• Clinical and Experimental Pediatrics
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• v.56 no.5
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• pp.211-217
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• 2013

Purpose: Sleep onset association disorder (SOAD) is a form of behavioral insomnia observed in children that is caused by inappropriate sleep training. SOAD typically disturbs the sleep of not only infants and children but also their parents. We investigated levels of depression and marital intimacy among parents of infants with typical SOAD, to understand the influence of SOAD on family dynamics, as well as examine ways for improving depression and marital intimacy through behavioral training. Methods: Depression and marital intimacy were assessed using the Beck Depression Inventory (BDI) and Waring Intimacy Questionnaire (WIQ). These measures were administered to 65 parents of infants (n=50) diagnosed with SOAD. We conducted sleep education and behavioral training for the parents and compared levels of depression and marital intimacy after 2-6 weeks of training. Results: The 65 parents consisted of 50 mothers and 15 fathers. Depressive symptoms were higher among mothers than fathers (P=0.007). Marital intimacy was negatively correlated with depressive symptoms. Twenty-six parents were assessed again after sleep training. We found that mothers' depressive symptoms and marital intimacy improved post training. Conclusion: SOAD can be detrimental to both infants and parents, especially for parents who sleep with their infants. For instance, disruption of sleep patterns in such parents can reduce marital intimacy. However, behavioral modification is an effective treatment for infants with frequent nighttime waking, as well as for diminishing the depressive symptoms of sleep-deprived parents.

• The Journal of Pediatrics of Korean Medicine
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• v.27 no.3
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• pp.65-73
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• 2013

The subjects were composed of 308 children who visited the department of pediatrics, ${\bigcirc}{\bigcirc}$ korean medicine hospital from January 2010 to May 2013. Results 1. Among 308 patients, there were 188 boys and 120 girls; their ratio was 1.57:1. The age distribution showed that 38.3% were in the age less than 1 years, 38.0% in 1 years, 7.8% in 2 years, 5.2% in 3 years, 3.3% in 4~5 years, 4.5% in 6~10 years, 2.9% in 19~21 years. 2. It was found that 36.7% of the sleep disorder was caused without motivation, 17.2% caused by negligent accidents, 13.9% by traffic accidents, 10.4% by the unfamiliar environment, 8.1% by separation from parents, 7.5% after suffering disease, and 6.2% by irritating sound. 3. The sleep onset insomnia accounts for 17.2% of sleep disorder, sleep maintenance insomnia for 67.5%, poor sleep quality 24.4%, and daytime sleep disorder takes 19.8%. The ratio of sleep onset insomnia in adolescence comprises larger proportion (44.4%) than it of any other age groups. 4. The symptoms complicated with sleep disorder are the respiratory infection which takes 25.3%, being easily startled 18.2%, anorexia 14.6%, soft stools frequency 13.0%, greenish stools 10.7%, and skin rash 10.7%. Conclusions The causes of sleep disorders, changes of sleeping patterns, and complicated diseases show diversity in children and adolescence. Further study of sleep disorders in children and adolescence should be progressed as well.

• The Korea Journal of Herbology
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• v.35 no.6
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• pp.29-34
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• 2020

Objectives : Gyejigamchoyonggolmoryeo-tang (GT, Guizhigancaolonggumulitang in Chinese) is a herbal medicine to be prescribed for insomnia caused by anxiety induced by Heart-Heat and elevated Liver-Yang. In the present study, the onset time (sleep latency) and the duration time of sleep were measured to find out the sleep inducing effects of GT. The expression of c-fos immunohistochemistry was also measured at the ventrolateral preoptic area (VLPO) and tuberomammillary nucleus (TMN) site in brain. Methods : The onset time (sleep latency) and the duration time of sleep were measured 30 minutes after thiopental sodium injection. Thereafter, brain tissue was obtained and c-fos immunohistochemistry was performed on the VLPO and TMN sites. Results : GT statistically significantly reduced the sleep latency required to enter sleep, and significantly increased sleep duration time. GT significantly increased the number of c-fos immunohistochemical staining-positive cells in the sleep-inducing center (VLPO), whereas GT significantly decreased the number of c-fos immunohistochemical staining-positive cells in the arousal center (TMN). Conclusions : It could be concluded that the GT shortened the sleep latency and increased the duration time for sleep induced by thiopental sodium. And it was confirmed that the mechanism was to stimulate the sleep-inducing center (VLPO) and suppress the arousal center (TMN) in the brain. The results of this study are considered to be useful as scientific evidence that can be used clinically for the treatment of insomnia caused by anxiety.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.56-64
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• 1996

The sleeplessness in childhood is quite different from that in adulthood in terms of causes, developmental process, and treatment. Sleep behavior in childhood is strongly influenced by parental personality and familial and cultural background. In understanding and management of sleeplessness of children, it is especially important to understand the separation anxiety and the ways of its management in bedtime because bedtime routine with children one of separation process from parents. Co-sleeping, parental intervention, transional object and bedtime routines can be appeared in order to reduce the anxiety from bedtime separation. Causes of sleeplessness in infant and toddler are bad sleep-onset association, nocturnal drinking, colic, and food allergy. In preschool and school aged children, limit-setting sleep problem and fears and nightmare can be causes of sleeplessness. When good sleep environment and habits are established sound sleep and more mature personality can be developed.

