• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.29-35
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• 2011

Purpose: Korean adolescents have severe nighttime sleep deprivation and daytime sleepiness because of their competitive educational environment. However, daytime sleep patterns and sleepiness have never been studied using age-specific methods, such as the pediatric daytime sleepiness scale (PDSS). We surveyed the daytime sleepiness of Korean adolescents using a Korean translation of the PDSS. Methods: We distributed the 27-item questionnaire, including the PDSS and questions related to sleep pattern, sleep satisfaction, and emotional state, to 3,370 students in grades 5-12. Results: The amount of nighttime sleep decreased significantly with increasing age. During weekday nights, $5-6^{th}$ graders slept for $7.95{\pm}1.05h$, $7-9^{th}$ graders for $7.57{\pm}1.05h$, and $10-12^{th}$ graders for $5.78{\pm}1.13h$. However, the total amounts of combined daytime and nighttime sleep during weekdays were somewhat greater, $8.15{\pm}1.12h$ for $5-6^{th}$ graders, $8.17{\pm}1.20h$ for $7-9^{th}$ graders, and $6.87{\pm}1.40h$ for $10-12^{th}$ graders. PDSS scores increased with age, $11.89{\pm}5.56$ for $5-6^{th}$ graders, $16.57{\pm}5.57$ for $7-9^{th}$ graders, and $17.71{\pm}5.24$ for $10-12^{th}$ graders. Higher PDSS scores were positively correlated with poor school performance and emotional instability. Conclusion: Korean teenagers sleep to an unusual extent during the day because of nighttime sleep deprivation. This negatively affects school performance and emotional stability. A Korean translation of the PDSS was effective in evaluating the severity of daytime sleepiness and assessing the emotional state and school performance of Korean teenagers.

• Journal of Society of Preventive Korean Medicine
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• v.26 no.1
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• pp.59-74
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• 2022

Objectives : Evidence supporting the cold-heat symptom and sasang constitution type, which are diagnostic items of traditional Korean medicine, is needed to manage sleep disturbances, which is a typical symptom of mibyeong (subhealth). This study examined the association between each cold-heat symptom and sleep disturbances according to each sasang constitution type. Methods : This research was a cross-sectional study of 5,793 subjects from the Korean Medicine Data Center (KDC) community cohort survey. The association between each cold-heat symptom and sleep disturbances was analyzed by logistic regression analysis adjusted for several demographic variables. Subgroup analysis was then performed for each type of sasang constitution. Results : The soeum and soyang types were 1.53 and 1.26 times more likely to have sleep disturbances than the taeum type. Sleep disturbances were associated with 'coldness of the abdomen', 'watery mouth' in the cold domain items, and 'body feverishness', 'flushed face and eye', 'thirst', and 'scanty dark urine' in the heat domain items. The soeum and soyang types were 1.55 and 1.39 times more likely to sleep less than five hours per night than the taeeum type. In addition, the associations of those showed a different pattern for each sasang constitution type. Conclusions : Sleep disturbances are associated with specific cold-heat symptoms, and the associated cold-heat symptoms differ according to the sasang constitution type. These results may help traditional medicine specialists select customized interventions for patients with sleep disturbances.

• Journal of Oriental Neuropsychiatry
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• v.25 no.4
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• pp.389-400
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• 2014

Objectives: Though there are many studies about sleep disorder, no research has been performed on the utilization of oriental medicine as a treatment. Therefore, the oriental medical treatment pattern of Korean patients with sleep disorders was examined herein using the Health Insurance Review and Assessment Service (HIRAS). Methods: The medical records of patients with sleep disorders (G47) or nonorganic sleep disorders (F51) as a main diagnosis were adopted from the HIRAS database from 2011 to 2013. Analysis was performed on the number of patients and cost per patient, with comparison between oriental and western medicine in terms of gender, age, patient care service type, and hospital type. Results: 1) Regarding sleep disorders, the medical visits and insurance charges have been increasing. Western medicine was utilized 8 times more often than oriental medicine during 3 years. 2) There were 2.5 times more women than men. 3) Among all ages, the 50~59 year group had the highest representation. 4) In comparison of average portions of patient care type over 3 years, outpatients were the majority, while the number of visits of outpatients and hospitalization has been increasing. 5) Comparison of average portion of oriental hospital type over 3 years revealed oriental clinics to be used most. The use of general hospitals was higher in western medicine treatment, while public health centers used oriental medicine more. 6) Regarding average oriental medical cost per patient over 3 years, the total was 88,000 won, with 353,000 won for hospitalization and 85,000 won for outpatients. The outpatient cost has been increasing. 7) In line with 6, oriental medical hospitals cost 126,000 won, local clinics were 85,000 won, and etc. was 95,000 won. Average costs of all types have increased during 3 years, except oriental medical hospitals in 2013. Conclusions: This study provided objective information about the epidemiologic characteristic of oriental medicine used for treatment of sleep disorder. For expansion of oriental medical demand for sleep disorder, this study would be helpful in understanding the recent status.

