• 수면정신생리
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• 제10권2호
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• pp.88-92
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• 2003

Sleep-disordered breathing (SDB), including snoring, sleep apnea and upper airway resistance syndrome are common problems in children. The pathophysiological mechanism of SDB in children is unclear but may include hypoxemia and changes in sleep architecture. Children with SDB show reduced neurocognitive function, and memory and attentional capacity. Furthermore, these children show increased problematic behaviour and reduced school performance. Whether early recognition and treatment of SDB in children may improve neurocognitive function and school performance remains to be fully evaluated in the future.

• 수면정신생리
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• 제9권1호
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• pp.9-13
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• 2002

Alzheimer's disease (AD) is one of the most common and devastating dementing disorders of old age. Most AD patients showed significant alternation of sleep structure as well as cognitive deficit. Typical findings of sleep architecture in AD patients include lower sleep efficiency, higher stage 1 percentage, and greater frequency of arousals. The slowing of EEG activity is also noted. Abnormalities in REM sleep are of particular interest in AD because the cholinergic system is related to both REM sleep and AD. Several parameters representing REM sleep structure such as REM latency, the amount of REM sleep, and REM density are change in patients with AD. Especially, measurements of EEG slowing during tonic REM sleep can be used as an EEG marker for early detection of possible AD. In addition, a structural defect in the suprachiasmatic nucleus is suggested to cause various chronobiological alternations in AD. Most of alternations related to sleep make sleep disturbances common and disruptive symptoms of AD. In this article, the author reviewed the alternation of sleep structure and circadian rhythm in AD patients.

• 대한한의학회지
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• 제43권2호
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• pp.75-91
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• 2022

Objectives: The purpose of this overview was to summarize the evidence regarding the effectiveness of Cognitive Behavioral Therapy (CBT) for sleep disorders through systematic reviews (SRs) and meta-analyses (MAs). Methods: An overview of systematic review was conducted according to the study protocol (reviewregistry1320). A comprehensive literature search was performed using three databases (Pubmed, Cochrane Central Register of Controlled Trials, and Web of Science) and three Korean databases (KoreaMed, KMbase, and ScienceON). Final studies were selected by three authors according to inclusion and exclusion criteria, and data needed for analysis were extracted by a pre-planned extraction framework. Methodological quality of systematic review was assessed using the 'Assessment of multiple systematic reviews 2 (AMSTAR2)'. Results: Fourteen SRs and MAs were included, of which eleven SRs were performed MAs. Twelve studies studied insomnia among sleep disorders, and the rest are nightmares and sleep disturbances with PTSD. Ten studies reported the effect of CBT on sleep disorders measured by insomnia severity index (ISI) and sleep onset latency (SOL), and all reported a significant improvement effect. Eight studies reported the effect of CBT on sleep disorders measured by wake time after sleep onset (WASO), and seven studies reported a significant improvement effect. The methodological quality of the studies evaluated with AMSTAR 2 was mainly low or very low because of omission of protocol registration and excluded study list. Conclusions: Practical guidelines and studies show that CBT is effective for sleep disorders, but access to CBT needs to be improved.

• 수면정신생리
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• 제3권2호
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• pp.43-55
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• 1996

Since REM sleep was found to be closely related with dream, efforts have been made to find the neurophysiological mechanism and the psychological meaning of dream. However, since most researchers have paid attention to dreams of adults, there are relatively few studies devoted to those of developing children. In the prevent study, we reviewed the previous studies and hypotheses about sleep and dream in various aspects and summarized the characteristics of sleep and dream of children in developmental domain as followings. (1) Sleep development : Across childhood, sleep architecture and sleep-wakefulness cycles are progressively changed toward the patterns of adult. They become similar to adult patterns only in their adolescence. Thus, the sleep event sconsidered as abnormal in adults may be normal in children. (2) Dream development : First, the content and meaning of the dream change with increasing age and develop in parallel with children's ego function, especially cognitive developmental stages. Second, for the children, the reality and the dream are on the continuous spectrum of 'reality-imitation-play-fantasy-dream'. Third, dreaming is the pure assimilation process for the children and through dreaming they can adapt and accomodate the reality without emotion.

