the prevalence of insomnia. We used chi-square tests to analyze demographic and job-related differences. A multivariate logistic regression analysis was employed to identify any relationship between flexible work schedules and sleep disorders. Results: Significant differences were found between flexible and non-flexible workers regarding age, income level, education level, and job type. Flexible workers reported sleep-related symptoms significantly more often. The odds ratio for insomnia was 1.40 (95% CI 1.21-1.61). For males, the odds ratio was 1.68 (1.36-2.08). Conclusion: This study establishes a correlation between flexible work schedules and sleep disorders among Korean salaried workers. Potential causes could include changes in circadian rhythm, increased work demands, and extended working hours. To precisely determine causality and associated diseases, further research is required.