• 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.

• Safety and Health at Work
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• v.12 no.3
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• pp.365-369
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• 2021

Background: Law enforcement communications (i.e., 911 dispatch and call takers) is a challenging and stressful occupation. The purpose of this study is to identify the main stressors associated with employment in law enforcement communications, and to identify and provide context to how these stressors affect workers' health and wellbeing. Methods: This research study included focus groups with 23 call takers and 911 dispatchers employed by a large, urban law enforcement agency in 2018. Thematic analyses were conducted to identify trends. Results: Four themes of stressors emerged (i.e., the high stakes nature of some 911 calls for service, understaffing, supervisor-related stress, and recruiting practice). Two health-related themes emerged as being occupation-related: weight gain and poor sleep patterns/insufficient sleep). Specifically, participants reported negative eating habits resulting in weight gain and obesity, lack of sleep and irregular sleep schedules, and development of hypertension and/or diabetes since beginning their jobs. Conclusion: Law enforcement communications professionals experience a number of the same stressors facing law enforcement officers in patrol. These stressors, combined with the sedentary nature of the job, could result in long-term, chronic health problems.

• IEMEK Journal of Embedded Systems and Applications
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• v.17 no.1
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• pp.1-7
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• 2022

The number of patients with many complications grows with the increase of aging population. As the elders and severely ill patients spend most of their time in bed, it leads to Pressure Injuries (PI) such as bedsores. Unfortunately, there is no method to automatically detect changes in patient's posture which leads to the need for a caregiver every set of times when the patient needs to be moved. Many studies are conducted to solve this inefficient problem. Yet, these studies require costly devices or use methods that disturb patient's sleeping environment. Those methods are mostly hard to implement in practice due to these reasons. We propose a method to detect posture using a three-axis acceleration sensor from the wrist band. We developed a wearable watch that measures sleep-related data. We analyzed 40 people's sleep data with a wearable module and watch to measure their postures such as supine, left-side, and right-side. Then, we compared the classified posture from the watch with the wearable module and achieved 90% accuracy. Therefore, we concluded that only by using the wearable watch, we can detect the sleeping position without any new equipment or system to diagnose the patients without discomfort during their daily lives.

• Journal of Oral Medicine and Pain
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• v.48 no.3
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• pp.96-105
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• 2023

Purpose: Mandibular advancement devices (MAD) are known to be insufficiently effective in all patients with obstructive sleep apnea (OSA). This study aimed to compare the treatment outcomes of MAD therapy according to OSA severity and to investigate the risk factors for the lack of response to MAD therapy. Methods: A total of 29 patients diagnosed with OSA received an adjustable two-piece MAD treatment. Sleep parameters measured with the home sleep apnea test device, including apnea-hypopnea index (AHI) and oxygen saturation (SpO₂), and daytime sleepiness using the Epworth Sleepiness Scale (ESS) were retrospectively assessed both before and after the MAD treatment. Results: The patients were classified into three groups according to AHI severity: mild (n=16, AHI<15), moderate (n=6, 15≤AHI<30), and severe OSA (n=7, AHI≥30). MAD therapy significantly improved the sleep parameters (p<0.001 for AHI and p=0.004 for minimum SpO₂) and daytime sleepiness (p<0.001 for ESS). Furthermore, successful outcomes (reduction in AHI>50% and AHI<10 events/h) were achieved in 83.3% and 71.4% of moderate and severe OSA cases, respectively. Of 13 patients with moderate and severe OSA, 10 were classified as responders and 3 as non-responders. The non-responders had significantly lower baseline value of SpO₂ (p=0.049 for average SpO₂ and p=0.007 for minimum SpO₂) and higher baseline AHI (p=0.049) than the responders. Conclusions: The results of the present study suggest that MAD is effective in the majority of patients with OSA of varying severities. The success of MAD therapy does not seem to depend solely on AHI severity. In addition to AHI, minimum SpO₂ may be a prognostic measure of the efficacy of MAD treatment in clinical dental practice.

• Sleep Medicine and Psychophysiology
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• v.23 no.2
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• pp.77-83
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• 2016

Objectives: The present study investigated current practices of insomnia treatment among Korean doctors in clinical settings. Methods: A total of 100 doctors participated in the present study and filled out a series of survey questions regarding their treatment of insomnia patients. Results: The results revealed that the primary type of insomnia treatment was pharmacological and that the most popular medication was zolpidem. The majority of doctors reported that they also utilized non-pharmacological treatments such as sleep hygiene education and cognitive-behavioral therapy. However, these treatments tended to result in low satisfaction. In addition, the doctors perceived that patients largely preferred pharmacological treatments to non-pharmacological ones and did not have sufficient knowledge of non-pharmacological treatments. Conclusion: Many doctors believed that non-pharmacological treatments for insomnia were important, but reported that they were difficult to implement in practice. The results of this study suggest that improved medical conditions for non-pharmacological treatments and education of physicians are necessary to appropriately treat insomnia.

