Childhood narcolepsy is one of the underdiagnosed diseases even the first symptoms often appear in childhood. Making diagnosis through history taking is not always easy because the symptoms of childhood narcolepsy are different from those of adulthood. Diagnostic laboratory tests such as sleep studies, tests for human leukocyte antigens, cerebrospinal fluid hypocretin measurement should be considered when the child has excessive daytime sleepiness without cataplexy. Treatment approach should be start as early as possible to avoid secondary academic, emotional difficulties. Both pharmacological and non-pharmacological management, and close cooperation between parents and school teachers should be maintained. In the near future, childhood narcolepsy can be a key to understand the pathogenesis of narcolepsy.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.48
no.5
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pp.277-283
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2022
Objectives: The main purpose of the present study was to investigate the associations between the risk of obstructive sleep apnea (OSA) and chronic orofacial pain in a nationally representative sample of the Korean population. Materials and Methods: Data from the 8th wave Korean national health and nutrition examination survey, which was conducted from 2019 to 2020 were analyzed. This study included 5,780 Koreans (2,503 males, 3,277 females) over 40 years of age. The presence of subjective chronic facial pain lasting more than 3 months was evaluated based on a self-reported questionnaire. The risk of OSA was determined using the STOP-BANG questionnaire. Data related to anthropometric and sociodemographic factors; diagnostic history of hypertension, depression, and OSA; level of health-related quality of life and stress awareness; health-related behaviors, including smoking and alcohol drinking; and sleep duration were collected. The participants were classified into two groups according to the presence of chronic facial pain. Results: The level of health-related quality of life and stress awareness showed significant differences between the two groups. The sleep duration on weekends also presented significant differences. No significant differences were observed in the presence of snoring and observed apnea, while participants with chronic facial pain showed significantly higher levels of tiredness between the groups. The risk of OSA evaluated by STOP-BANG questionnaire showed significant differences between groups; however, the risk of OSA seemed to be higher in participants without chronic facial pain. Conclusion: The participants with chronic facial pain demonstrated decreased sleep duration, lower health-related quality of life, and increased stress and tiredness. Even though, the role of OSA in the development of chronic facial pain was inconclusive from the study, it is possible that ethnicity play a role in relationship between OSA and chronic facial pain.
Objectives: REM sleep behavior disorder (RBD), characterized by excessive motor activity during REM sleep, is associated with loss of muscle atonia. In recent years, it has been reported that RBD has high co-morbidity with CNS disorders (especially, Parkinson's disease, dementia, multiple system atrophy, etc.). We aimed to assess differences in clinical and polysomnographic findings among RBD patients, depending on the presence or absence of central nervous system (CNS) disorders. Methods: The medical records and polysomnographic data of 81 patients who had been diagnosed as having RBD were reviewed. The patients were classified into two groups: associated RBD (aRBD, i.e., with a clinical history and/or brain MRI evidence of CNS disorder) and idiopathic RBD (iRBD, i.e., without a clinical history and/or brain MRI evidence of CNS disorder) groups. Twenty-one patients (25.9%) belonged to the aRBD group and 60 patients (74.1%) belonged to the iRBD group. The clinical characteristics and polysomnographic findings of the two groups were compared. Results: Periodic limb movement disorder (PLMD), i.e., PLMI (periodic limb movement index)>5, was observed more frequently in the aRBD group than in the iRBD group (p<0.001, Fisher's exact test). Also, obstructive sleep apnea syndrome (OSAS), i.e., RDI (respiratory disturbance index)>5, was found more frequently in the aRBD group (p=0.0042, Fisher's exact test). The percentages for slow wave sleep and sleep efficiency were significantly lower in the aRBD group than in the iRBD group. Conclusion: We found that 1 out of 4 RBD patients had associated CNS disorders, warranting more careful neurological evaluation and follow-up in this category of RBD. In this category of RBD patients, we also found more frequent PLMD and OSAS. These patients were also found to have lower slow wave sleep and sleep efficiency. In summary, RBD patients with associated CNS disorders suffer from more disturbed sleep than those without them.