• Journal of Families and Better Life
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• v.32 no.2
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• pp.41-52
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• 2014

The present study investigated the sleep patterns 1-to 3-year-old children and examined whether their sleep patterns would predict their early adjustment to daycare centers. The participants were 239 young children attending daycare centers in Seoul. The data on children's sleep patterns were collected by parent report. Children's adjustment to daycare was assessed by daycare providers' reports. The data were analyzed by means of Chi-square test, t-test, Pearson's correlation, ANOVA and discriminant analysis. The results were as follows: Children from dual-earner families had shorter nocturnal sleep duration than those from single-earner families. There was no significant relation between daytime sleep duration and sleep-onset time at night. It was found that children who go to bed earlier were more likely to get sufficient sleep without nocturnal wakefulness. Age and total sleep duration were seen to be significant variables when it came to discriminating between the adjustment versus maladjustment groups.

• Sleep Medicine and Psychophysiology
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• v.28 no.2
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• pp.70-77
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• 2021

Objectives: Our study aims to investigate the clinical and polysomnographic variables associated with subjective sleep perception. Methods: Among the patients who underwent nocturnal polysomnography (PSG) at the Center for Sleep and Chronobiology of Seoul National University Hospital from May 2018 to July 2019, 109 diagnosed with insomnia disorder based on DSM-5 were recruited for the study, and their medical records were retrospectively analyzed. Self-report questionnaires about clinical characteristics including Pittsburgh sleep quality index (PSQI), Beck depression inventory (BDI), and Epworth sleepiness scale (ESS) were completed. Subjective sleep quality was measured using variables of subjective total sleep time (subjective TST), subjective sleep onset latency (subjective SOL), subjective number of awakenings, morning feeling after awakening, and sleep discrepancy (subjective TST-objective TST) the morning after PSG. Pearson and Spearman correlation analyses were used to determine the factors associated with subjective sleep perception. Results: In patients with insomnia, subjective TST was negatively correlated with Wake After Sleep Onset (WASO) (p = 0.001) and N1 sleep (p = 0.039) parameters on polysomnography. Also, it was negatively correlated with PSQI (p < 0.001) and BDI (p = 0.014) scores. Sleep discrepancy was negatively correlated with PSQI score (p = 0.018). Morning feeling was negatively correlated with PSQI (p = 0.019) and BDI (p < 0.001) scores. Conclusion: Our results demonstrated that subjective sleep perception is associated with PSG variables (WASO and N1 sleep) and with PSQI and BDI scores. In clinical practice, it is helpful to assess and manage insomnia patients in consideration of objective sleep variables, subjective sleep quality, and depressed mood, which can influence subjective sleep perception.

• Journal of mucopolysaccharidosis and rare diseases
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• v.1 no.2
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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.

• Sleep Medicine and Psychophysiology
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• v.22 no.2
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• pp.53-56
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• 2015

Good sleepers tend to more resilient than poor sleepers. As sleep and resilience may have a bidirectional relationship, it is important to explore the relationship between healthy sleep and resilience. Objectively and subjectively measured sleep quality showed positive association with resiliency. In one study, more resilient adolescents had higher sleep efficiency, less light sleep, more slow-wave sleep, and a smaller number of awakenings after sleep onset. Circadian typology, jetlag and circadian misalignment may be associated with the capacity to deal with adversity. Eveningness, exposure to chronic jetlag and circadian misalignment might be risk factors for development of psychological problems and mental disorders. Additional studies are needed to evaluate whether promoting healthy sleep behaviors results in increased resilience.

• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.139-150
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• 2024

Purpose: This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work. Methods: This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis. Results: Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning. Conclusion: Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.1
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• pp.12-19
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• 2016

Purpose: This study was performed to evaluate the quality of sleep in snoring obese children without obstructive sleep apnea (OSA); and to study the possible relationship between sleep interruption and gastroesophageal reflux (GER) in snoring obese children. Methods: Study subjects included 13 snoring obese children who were referred to our sleep lab for possible sleep-disordered breathing. Patients underwent multichannel intraluminal impedance and esophageal pH monitoring with simultaneous polysomnography. Exclusion criteria included history of fundoplication, cystic fibrosis, and infants under the age of 2 years. Significant association between arousals and awakenings with previous reflux were defined by symptom-association probability using 2-minute intervals. Results: Sleep efficiency ranged from 67-97% (median 81%). A total of 111 reflux episodes (90% acidic) were detected during sleep, but there were more episodes per hour during awake periods after sleep onset than during sleep (median 2.3 vs. 0.6, p=0.04). There were 279 total awakenings during the sleep study; 56 (20.1%) of them in 9 patients (69.2%) were preceded by reflux episodes (55 acid, 1 non-acid). In 5 patients (38.5%), awakenings were significantly associated with reflux. Conclusion: The data suggest that acid GER causes sleep interruptions in obese children who have symptoms of snoring or restless sleep and without evidence of OSA.