• Sleep Medicine and Psychophysiology
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• v.8 no.1
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• pp.37-44
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• 2001

Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

• Sleep Medicine and Psychophysiology
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• v.26 no.2
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• pp.86-103
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• 2019

Objectives: The objective of this study was to develop evidence- and consensus-based clinical safety usage guidelines for sedative hypnotics using the Delphi technique. Methods: A group of 15 sleep experts from Korean Academy of Sleep Medicine were chosen for this study comprising a three-round web-based Delphi survey. The first round survey was composed of 39 questions to identify problems with sedative hypnotics usage in Korean clinical practice and the result roughly outlined what should be included in the guidelines. The second round survey was composed of 21 questions to collect specific opinions of experts on clinically important issues in prescribing sedative hypnotics, and its result provided the basis for the guidelines. A third round survey aimed to evaluate the reliability and validity of the established guidelines. Results: In the third round, all 17 items showed a median of 4 or more, with an average of 4.12 and a standard deviation of 0.32. Thus we present safety usage guidelines with 13 propositions for prescription, maintenance, and withdrawal of sedative hypnotics. Conclusion: The safety usage guidelines on sedative hypnotics developed from this study could lead to safe and effective prescription of hypnotics in clinical practice, especially for the non-experts in sleep medicine. Furthermore, the guidelines will help to improve the quality of insomnia treatment by contributing to the establishment of a safe regime for sedative hypnotics without excessive use of drugs.

• Journal of the Korea Convergence Society
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• v.12 no.7
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• pp.337-347
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• 2021

This study sought to determine whether there were mediating effects on both mental health and sleep problems as induced by COVID-19 fears and its effects on preventive practices. The participants were 310 adults living in the Seoul/Gyeonggi Province. For data collection, an online survey was conducted using a semi-structured questionnaire. The collected data were analyzed using PROCESS Macro (Model 6) to validate the dual mediating effects. This study analyzed the direct effects of COVID-19 fears on the mental health problems, sleep problems and preventive practices. Both mental health and sleep problems had dual mediating effects in the influence of COVID-19 fears on preventive practices. Preventive practice has shown that the mediated effects of mental health problems play a strong role in instances when COVID-19 fears increase.

• Journal of Naturopathy
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• v.11 no.2
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• pp.116-122
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• 2022

Background: Studies on the effect of abdominal or thoracic breathing therapy on sleep or blood oxygen concentration are still scarce. Purpose: This study was to examine the effect on blood oxygen saturation and pulse variability, changes in the severity of insomnia, changes in wakefulness before sleep, and dysfunctional beliefs and attitudes toward the Korean version of sleep in women in their 50s after healing with abdominal breathing and thoracic breathing. We investigated the effect. Methods: Subjects were investigated before and after the change of breathing (breathing) therapy for 12 weeks, 3 times a week, and 36 breaths perweek. Results: It wa evaluated respiratory healing as having no significance in the pulse rate change. However, oxygen saturation was significant in the experimental group, increasing to 93.60 SpO₂% before the respiratory rally and 96.5 SpO₂% after respiratory recovery (p < .002). In addition, the insomnia severity scale and dysfunctional beliefs about sleep significantly decreased after respiratory rally than before (p < .000). Conclusions: It evaluated that respiratory therapy for the subjects is beneficial to health as it is effective for insomnia, pulse, and oxygen saturation.

• Sleep Medicine and Psychophysiology
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• v.27 no.1
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• pp.16-23
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• 2020

Objectives: Sleep disturbance in the elderly is associated with cognitive decline. Sleep quality is known to deteriorate with age, and prospective studies seldom have examined the relationship between sleep quality and cognitive function. This study investigates the relationship between early sleep quality and cognitive function based on six-year follow-up data of community individuals older than 60 years. Methods: The participants included 622 community elderly people older than 60 years from Jinju-Si. The final analysis comprised 322 elderly people. Pittsburgh sleep quality index (PSQI) and the Korean version of Consortium to Establish a Registry for Alzheimer's Disease (CERAD-K) were used to assess early sleep quality and cognitive function after six years. Multiple linear regression analysis was performed to investigate the association between early sleep quality and cognitive function in the elderly. Results: Early sleep quality (PSQI) was significantly associated with the results of the digit span test, clock drawing test (clox 1), and word recall test after six years. Sleep quality (PSQI) decreased significantly after six years, and lower quality of sleep (PSQI) score was associated with higher digit span test score (β = -0.167, p = 0.026) and higher clock drawing test score (β = -0.157, p = 0.031). Lower quality of sleep (PSQI) score was associated with higher word recall test (β = -0.140, p = 0.039). Conclusion: The digit span test, word recall test, and clock drawing task (CLOX 1) shown to be significantly associated to sleep quality can be performed fast and easily in clinical practice. It is important to assess early cognitive function in the elderly with poor sleep quality, and further studies could suggest that these tests may be useful screening tests for early dementia in elderly with poor sleep quality.