• Journal of Physiology & Pathology in Korean Medicine
• /
• v.31 no.2
• /
• pp.83-93
• /
• 2017

This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.

• Journal of Korean Biological Nursing Science
• /
• v.11 no.1
• /
• pp.23-31
• /
• 2009

Purpose: The purpose of the present study was to investigate the prevalence and related factors of sleep-wake disturbance (SWD) in Korean post-stroke patients. This study was the first to address post-stroke SWD in Korea using a structured questionnaire. Method: We investigated the prevalence of SWD and related factors including lesion location, stroke severity, presence of depression and fatigue. We assessed sleep-wake pattern including quality of sleep, sleep latency, wake episodes, wake time after sleep onset, daytime sleep episode and sleep time at daytime. Ninety stroke patients admitted to a university affiliated hospital in Seoul between the period September 2008 and January 2009 were included in the study. Result: Thirty five patients (38.9%) complained insomnia and 32 (35.6%) complained excessive daytime sleepiness (EDS). Quality of sleep (p=.000), sleep latency (p=.000) and total sleep time (p=.001) were significantly poorer in 16 patients with both insomnia and EDS than in the others. The related factors to insomnia were level of education (p=.030), depression (p=.007) and fatigue (p=.034), though related factors to EDS were stroke onset time (p=.049), stroke severity (p=.005), motor dysfunction (p=.035), dysphasia (p=.018), fatigue (p=.001) and lesion location (p=.019). Conclusion: Sleep-wake disturbance is a common problem in Korean stroke patients. Strategies to improve quality of sleep are urgently needed in the post-stroke patients.

• Journal of the Korean Society for Aviation and Aeronautics
• /
• v.32 no.1
• /
• pp.91-102
• /
• 2024

This study aimed to investigate the sleep-wake patterns, social jetlag (SJL), and daytime sleepiness (DS) among air traffic controllers (ATCs) with rotating shifts. A total of 133 shift-rotating ATCs participated by completing self-report questionnaires regarding their sleep-wake patterns and DS. SJL, indicating the mid-sleep difference between workdays (W) and free days (F), was calculated for each shift. Night-shift workdays had the shortest sleep duration (SD) (5.28 hours), whereas free days following day shifts had the longest SD (6.66 hours). SJL for day and night shifts was 2.73 and 2.71 hours, respectively. The average DS score was 7.92 out of 24, with a 28.6% prevalence of DS. There was a negative correlation between SD following day shifts and SJL for the day shifts. Given these findings, it is recommended to implement effective interventions and work schedules to maintain consistent sleep patterns and minimize social jetlag to address sleep issues for shift-working ATCs.

• 대한상한금궤의학회지
• /
• v.11 no.1
• /
• pp.153-167
• /
• 2019

Objective : To explore the meaning of Eumyangyeokchahunobok-byung (陰陽易差後勞復病) through two cases and finding the relationship with the DSM-5 sleep-wake disorder. Methods : Following a disease pattern identification diagnostic system based on Shanghanlun provisions (DPIDS), we analyzed cases with chronic fatigue and diplopia caused after sleep disorders. The patients were treated with the Soshiho-tang and Yijoong-tang. Results : The two herbal medicines showed remarkable improvement in the patients. The sleep disorders and the secondary pathologies were rapidly relieved within a month. Conclusions : The patterns of sleep disorders of the two patients were found to be very similar to the circadian rhythm sleep-wake disorders, as described in DSM-5. Although the etymology of the Chinese characters has not been clearly known yet, it was possible to present the original hypotheses on 更and 了due to clinical inference.

