• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.79-84
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• 1996

Kleine-Levin syndrome is a disorder characterized by recurrent episodes of hypersomnia, hyperphagia and hypersexuality that typically occur weeks or months apart. A 17-years-old male showed these episodes and took nocturnal polysomnography(NPSG) and multiple sleep latency test(MSLT). As results of NPSG, sleep latency was 82.5min, sleep efficiency was 82.5min, sleep efficiency was 82.5%, latency and percentage of REM sleep were 106.5min and 14.6% and percentage of slow wave sleep was 12.7%. In 4 times MLST, average of sleep latency and REM latency were 8min 7sec and 5min 20sec with 3 times sleep onset REM period(SOREMP). These findings are consistent with these of Keine-Levin syndrome. And the possible causes and classification of this syndrome were discussed.

• Sleep Medicine and Psychophysiology
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• v.3 no.1
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• pp.47-55
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• 1996

Narcolepsy is characterized by sleep attack with excessive daytime sleepiness(EDS), cataplexy, sleep paralysis, and hypnagogic hallucination. Paradoxically, narcoleptics tend to complain of frequent arousals and shallow sleep during the night time despite their excessive sleepiness. However, nocturnal sleep fragmentation in narcoleptics is relatively ignored in treatment strategies, compared with sleep attack/EDS and cataplexy. In our paper, we attempted to investigate further on the poor nocturnal sleep in narcoleptics and to discuss possible treatment interventions. Out of consecutively seen patients at Seoul National University Sleep Disorders Clinic and Division of Sleep Studies, we recruited 57 patients, clinically assessed as having sleep attack and/or EDS. Nocturnal polysomnography and multiple sleep latency test(MSLT) were done in each of the subjects. We selected 19 subjects finally diagnosed as narcolepsy(mean age $26.0{\pm}18.3$ years, 16 men and 3 women) for this study, depending on the nocturnal polysomnographic and MSLT findings as well as clinical history and symptomatology. Any subject co-morbid with other hypersomnic sleep disorders such as sleep apnea or periodic limb movements during sleep was excluded. Sleep staging was done using Rechtschaffen and Kales criteria. Sleep parameters were calculated using PSDENT program(Stanford Sleep Clinic, version 1.2) and were compared with the age-matched normal values provided in the program. In narcoleptics, compared with the normal controls, total wake time was found to be significantly increased with significantly decreased sleep efficiency(p<.01, p<.05, respectively), despite no difference of sleep period time and total sleep time between the two groups. Stage 2 sleep%(p<.05), slow wave sleep%(p<.05), and REM sleep%(p<.01) were found to be significantly decreased in narcoleptics compared with normal controls, accompanied by the significant increase of stage 1 sleep%(p<.01). Age showed negative correlation with slow wave sleep%(p<.05). The findings in the present study indicate significant fragmentation of nocturnal sleep in narcoleptics. Reduction of REM sleep% and the total number of REM sleep periods suggests the disturbance of nocturnal REM sleep distribution in narcoleptics. No significant correlations between nocturnal polysomnographic and MSLT variables in narcoleptics suggest that nocturnal sleep disturbance in narcoleptics may be dealt with, in itself, in diagnosing and managing narcolepsy. With the objective demonstration of qualitative and quantitative characteristics of nocturnal and daytime sleep in narcoleptics, we suggest that more attention be paid to the nocturnal sleep fragmentation in narcoleptics and that appropriate treatment interventions such as active drug therapy and/or circadian rhythm-oriented sleep hygiene education be applied as needed.

• Sleep Medicine and Psychophysiology
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• v.29 no.1
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• pp.1-3
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• 2022

Sleep is associated with Alzheimer's dementia. Many previous researches have shown that inadequate sleep is one of the risk factors that predict Alzheimer's dementia. The causal mechanism of this association is not clear. Slow wave sleep and REM sleep are critical stages in memory consolidation, and by sequential hypothesis both stages are important. Deposition of amyloid beta and tau, the main pathology of Alzheimer's dementia, are also associated with sleep. This review provides the association of sleep and Alzheimer's dementia, and future research is necessary to examine the specific mechanism of this association between sleep and Alzheimer's dementia, which may lead to an early intervention in sleep.