• 수면정신생리
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• 제7권2호
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• pp.102-108
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• 2000

목 적 : 파킨슨병 환자의 상당수에서 아침에 일어났을 때 수면이득으로 알려진 운동성 기능의 일시적인 호전을 보고 한다. 파킨슨병 환자에서의 수면이득이 수면과 관련되는 현상임에도 불구하고 수면다원검사 등의 객관적인 방법을 이용한 연구는 드물다. 본 연구의 목적은 수면이득이 있는 환자 군과 없는 환자 군의 임상특징 및 수면다원검사 소견을 비교하는데 있다. 방 법 : 33명의 일차성 파킨슨병 환자(남 14, 여 19)를 대상으로 하였다. 모든 환자들은 수면이득의 여부를 확인하기 위하여 면담을 하였고, 의무 기록지를 통하여 임상적 자료를 얻었고, 수면검사실에서 하룻 밤의 수면다원검사를 실시하였다. 결 과 : 수면이득이 있는 환자가 16명(48.5%), 없는 환자가 17명(51.5%)이었다. 수면이득이 있는 환자들이 없는 환자들에 비하여 더 젊었고(p<0.02), 수면효율이 더 좋았고 (p<0.05), 그리고 수면잠복기가 더 짧았다(p<0.02). 그러나 수면이득은 유병기간, 레보도파 일일 복용 용량, 운동기능의 장애 등과 관련되지 않았고, 특정 수면단계와도 관련되지 않았다. 두 군 모두에서 렘수면행동장애 등의 수면장애의 빈도가 높았으나 일차성 코골이를 제외하고는 두 군간에 차이는 없었다. 결 론 : 본 연구의 결과는 수면이득이 젊은 나이, 좋은 수면효율, 짧은 수면잠복기와 관련됨을 시사한다.

• 동의신경정신과학회지
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• 제24권1호
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• pp.103-108
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• 2013

Objectives : Korea's average life expectancy is getting longer and longer and the pace of change in society has increased every year as people experience stress more easily. Under this situation, chronic sleep disorder is increasing, but there is no specific program for the treatment of sleep disorder in Korean medicine. Therefore, we studied a Korean medical treatment program for sleep disorder to apply to outpatient clinic patients. Methods : For this study, we evaluated the Insomnia Severity Index (ISI), BDI, STAI, FSS on 29 insomnia patients who visited Kyunghee Korean medical hospital from July 2010 to May 2012. Herbal medicine, acupuncture, herbal acupuncture, moxibustion, sleep hygiene, and medical qigong were applied. We compared ISI scores before treatment and after 4 weeks of treatment. Results : ISI score was improved after Korean medical treatment for sleep disorder. Before the treatment ISI score was 18.1, which means clinical insomnia. After the Korean medical treatment, the score was 7.5, which means no clinically significant insomnia. Conclusions : The study showed a significant effect on the Korean medical treatment program for sleep disorder to apply to outpatient clinic patients. ISI score was improved and the patients were satisfied with the treatment, so it would be more helpful to apply in sleep clinics.

• Journal of Oral Medicine and Pain
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• 제41권4호
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• pp.188-194
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• 2016

Purpose: Burning mouth syndrome (BMS) is ambiguous and enigmatic oral condition. Sleep disturbance is one of the most prevalent complaints of patients with chronic pain. The aim of this study was to estimate general sleep characteristics and propensity in patients with BMS. Methods: A total of thirty BMS patients and thirty healthy control subjects were investigated. Self-reported measures of sleep quality were conducted using two widely used methods; the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Data were analyzed with one-way ANOVA, chi-square, Fisher's exact test, Kruskal-Wallis test, Holm method with 95% confidence interval and p<0.05 significant level. Results: BMS patients showed more poor sleepers than those in control subjects in both ESS and PSQI test. BMS patients also showed statistically significant poorer sleep quality compared with control subjects in both test. When BMS group were divided into three groups on the basis of numeric rating scale, the higher score subjects had, the more mean rank they had in the PSQI. Conclusions: BMS patients showed up poor sleep characteristics and propensity than control group, and they also showed the more severe the pain was, the worse the sleep quality was.