• Sleep Medicine and Psychophysiology
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• v.5 no.1
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• pp.45-53
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• 1998

Objectives : The change of sleep patterns commonly occurs in association with the pregnancy. This study was to investigate sleep habits during the course of normal pregnancy. Methods : Sleep habits questionnaire was administered to healthy women in their first trimester(TR1) of pregnancy and then the same questionnaire was repeatedly administered during their second(TR2) and third(TR3) trimesters. The following aspects were assessed : patterns of night sleep, daytime status, sleep posture, reasons for sleep alteration, and the experience of any particular parasomnias, as well as sleep problem-related treatment or medication. Data analysis was based on 26 women who maintaind good health throughout their pregnancy and completed the questionnaire three times. Results : In comparisons between each trimester and non-pregnant state, total night sleep time, daytime tiredness, and sleepiness were significantly increased in all trimesters. Sleep latency was significantly decreased in TR1 and TR2, but not in TR3. In addition, refreshed feeling on waking the following day was significantly decreased and the number of awakenings during night sleep was significantly increased in TR3, but not in TR1 and TR2. In comparisons between trimesters, there was a significant increase in sleep latency, daytime sleepiness and the number of awakenings during night sleep and a significant decrease in refreshed feeling on waking the following day in TR3 compared to TR1 and TR2. Over the course of pregnancy, the rate of lateral position during sleep was gradually increased and all the pregnant women took the lateral sleeping posture in TR3. The major reasons for sleep pattern alteration were nausea, vomiting and heartburn in TR1, urinary frequency, fetal movement and ache in hips in TR2, and urinary frequency, fetal movement, cramp in legs and backache in TR3. Conclusion : These findings are expected to be useful for educating pregnant women about sleep hygiene. In future studies, the underlying factors and mechanisms regarding sleep patterns during pregnancy will need to be clarified.

• Sleep Medicine and Psychophysiology
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• v.7 no.1
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• pp.18-26
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• 2000

Objectives: To investigate the airway narrowing patterns by multi-level airway pressure(MAP) monitoring during sleep and to evaluate the value of CT scan taken during waking and sleep apneic periods to identify the level of airway narrowing(LAN) in patients with obstructive sleep apnea syndrome(OSAS). Methods: Eleven patients with OSAS underwent a night polysomnography with continuous MAP monitoring by 4-sensor(placed at nasopharynx, caudal-uvula, hypopharynx, esophagus) or 2-sensor(placed at caudal-uvula and esophagus) catheter. All patients had cine CT at five levels of high retro and alatal, low retropalatal, retroglossal, epiglottis and hypopharynx during awake and sleep periods. In each patient, LAN determined by CT scan($LAN_{CT}$) during sleep apnea was compared with LAN by MAP monitoring($LAN_{MAP}$). Results: MAP monitoring showed that four patients(36%) had a single pattern of LAN while the other seven patients(64%) showed two or more different LANs in different apneic episodes. Velopharynx was the most common level of frequently observed airway narrowing during sleep apnea(63.6%). However, a single pattern of airway narrowing was more frequent(72.7%) in airway CT during sleep apnea. Velopharynx was the most common narrowest level also in apneic CT(66%). In comparing $LAN_{CT}$ with $LAN_{MAP}$, the $LAN_{CT}$ of five patients(45.5%) were high-concordant, those of another five(45.5%) low-concordant, and that of one(9%) discordant with $LAN_{MAP}$. Conclusions: Cine CT scan during the awake state or sleep apnea may not reflect the LAN correctly in OSAS because most patients showed two or more different airway narrowing patterns during different episodes of sleep apnea in each patient.

