• Title/Summary/Keyword: sleep medicine

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Neuropsychiatric Dysfunction in Sleep-Related Breathing Disorders (수면관련 호흡장애에서의 신경정신과적 증상)

  • Yoon, In-Young
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.140-146
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    • 1997
  • Sleep-related breathing disorders, especially sleep apnea syndrome are complicated by neuropsychiatric dysfunction such as excessive daytime sleepiness, cognitive dysfunction, and depression. As the determinants of daytime sleepiness, sleep fragmentation is more influential than nocturnal hypoxia. Daytime sleepiness can be improved by continuous positive airway pressure (CPAP) or surgery in up to 95% of the treated subjects. Both sleepiness and nocturnal hypoxia would cause cognitive dysfunction. While impairments in attention and verbal memory are more related with sleepiness and prominent in mild to moderate sleep apnea syndrome (SAS), impairments in general intellectual function and executive function are more related with nocturnal hypoxia and prominent in severe SAS. Several cognitive deficits related with nocturnal hypoxia may be irreversible despite CPAP or surgical treatments. So, early detection and early appropriate treatment of SAS would prevent sleepiness and cognitive deterioration.

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Overview of Periodic Limb Movements During Sleep (주기성 사지운동증의 개관)

  • Cyn, Jae-Gong
    • Sleep Medicine and Psychophysiology
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    • v.15 no.1
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    • pp.17-24
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    • 2008
  • Periodic leg movements during sleep (PLMS) are best described as repetitive stereotypical movements of the lower extremities characterized by dorsiflexion of the ankle, dorsiflexion of the toes and a partial flexion of the knee and sometimes the hip. The prevalence of PLMS is about 5-11% in adults and is predicted much higher than previously surveyed. They are also frequently found in various sleep disorders, several disorders not primarily affecting sleep, and patients taking psychiatric medications. Although they are rarely found in children, they are common findings in children referred to a pediatric sleep laboratory. The pathophysiology is strongly associated with decline of central dopaminergic function and closely related to arousal system during sleep. Benzodiazepines, levodopa, dopamine agonists and opioids are generally recommended for treatment but more controlled studies on the effectiveness are needed.

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An update on the cause and treatment of sleep disturbance in children and adolescents with autism spectrum disorder

  • Seo, Wan Seok
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.275-281
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    • 2021
  • Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by abnormalities in social communication/interaction and restrictive, repetitive patterns of behavior. ASD is a relatively common psychiatric disorder, with a prevalence of approximately 1.7% in children. Although many children and adolescents with ASD visit the hospital for medical help for emotional and behavioral problems such as mood instability and self-harming behavior, there are also many visits for sleep disturbances such as insomnia and sleep resistance. Sleep disturbances are likely to increase fatigue and daytime sleepiness, impaired concentration, negatively impact on daytime functioning, and pose challenges in controlling anger and aggressive behavior. Sleep disturbance in children and adolescents with ASD negatively affects the quality of life, nothing to say the quality of life of their families and school members. In this review, sleep disturbances that are common in children and adolescents with ASD and adolescents are presented. The developmental and behavioral impacts of sleep disturbances in ASD were also considered. Finally, non-pharmacological and pharmacological treatments for sleep disturbances in children and adolescents with ASD and adolescents are reviewed.

Comparing Two Mycobacterium tuberculosis Genomes from Chinese Immigrants with Native Genomes Using Mauve Alignments

  • Ryoo, Sungweon;Lee, Jeongsoo;Oh, Jee Youn;Kim, Byeong Ki;Kim, Young;Kim, Je Hyeong;Shin, Chol;Lee, Seung Heon
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.3
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    • pp.216-221
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    • 2018
  • Background: The number of immigrants with tuberculosis (TB) increases each year in South Korea. Determining the transmission dynamics based on whole genome sequencing (WGS) to cluster the strains has been challenging. Methods: WGS, annotation refinement, and orthology assignment for the GenBank accession number acquisition were performed on two clinical isolates from Chinese immigrants. In addition, the genomes of the two isolates were compared with the genomes of Mycobacterium tuberculosis isolates, from two native Korean and five native Chinese individuals using a phylogenetic topology tree based on the Multiple Alignment of Conserved Genomic Sequence with Rearrangements (Mauve) package. Results: The newly assigned accession numbers for two clinical isolates were CP020381.2 (a Korean-Chinese from Yanbian Province) and CP022014.1 (a Chinese from Shandong Province), respectively. Mauve alignment classified all nine TB isolates into a discriminative collinear set with matched regions. The phylogenetic analysis revealed a rooted phylogenetic tree grouping the nine strains into two lineages: strains from Chinese individuals and strains from Korean individuals. Conclusion: Phylogenetic trees based on the Mauve alignments were supposed to be useful in revealing the dynamics of TB transmission from immigrants in South Korea, which can provide valuable information for scaling up the TB screening policy for immigrants.

The Study on Korean Medical Pattern Differentiation of Sleep-Wake Disorders by DSM-V Classification (DSM-V 분류에 따른 수면-각성장애의 한의학적 변증 연구)

  • Na, Il Doo;Park, Mi Sun;Kim, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.2
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    • pp.83-93
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    • 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.