• 수면정신생리
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• 제3권1호
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• pp.38-46
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• 1996

The purpose of this study is to investigate the neurocognitive dysfunction and the degree of severity according to the oxygen desaturation in obstructive sleep apnea patients. We performed nocturnal polysomnographic recording and administered 3 Vienna Test System subtest of Reaction unit, Continuous attention and Cognitrone to 11 obstructive sleep patients and 13 controls. The result were as follows: 1) On Continous attentin and Cognitrone, patients with obstructive sleep apnea showed significant lower score on correct answer, higher score on missed answer and prolonged reaction time than control. But, there was no significant difference on Reaction unit between two groups. 2) Among 3 groups divided by degree of oxygen desaturation, there were no significant differences on Reaction unit. As the oxygen saturation decreased however, the obstructive sleep apnea group revealed significantly poor performance score on continuous attention and cognitrone. We suggested that obstructive sleep apnea patients showed disturbed neurocognitive function with complex cognitive process and the severity of neurocognitive dysfunction was also correlated with oxygen desaturation.

• 수면정신생리
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• 제12권2호
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• pp.105-110
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• 2005

The pathogenesis and mechanism of obstructive sleep apnea (OSA) has been under investigation for over 25 years, but its etiology and mechanism remains elusive. Skeletal (maxillary and/or mandibular hypoplasia or retrodisplacement, inferior displacement of hyoid) and soft tissue (increased volume of soft tissue, adenotonsillar hypertrophy, macroglossia, thickened lateral pharyngeal walls) factors, pharyngeal compliance (increased), pharyngeal muscle factors (impaired strength and endurance of pharyngeal dilators and fixators), sensory factors (impaired mechanoreceptor sensitivity, impaired pharyngeal dilator reflexes), respiratory control system factors (unstable respiratory control) and so on facilitate collapse upper airway. Therefore, OSA may be a heterogeneous disorder, rather than a single disease entity and various pathogenic factors contribute to the OSA varies person to person. As a result, patients may respond to different therapeutic approaches based on the predominant abnormality leading to the sleep-disordered breathing.

• Nutrition Research and Practice
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• 제14권6호
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• pp.606-620
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• 2020

BACKGROUND/OBJECTIVES: Although some juices affect subjective sleep quality, there is a lack of information on the effect of a specific juice on objective sleep quality and heart rate variability (HRV) during sleep; thus the present study investigated whether a blended juice made from natural extracts influenced sleep quality and HRV during sleep in adults with disturbed sleep. SUBJECTS/METHODS: A randomized, crossover study was conducted on twenty-five adults (15/10, female/male) complaining of difficulty initiating or maintaining nighttime sleep (Pittsburgh sleep quality index [PSQI] ≥ 5). During feeding sessions (FS), subjects received sleep-inducing juice made of natural ingredients (250 mL/trial) twice a day for 8 weeks or non-FS (N-FS) for 8 weeks while maintaining normal activities. Sleep quality and parameters were recorded via wearable actigraph for 7 consecutive days, and PSQI scores were assessed before and after the intervention. HRV was also monitored at rest and during sleep. RESULTS: After receiving the sleep-inducing juice intervention (FS), PSQI scores were significantly decreased (P < 0.001) and correlated with a significant decline in fatigue severity scale and visual analogue scale levels (P < 0.05; both). HRV indices of vagal activity were significantly improved during FS (P < 0.05), and no significant differences in N-FS were observed. Sleep efficiency and total sleep time increased significantly (P < 0.05) and sleep latency, total counts, sleep fragmentation index, and movement index, decreased significantly (P < 0.05, all 4) during FS, with no significant differences-observed during N-FS. CONCLUSIONS: This study results demonstrated that an 8-week course of sleep-inducing juice has led to improve sleep quality, suggesting an enhanced cardiac vagal tone during sleep. Thus, it could be a well-tolerated option for adults with disturbed sleep.