Kim, Se-Joong;Jung, Ki-Hwan;Jo, Won-Min;Kim, Young-Sik;Shin, Chol;Kim, Je-Hyeong
Tuberculosis and Respiratory Diseases
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v.70
no.4
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pp.338-341
/
2011
Hydatid disease is caused by the larval stage of taenia $Echinococcus$, which endemic in the Mediterranean region. Recently, the prevalence of the disease has increased worldwide due to an increase in the frequency of travel and immigration. As the infested larvae migrate through the bloodstream, the final destination is most commonly the liver or lungs; direct pleural invasion is very rare. A 50-year-old diabetic Korean man presented with an incidentally noted 2 cm right pleural nodule. On follow up imaging after three months, its size had increased. To confirm the diagnosis of the lesion, surgical excision was performed. Histopathological examination showed the diagnosis of a hydatid cyst. The patient had no history of overseas travel, but lives in an urban area where many foreign workers from endemic countries reside. This is the first reported case of primary pleural hydatid disease in a non-endemic country.
This study was performed to investigate about sleep quality and orofacial pain pattern between experimental and control group. 101 subjects with temporomandibular disorders without any psychologic and neurologic problem were selected from the patients presented to Wonkwang University dental hospital. Routine clinical examination for TMD was carried out, especially for the frequency of headache and the craniocervical muscles were also done by the author in the first visit. All the subjects filled out the questionnaires, that was, for the evaluation of sleep quality using Pittsburgh sleep quality index(PSQI), and for the analysis of behavioral pain scale questionnaires. Data obtained were statistically processed by the SPSS Windows program and the results of this study were as follows: 1. Subjective sleep index, sleep latency, sleep disturbance, global score in control group were significantly lower than 2. Subjective sleep index, sleep disturbance, global score in subject with headache were significantly lower than subject without headache(P<0.05). 3. Medicine taker have sleeping drug. Caffeine drinkers was significantly higher in daytime dysfunction, global score than no drinker. 4. It have more frequent head and neck pain, pain spreading, daily life difficult in poor sleeper than good sleeper.
Kim, In Sik;Eom, Ji Hun;Yoon, Hyung Joon;Kim, Dong Hwan;Kim, Kyung Rae;Cho, Seok Hyun
Journal of Rhinology
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v.25
no.2
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pp.69-74
/
2018
Background and Objectives: Sleep disturbances and excessive daytime sleepiness (EDS) are the major symptoms of obstructive sleep apnea (OSA). This study aimed to investigate clinical implications of insomnia and EDS in patients with OSA using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Materials and Method: We evaluated 131 subjects with suspected OSA who were undergoing polysomnography (PSG) and performing the PSQI and ESS surveys. OSA was diagnosed when the apnea-hypopnea index was five or more. EDS was defined when ESS score was 11 points or higher. Detailed history and questionnaire were used to categorize insomnia. We compared clinical variables and PSG results in subgroups with or without insomnia and EDS. Results: There were no significant differences of PSQI and ESS score between controls and OSA. OSA with insomnia had significantly increased total score (p<0.001) and decreased total sleep time (p=0.001) and sleep efficiency (p=0.001) on the PSQI compared to those without insomnia. OSA with EDS showed significantly increased PSQI score (p=0.022) and decreased total sleep time (p=0.018) on PSG compared to those without EDS. Neither PSQI nor ESS score had a correlation with respiratory variables such as AHI and oxygen saturation. Total sleep time had a significant effect on both insomnia and EDS in patients with OSA. Conclusion: Decreased total sleep time had important effects on subjective symptoms of OSA and comorbid insomnia. Therefore, restoration of decreased sleep time is important in the management of OSA.
Objectives: The aim of this study was to determine the affecting factors of metabolic syndrome (MetS) and it's components in Korean adults in their 30s and 40s. Methods: The present study assessed 1,215 subjects who participated in the Korea National Health and Nutrition Examination Survey in 2014. We analyzed the prevalence rate of MetS and it's components and their affecting factors. Results: The prevalence rate of MetS was 16%. Family history of diabetes mellitus and, low or high saturated fat intake were associated with MetS in males. Low income, low education, excessive sleep, excessive carbohydrate and low saturated fat intake were associated with MetS in females. Triglycerides showed the highest prevalence in males and were related to white collar socioeconomic status, smoking, and obesity. Triglycerides and high-density lipoprotein cholesterol were high in females, and triglycerides were affected by excessive sleep, family history, low saturated fat intake, and obesity. High-density lipoprotein cholesterol was affected by obesity. Conclusions: Because sex differences exist in MetS, it is necessary to intervene through diverse approaches. In particular, a continuous management and preventive intervention for obesity is needed.