• Sleep Medicine and Psychophysiology
• /
• v.4 no.2
• /
• pp.147-155
• /
• 1997

To assess the reliability of chronobiological models of sleep/wake regulation, it is necerssary that the models predict the data which has been studied in sleep research, and they should be generalized across all ages. To date, many adult human data on such models have accumulated, yet it is evident that a comprehensive theory of the biorhythmic aspects of sleep/wake states has not established. Circadian rhythms such as the time going to bed, sleep onset, slow wave sleep pressure, periodicity of REM sleep, daytime performance, and early evening alertness are resumed everyday. Even in adult humans, sleep is inherently polyphasic. In both the disentrained and entrained states, naps when allowed tend to recur in a temporally lawful manner. The monophasic sleep pattern of most industrial societies therefore appears to be purely of social origin. The endogenous biorhythmic nature of circasemidian sleep tendency is supported by the ubiquity of the phenomenon across all ages. The NREM/REM sleep cycle within sleep with its inherent physiological, endocrine, and neurochemical fluctuations represents the best-documented ultradian sleep rhythms. Also, a daytime ultradian variation in sleepiness with a periodicity similar to nocturnal NREM/REM cycle(BRAC hypothesis) is suggested. This review article provides a brief synoptic review of the evidences for circadian, circasemidian, and ultradian sleep/wake rhythms, and then the authour will suggest the issues which expedite fuller modeling of sleep/wake system, to be further discussed.

• The Korean Journal of Physiology and Pharmacology
• /
• v.14 no.5
• /
• pp.291-297
• /
• 2010

The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were treated for 2 hours with $ad$ $libitum$ sleep (Control), sleep deprivation (SD), and isoflurane anesthesia with delta-wave- predominant state (ISO-1) or burst suppression pattern-predominant state (ISO-2) with at least a 1-week interval. Electroencephalogram and electromyogram were recorded and sleep-wake architecture was evaluated for 4 hours after each treatment. In the post-treatment period, the duration of transition to slow-wave-sleep decreased but slow wave sleep (SWS) increased in the SD group, but no sleep stages were significantly changed in ISO-1 and ISO-2 groups compared to Control. Different levels of anesthesia did not significantly affect the post-anesthesia sleep responses, but the deep level of anesthesia significantly delayed the latency to sleep compared to Control. The present results indicate that a natural sleep-like process likely occurs during isoflurane anesthesia and that the post-anesthesia sleep response occurs irrespective to the level of anesthesia.

• Clinical and Experimental Pediatrics
• /
• v.50 no.8
• /
• pp.711-717
• /
• 2007

Sleep is a vital, highly organized process regulated by complex systems of neuronal networks and neurotransmitters. Normal sleep comprises non-rapid eye movement (NREM) and REM periods that alternate through the night. Sleep usually begins in NREM and progresses through deeper NREM stages (2, 3, and 4 stages), but newborns enter REM sleep (active sleep) first before NREM (quiet sleep). A period of NREM and REM sleep cycle is approximately 90 minutes, but newborn have a shorter sleep cycle (50 minutes). As children mature, sleep changes as an adult pattern: shorter sleep duration, longer sleep cycles and less daytime sleep. REM sleep is approximately 50% of total sleep in newborn and dramatically decreases over the first 2 years into adulthood (20% to 25%). An initial predominant of slow wave sleep (stage 3 and 4) that peaks in early childhood, drops off abruptly after adolescence by 40% from preteen years, and then declines over the life span. The hypothalamus is recognized as a key area of brain involved in regulation of sleep and wakefulness. The basic function of sleep largely remains elusive, but it is clear that sleep plays an important role in the regulation of CNS and body physiologic processes. Understanding of the architecture of sleep and basic mechanisms that regulate sleep and wake cycle are essential to evaluate normal or abnormal development of sleep pattern changes with age. Reduction or disruption of sleep can have a significant impact on daytime functioning and development, including learning, growth, behavior, and emotional regulation.

• Sleep Medicine and Psychophysiology
• /
• v.14 no.1
• /
• pp.5-12
• /
• 2007

Sleep changes substantially with age. There is a phase advance in the circadian sleep cycle and increased waking after sleep onset. The elderly people wake more frequently during the night and experience fragmented sleep and excessive daytime sleepiness. The prevalence of sleep disorders increases with age, and the composition of sleep disorders in the elderly differs from that in the young. The most frequently encountered sleep disorders are psychophysiologic insomnia, sleep disturbance due to dementia, sleeprelated respiratory disorder, restless legs syndrome and periodic limb movement disorder, and REM sleep behavior disorder. To treat the elderly sleep problem appropriately, it is important to know how sleep pattern changes as we age and to understand the cause of sleep-related symptoms. This article will review the sleep physiology and common sleep disorders in the elderly.