The Causes and Developmental Mechanism of Insomnia (불면증의 원인과 발생기전)

  • Lee, Sung-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.1 no.1
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    • pp.3-8
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    • 1994
  • With the recent development of sleep medicine, insomnia has been perceived as a disease from a simple symptom. As there are various causes in a disease, proper treatment according to each cause is necessary for a more effective treatment In general, insomnia is classified into five categrories of physical, physiological, psychological, psychiatric and pharmacological aspects. However, such categorizations are often insufficient in treating insomnia. Furthermore understanding of the developmental mechanisms of insomnia is required. The function of sleep is developed and maintained through the balance of the reciprocal forces of sleep and arousal. These forces are contantly regulated by what is called a circadian rhythm. Sleep is induced by this rhythm which is affected by factors such as awakening time in the morning, amount of intellectual function, amount and time length of physical exercise and sunlight Insomnia could develop when this rhythm is delayed and leads to a "forbidden zone" which is a very difficult period for inducing sleep about two to four hours before the routine bedtime. Whereas sleep gradually develops in line with the circardian rhythm, arousal can occur very abruptly by any cause triggered by emotional discomfort or anxiety. Such characteristic and emotional factors as perfectionism, separation anxiety, secondary gain, insecurity, and negative cognition may provoke the inner anxiety and fear for insomnia, which can lead acute insomnia to a chronic one. As chronic insomnia is developed by multiple causes and factors, integrated approaches through analysis of above mentioned factors will be more effective in the treatment of insomnia than a simple administration of hypnotics.

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Successful Treatment of Five Cases of Idiopathic Central Nervous System Hypersomnia (치료(治療)에 반응(反應)한 특발성(特發性) 중추성(中樞性) 수면과다증(睡眠過多症) 5예(例) 분석(分析))

  • Yoon, In-Young;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.4 no.1
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    • pp.89-95
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    • 1997
  • The authors studied 5 cases of idiopathic CNS hypersomnia who visited Division of Sleep Studies, Seoul National University Hospital in 1995. Detailed medical history was taken and nocturnal polysomnography(NPSG), multiple sleep latency test(MSLT) and human leukocyte antigen(HLA) typing were performed. Neither cataplexy nor hypnagogic hallucination was reported in all cases and in NPSGs, there were tendencies of increased sleep period time and decreased slow wave sleep time. In MSLT, all the subjects showed average sleep latencies less than 8 minutes without sleep-onset rapid eye movement period(SOREMP). In HLA typing, some correlation between idiopathic CNS hypersomnia and HLA DR4 was observed. In contrast to previous reports, overall treatment response with methylphenidate was remarkable. Therefore, the authors suggest that patients suspected of idiopathic CNS hypersomnia be actively evaluated and treated with rather optimistic perspective.

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Noise in hospital rooms and sleep disturbance in hospitalized medical patients

  • Park, Marn Joon;Yoo, Jee Hee;Cho, Byung Wook;Kim, Ki Tae;Jeong, Woo-Chul;Ha, Mina
    • Environmental Analysis Health and Toxicology
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    • v.29
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    • pp.6.1-6.6
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    • 2014
  • Objectives Hospitalized patients are vulnerable to sleep disturbances because of environmental stresses including noise. While most previous studies on hospital noise and sleep have been performed for medical machines in intensive care units, there is a limited data for patients hospitalized in medical wardrooms. The purpose of present study was to measure noise level of medical wardrooms, identify patient-perceived sources of noise, and to examine the association between noise levels and sleep disturbances in hospitalized patients. Methods Noise dosimeters were used to measure noise level in 29 inpatient wardrooms at a university hospital. Sleep pattern and disturbance were assessed in 103 hospitalized patients, using the Pittsburgh Sleep Quality Index (PSQI) and Leeds Sleep Evaluation Questionnaire. Results The mean equivalent continuous noise level for 24 hours was 63.5 decibel A (dBA), which was far higher than 30 dBA recommended by the World Health Organization for hospital wardrooms. Other patients sharing a room were perceived as the most common source of noise by the patients, which was usually preventable. Of the patients in the study, 86% had bad sleep as assessed by the PSQI. The sleep disturbance was significantly correlated with increasing noise levels in a dose response manner. Conclusions Systemic organizational interventions are needed to keep wardrooms private and quiet to reduce sleep disturbance.

Association between Regular Breakfast and Sleep-related Factors in Korean Adolescents (청소년의 규칙적 아침식사를 위한 수면 관련 요인 분석)

  • Cho, Yoon Jeong;Hwang, Jun Hyun
    • Journal of the Korean Society of School Health
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    • v.30 no.3
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    • pp.317-324
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    • 2017
  • Purpose: Breakfast is the most important meal to provide energy for the day. Breakfast is especially important to give enough nutritional support to children and adolescents for their physical growth and sexual development. Sleep-related factors like average sleep duration and wake up time would mostly be associated with regular breakfast. This study aimed to investigate the effect of sleep on regular breakfast consumption in Korean adolescents. Methods: The study used the data from the 12th Korea Youth Risk Behavior Web-based Survey (KYRBS-XII) conducted in 2016 by the Korea Centers for Disease Control and Prevention. The data of 62,820 subjects (middle/high school students) were included in the final analysis. The study examined the factors related to regular breakfast, focusing on weekday average sleep duration and wake up time of middle school students and high school students, respectively. Results: Regular breakfast consumption was shown to have a statistically significant association with high economic status, nutritional education, weekday average sleep duration, wake up time, and subjective sleep satisfaction in the multivariate logistic regression. Regardless of the school level, regular breakfast consumption was significantly associated with early wake up time. As to the effect of weekday average sleep duration on regular breakfast consumption, it showed some different results depending on the school level. Conclusion: Regular breakfast consumption of Korean adolescents was related to weekday average sleep duration and wake up time. Having breakfast regularly was affected by both adequate weekday average sleep duration and early wake up time.