Park, Jin-Hee;Jung, Young-Mi;Lee, Hye Jin;Seo, Ji-Young
Journal of Korean Academy of Fundamentals of Nursing
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v.25
no.4
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pp.282-292
/
2018
Purpose: The purpose of this study was to identify the prevalence of irritable bowel syndrome and factors related to irritable bowel syndrome (IBS) in university students. Methods: A cross-sectional, descriptive study was conducted using a self-report structured questionnaire with 420 university students. Data collection was done during May and June, 2017. The data were analyzed using descriptive statistics, a t-test, $x^2$ test, and binary logistic regression analysis with IBM SPSS/WIN 22.0 program. Results: The prevalence for IBS was 24% among Korean university students. Family history of IBS (OR=2.98, 95% CI=1.32~6.70), history of stomach and intestinal disease (OR=2.24, 95% CI=1.36~3.77), sleep quality (OR=2.01, 95% CI=1.16~3.48), mild anxiety (OR=2.75, 95% CI=1.19~6.33) and more than moderate anxiety (OR=2.02, 95% CI=1.02~4.00) were found to be factors related to IBS. Conclusion: The prevalence of IBS was high among university students, and sleep quality and anxiety significantly influenced prevalence of IBS in these students. Therefore, interventions to decrease symptom of IBS must focus on management of sleep quality and anxiety.
Objectives: A number of studies have shown that sleep deprivation results in reduced vigilance and increased negative affects such as tension, depression and anger. However there are few studies about effects of sleep deprivation on anxiety. The purpose of this study was to investigate the effects of 40 hour sleep deprivation on state anxiety, affects, sleepiness and fatigue. The authors also intended to study the effect of trait-anxiety on these psychological variables after sleep deprivation. Methods: Twenty nine subjects(22 men, 7 women, $24.59{\pm}1.35$ years of age) participated in this study. Subjects had no past history of psychiatric disorders and physical illnesses, and had normal sleep-waking cycle without current sleep disturbances. All of the subjects completed sleep dairy for two weeks to exclude some who suffered from chronic sleep deprivation or sleep disturbances. Subjects were instructed to get a normal sleep as usual at night before the study. After awakening, subjects remained awake for 40 hours under continuous surveillance. They completed State-Trait Anxiety Inventory, Index of General Affect, Stanford Sleepiness Scale and Fatigue Questionnaire every three hours, therefore they completed the scales 14 times totally. Subjects were dictated not to take caffeine, alcohol, or any medications on the day of the study. Heavy exercises and naps were restricted too. Results: Sleep deprivation resulted in increased state anxiety, negative general affects, and increased sleepiness and fatigue(p<.001). Dividing into high trait-anxiety group and low trait-anxiety group, there was significant sleep deprivation x traitanxiety interaction effect on general affect(p<.05). But, there was no significant sleep deprivation x trait-anxiety interaction effect on state-anxiety, sleepiness and fatigue. During sleep deprivation, the highest ratings of scales on anxiety, negative affect, sleepiness and fatigue occurred between 4 : 00AM and 7 : 00AM. Conclusions: These results show that sleep deprivation results in increased anxiety, mood state disturbance and increment of sleepiness and fatigue. These findings also suggest that trait-anxiety is a factor that influences the degree of worsening in general affect caused by sleep deprivation. During sleep deprivation, the rating curves of anxiety, affect, sleepiness and fatigue show rhythmicity that may be related to circadian rhythm.
Kim, Ju-Sang;Kim, Sung-Kyung;Lee, Sang-Haak;Ahn, Joong-Hyun;Kim, Chi-Hong;Moon, Hwa-Sik
Sleep Medicine and Psychophysiology
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v.14
no.1
/
pp.49-53
/
2007
Mitochondrial myopathy is characterized by variable clinical manifestations from mild limb weakness to fatal respiratory failure and central nervous system sequela. But it is a rare event that sleep disordered breathing become a clue of diagnosis for mitochondrial myopathy. We report a case of a 21 year-old man who was diagnosed as mitochondrial myopathy during the investigation for the possible cause of chronic hypoventilation syndrome. Before being admitted to our hospital, he was suspected as having sleep apnea syndrome in another hospital. We re-evaluated the history, physical examination, laboratoy findings and polysomnography in detail. Severe hypoxemia was noted during REM sleep on nocturnal polysomnography and the diagnosis of mitochondrial myopathy was made by muscle biopsy in rectus abdominis muscle. We treated him with bilevel positive airway pressure therapy during sleep and it could reverse the hypoxemia during REM sleep. He could be discharged with improved condition and is being well with the use of this ventilatory assistance.
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