• Journal of Korean Academy of Nursing
• /
• v.39 no.3
• /
• pp.422-432
• /
• 2009

Purpose: In this study rest-activity rhythm, sleep pattern and quality of life of patients with restless legs syndrome were compared with those of a normal group. Methods: The participants in this study were 36 patients with restless legs syndrome diagnosed by a neurologist and 36 participants in the normal group. An actigraph, sleep diary, Pittsburgh Sleep Quality Index and Insomnia Severity Index scale were used as measurement tools for the study. Chi-square test, Lamda test, t-test and Kendall's correlation with SPSS 12.0 program were used to analyze the data. Results: Patients with restless legs syndrome had a higher rest-activity rhythm curve of Least 5 hr's activity(L5) and Most 10 hr's activity(M10) than those of normal group and sleep problems included decreased sleep efficiency and increased sleep latency, wake time and number of awakenings. The scores for the subscales of quality of life in patients with restless legs syndrome were lower than the normal group for general health, physical functioning, role limitations due to emotional problems, role limitation due to physical problems, social functioning, bodily pain, vitality and mental health. Conclusion: The results suggest that further studies are needed to identify rest-activity rhythm according to symptom severity and to develop nursing interventions which consider rest-activity rhythm.

• Sleep Medicine and Psychophysiology
• /
• v.13 no.1
• /
• pp.15-21
• /
• 2006

Introduction: The objective of the present study was to investigate bedtime, rise time and time-in-bed of Korean college students, separately on weekday and on weekend and to compare them. In addition, this study also aimed to evaluate the influence of gender, age and grade on the above sleep parmeters in Korean college students. Methods: Information regarding bedtime and rise time, separately on weekday and on weekend, of Korean college students were obtained by self-administered questionnaire. Questionnaires of 1,825 students (1,416 females and 409 males, age 18-30；mean age $21.1{\pm}2.2$) were used for statistical analyses. Results: Korean college students retired to bed 50 minutes later (00：49 on weekday；01：40 on weekend；t=39.67, p<0.001), rose 1 hour 58 minutes later (07：52 on weekday；09：50 on weekend；t=39.46, p<0.001), and slept 1 hour 8 minutes longer (t=13.33, p<0.001) on weekend. Compared to male students, female students had earlier rise time (t=8.96, p<0.01；t=3.89, p<0.01) and earlier bedtime both on weekday and weekend (t=7.10, p<0.01；t=6.04, p<0.01), and shorter time-in-bed on weekday (t=1.99, p<0.01). In addition, rise time delay and time-in-bed increase on weekend were more prominent in female students than in male students (t=3.41, p<0.01; t=3.68, p<0.01). Grade was correlated with bedtime and rise time on weekday (${\beta}=0.1022$, p<0.01；${\beta}=0.1009$, p<0.01), bedtime and time-in-bed on weekend (${\beta}=0.1096$, p<0.01；${\beta}=-0.0990$, p<0.01), and differences between week-day and weekend of the rise time and the time-in-bed (${\beta}=-0.0906$, p<0.01；${\beta}=-0.1115$, p=0.02). Conclusions: In this study, Korean college students had earlier bedtime/rise time and shorter time-in-bed on weekday than on weekend. These findings suggest that weekday sleep-wake schedule of Korean college students may be advanced relative to their biological sleep-wake cycle and that this discrepancy may be associated with weekday sleep deprivation. In addition, differences of sleep patterns between weekday and weekend were more prominent in female students and students with lower grade. Therefore, discrepancy between weekday sleep-wake schedule and biological sleep-wake cycle, as well as weekday sleep deprivation, might be more serious in female or lower-grade students.