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

• Tuberculosis and Respiratory Diseases
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• v.42 no.2
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• pp.238-243
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• 1995

Sleep Apnea Syndrome is characterized by hypersomnolence, snoring, and sleep apnea. The symptoms of hypothyroidism include apathy, somnolence, lethargy, personality change, and intellectual deterioration and may be related to hypothyroid-related sleep disorders. Central, obstructive, and mixed patterns of sleep apnea may be observed in hypothyroidism. A 60-yr-old man was admitted due to hypersomnolence, snoring and generalized edema. Polysomnogram showed obstructive pattern of sleep apnea syndrome. Neck CT scan revealed narrowing of upper airway which is consistent with obstructive sleep apnea syndrome. Physical examination and hormonal study also disclosed the evidence of hypothyroidism. We report a case of sleep apnea syndrome due to primary hypothyroidism with review of literatures.

• The Journal of the Convergence on Culture Technology
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• v.5 no.2
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• pp.287-297
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• 2019

The purpose of this study was to investigate the factors influencing suicidal ideation among the elderly over 60 years old living in the community centered on sleep and depression. A total of 210 elderly people living in a metropolitan city were surveyed about suicidal ideation, sleep pattern (sleep time, quality of sleep) and depression. Data analysis showed that 14.3% of the subjects were seniors with a high suicidal ideation, 23.3% were sleeping less than 5 hours, 17.6% were poor sleep quality, and 33.3% were depressed. According to multiple logistic regression analysis, the factors influencing suicidal ideation were identified as depression (OR=6.889, 95% CI=2.679-17.712), sleep quality (OR=3.770, 95% CI=1.469-9.679), and gender (OR=3.080, 95% CI=1.266-7.491). These three factors accounted for 31.6% of suicidal ideation variables. Based on the results of this study, it is suggested that reducing the depression and improving the quality of sleep in consideration of gender should be an essential strategy for the elderly in the community to reduce the suicidal ideation.

• 대한상한금궤의학회지
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• v.9 no.1
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• pp.115-123
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• 2017

Objective : The purpose of this paper is to report the improvement of patient with Chronic Fatigue Syndrome(CFS) treated by herb medication based on Shanghanlun disease pattern identification diagnostic system. Methods : According to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions', the patient was diagnosed with Eumyangyeokchahunobok-byung, number 393 provision, and took Jisilchija-tang herb medication for 75days. The changing symptom of chronic fatigue syndrome was estimated by QOL-CFS(Chalder Fatigue Scale) and VAS(Visual Analogue Scale). Results : The QOL-CFS changed 21 to 8 and VAS changed 10 to 1. Conclusions : It is existing theory that Eumyangyeokchahunobok-byung is caused by 'having too much sex relation'. But the author diagnosed Eumyangyeokchahunobok-byung as 'Symptoms worsen when awaken at night, and sleep at day caused by poor sleep pattern' according to the palaeography about shanghanlun, and got a good results.

• 대한상한금궤의학회지
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• v.11 no.1
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• pp.113-123
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• 2019

Objective : The purpose of this study was to report the improvement in two patients with different complaints of sleep disorder treated with herbal medication based on the Shanghanlun disease pattern identification diagnostic system (DPIDS), and hypothesize the meaning of word '更'. Methods : According to DPIDS, patients were diagnosed with Taeyang-byung no. 29 provision, and took Gamchogungang-tang herb medication 15 or 90days. The results of administration were evaluated by the hyperhidrosis disease severity scale (HDSS) and the visual analog scale (VAS). Results : After administration of Gamchogungang-tang 15 or 90days, based on 29 provision of Gamchogungang-tang diagnosed according to Shanghanlun provisions, in one case the HDSS decreased from 3 to 1 and the VAS decreased from 10 to 1. In the other case, the VAS decreased from 10 to 1. Conclusions : Each patient not only recovered from symptoms of hyperhidrosis and alopecia areata, but also from sleep disorders following administration of a single medication of Gamchogungang-tang. This case report suggests that the word '更' in the 29 provisions of Shanghanlun means sleep disorder in this case.