• Journal of Genetic Medicine
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• v.19 no.2
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• pp.100-104
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• 2022

The gene encoding solute carrier family 9 member 6 (SLC9A6) on Xq26.3 is associated with Christianson syndrome (CS) mimicking Angelman syndrome. In CS, developmental and epileptic encephalopathy (DEE) appears in about 20%, and DEE with spike-and-wave activation in sleep (SWAS) is reported only in several cases. A 10-year-old boy with DEE showed multidrug resistant focal seizures from 6 months of age. He had progressive microcephaly, regression, global developmental delay without speech, hyperkinesia, and truncal ataxia; he had a long thin face, esotropia, and happy demeanor. Brain magnetic resonance imaging demonstrated cerebellar atrophy. Electroencephalogram at 7.5 years of age showed nearly continuous diffuse paroxysms in slow wave sleep. The seizures were responsive to corticosteroids for a while. Trio whole exome sequencing exhibited a likely pathogenic variant of SLC9A6 in the proband and his asymptomatic mother: c.1194dup (p.Leu399AlafsTer12). This is a rare case report of CS with DEE-SWAS in a Korean patient.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2000.04a
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• pp.86-90
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• 2000

The effects of the timing of daily bathing on sleep in winter were studied. Eight healthy male subjects were assigned to three sleep conditions: bathing just before sleeping (Condition J), bathing 2 h before sleeping (Condition T0 and no bathing before sleeping (Control). We can found that slow wave sleep and REM sleep were increased, and sleep onset latency and wake after sleep onset were shortened in Condition T compared with Condition J. Rectal and mean skin temperatures n both bathing conditions were the same levels after the first half of sleep. Furthermore, subjective sleep sensation was the highest value in Condition T. These results suggest that bathing done before going to bed in winter was good for sleep; moreover, bathing 2 h before going to bed was more effective than bathing immediately before going to bed.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.711-717
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• 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
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• v.2 no.1
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• pp.91-96
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• 1995

A 24-year-old woman complained of recurrent episodes of hypersomnia lasting on the average about 15 days with mild mood alternation such as depression and irritability. During interepisode interval, she was free of any symptoms. Depending on the absence of excessive eating and hypersexuality, she was clinically diagnosed as recurrent monosymptomatic hypersomnia or the incomplete form of Kleine-Levin syndrome. When nocturnal polysomnography and multiple sleep latency test were performed 10 days after her recovery from a hypersomnic episode, reduced slow wave sleep % and pathologic daytime sleepiness were still noted. The authors suggest that the clinical recovery in recurrent monosymptomatic hypersomnia precede electrophysiological normalization by several days.

• Korean Journal of Air-Conditioning and Refrigeration Engineering
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• v.18 no.7
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• pp.535-540
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• 2006

This study was performed In evaluate sleep efficiencies and conditions for comfortable sleep based on the analysis of Physiological signals under variations in thermal conditions. Five female subjects who have similar life cycle and sleep patterns were participated for the sleep experiment. It was checked whether they had a good sleep before the night of experiment. EEGs were obtained from C3-A2 and C4-A1 electrode sites and EOGs were acquired from LOC (left outer canthus) and ROC (right outer canthus) for REM sleep detection. Sleep stages were classified, then TST (total sleep time), SWS (slow wave sleep) latency and SWS/TST were calculated for the evaluation of sleep efficiencies on thermal conditions. TST was defined as an amount of time from sleep stage 1 to wakeup. SWS latency was from light off time to sleep stage 3 and percentage of SWS over TST was calculated for the evaluation of sleep quality and comfort sleep under thermal conditions. As result, the condition which raise a room temperature provided comfortable sleep.

• 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.

• Sleep Medicine and Psychophysiology
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• v.17 no.1
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• pp.21-27
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• 2010

Objectives: It is well established that primary insomnia affects the activity of autonomic nervous system. We tried to know how the activity of autonomic nervous system during night sleep changes by analyzing correlation between heart rate variability (HRV) index and the variables related with sleep structure in primary insomnia. Methods: Thirty three subjects (mean age: $36.2{\pm}14.2$ years, male:female=15:18) who were diagnosed with primary insomnia were selected for the study. Nocturnal polysomnography (NPSG) was carried out on each subject and correlation was analyzed between high frequency/low frequency ratio (LF/HF ratio), one of HRV indices and the variables related with sleep structure which were calculated from NPSG. Results: When age and sex were controlled, LF/HF ratio showed negative correlations with slow wave sleep and stage 2 sleep, respectively ($r_p$=-0.43, p=0.01; $r_p$=-0.37, p=0.04). On the other hands LF/HF ratio showed a positive correlation with arousal index ($r_p$=0.65, p<0.001). The activity of autonomic nervous system responded differentially depending on the change of sleep structure in primary insomnia. Especially the increase of arousal index and the decrease of slow wave sleep and stage 2 sleep which are the components of non-REM sleep provoked hyperactivity of sympathetic nervous system. Conclusion: This study suggests that the typical change of sleep structure in primary insomnia can negatively impact on cardiovascular system.