• Journal of Korean Neurosurgical Society
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• v.63 no.2
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• pp.261-267
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• 2020

Objective : We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. Methods : From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). Results : At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. Conclusion : Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

• Journal of Korean Biological Nursing Science
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• v.18 no.4
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• pp.203-212
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• 2016

Purpose: The purpose of this study was to identify the sleep patterns of nursing students using self-report questionnaire and physiologic measurement, to examine the factors influencing sleep patterns in based on Spielman's model. Methods: Participants were 119 nursing students who were in the clinical practice period. Self-report questionnaires and actigraphy were used to collect the data. Data were analyzed using descriptive statistics, correlation and regression by the SPSS/WIN 21.0 programs. Results: When sleep was measured by self-report questionnaire, 84 students (70.6%) showed poor sleep quality. The mean sleep efficiency was 82.6%, and 67 students(56.3%) showed low sleep efficiency (less than 85.0%). The factors affecting subjective sleep pattern measured by KMLSEQ were circadian sleep type (${\beta}=.28$, ${\rho}=.003$) and alcohol (${\beta}=.20$, ${\rho}=.031$). The factors affecting total sleep time were sedentary behavior (${\beta}=-.27$, ${\rho}=.003$) and daytime sleepiness (${\beta}=-.33$, ${\rho}$<.001). Conclusion: Many nursing students in their clinical practice period expressed sleep disturbance. Factors affecting the perceived sleep measured by the self-report questionnaire and objective sleep evaluated by physiologic measures were different. The evening type of students perceived poor sleep quality, however, sedentary life style and daytime sleepiness resulted in short sleep time. Therefore, more studies measuring the objective sleep characteristics are needed using subjective and objective characteristics.

• The Journal of Korean Medicine
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• v.35 no.2
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• pp.12-18
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• 2014

Objectives: This was a retrospective case series about the clinical effect of integrated approach with behavior therapy for obstructive sleep apnea (OSA). Methods: Medical records of twelve patients with OSA who were treated with behavior modification including nasal breathing with oral appliances and sleep in lateral position, oral administration of herbal medicines and acupuncture treatment between January and September of 2013 were reviewed. Apnea-hypopnea index (AHI), day time sleepiness, apneas and hypopneas counts during sleep, risk indicator (RI), oxygen desaturation index, average saturation during sleep, lowest desaturation, lowest saturation, snoring events ratio and number of desaturations (%) were assessed before and after treatments with the ApneaLink device, which is a portable diagnostic apparatus for monitoring airflows of the patient's breath at home. Results: After an average 62.67 (SD 37.16) days of treatment, AHI (from 17.67, 12.79 to 8.75, 8.25, p=0.007), RI (from 22.00, 13.26 to 12.09, 8.03, p=0.004), oxygen desaturation index (from 17.33, 12.17 to 8.17, 7.86, p=0.005), and number of desaturations (from 7.00 times, 9.79 to 0.92 times, 1.39, p=0.044) showed significant improvement. Daytime sleepiness improved from 6.5 (3.2) to 3.8 (1.8) but there was no significant difference after treatment (p=0.17). No adverse events related to treatment were observed during participation in the treatment. Conclusion: From this case series, we found that behavior modification with herbal medication and acupuncture may be effective for improving sleep apnea without serious adverse events. Future randomized controlled trials with larger sample size will be necessary for concrete evidence on the benefit of this integrated treatment for OSA.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.305-313
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• 1991

In order to investigate industrial fatigue due to visual display terminal (VDT) work of banking operations the questionnaire survey for subjective symptoms of fatigue was carried out on 470 bank clerks who had been engaged in VDT work for various length of work hours. The questionnaires comprised three groups of 10 items each, representing dullness and sleepiness (level of cerebral activation), difficulty in concentration (level of motivation) and bodily projection of fatigue. The results were as follows : 1. Of the 30 items of questionnaires, the highest percentage was accounted for by 'eye strain' (51.5% ), followed by 'feel stiffness in the neck or the shoulders'(33.4%), 'feel a pain in the low back'(26.8%), 'whole body feels tired'(19.6%) and 'feel headache'(17.9%) in the order of sequence. 2. The average weighted score for the first group of questionnaire items (dullness and sleepiness) was the largest among three groups and was followed by 'the third cup (bodily projection of fatigue) and the second item group (difficulty in concentration) in the order of sequence, suggesting the heavier mental stress of VDT work in banking operations rather than physical burden. 3. In terms of the age and sex of workers, work duration and VDT work percentage, the difference in average weighted score was noted only between sex, the score of female being larger than that of male. 4. The complaint rates of subjective symptoms showed close associations with the subjective optimums of room temperature, ventilation, illumination and noise level. 5. The significant correlation was showed between age, work duration and item of 'whole body feels tired', between VDT work percentage and items of 'eye strain' and 'feel stiffness in the neck or shoulders' and between all items of subjective symptoms.

• Sleep Medicine and Psychophysiology
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• v.2 no.2
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• pp.146-155
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• 1995

Jet lag can be defined as the cumulative physiological and psychological effects of rapid air travel across multiple time zone. The consequences of jet lag include fatigue, general malaise, sleep disturbances, and reductions of cognitive and psychomotor performance, all of which have been documented in experimental biological and air crew personnel studies. Thus authors tried to study the jet lag of natural travellers by modified self reporting sleep log. Total 61 healthy travellers was studied for 3 days before and 7 days after jet-flights across seven to ten time zone. The eastbound travelling group was 38 persons, aged 19 -70 and westbound travelling group was 23 persons, aged 13 - 69. Sleep onset time, wake-up time, sleep latency, awakening frequency on night sleep, awakening duration on night sleep, sleepiness at wake-up and nap length were evaluated. Our results suggested that the 7 to 10 time zone shift gave significant influence to traveller's sleep-wake cycles. The date which subjective physical condition was recovered on was $5.16{\pm}1.50$ day after arrivals for eastbound, while for westbound, $4.91{\pm}1.62$ day. In eastbound travelling, sleep onset time became later than baselines and could not recover until 7th day. But in westbound, it became earlier than baseline and could recover until 6th day. The mean score of 24-hour sleepiness was greater in eastboumd than westbound. Therefore the eastbound travelling caused more sleep-wake cycle disturbance and daytime dysfunction than westbound travelling. In other parameters, there was no definite difference between east and westbound. From our results, it was suggested that the symptom severity of jet lag was dependent on the travelling direction. To demonstrate more definite evidence, large sized data collections and comparision by age difference were needed.

• The Journal of the Korean dental association
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• v.53 no.1
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• pp.47-56
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• 2015

Obstructive sleep apnea (OSA), most common respiratory disorder of sleep, is characterized by intermittent partial or complete occlusions of the upper airway due to loss of upper airway dilating muscle activity during sleep superimposed on a narrow upper airway. Termination of these events usually requires arousal from sleep and results in sleep fragmentation and hypoxemia, which leads to poor quality of sleep, excessive daytime sleepiness, reduced quality of life and numerous other serious health consequences Untreated OSAS can cause various problems such as hypertension, diabetes, stroke, cardiac disease, daytime sleepiness. Various treatments are available, including non-surgical treatment such as medication or modification of life style, surgical treatment, continuous positive airway pressure (CPAP) and oral appliance (OA). Oral appliance is known to be effective in mild to moderate OSA, also genioglossus muscle advancement (GA) or maxillomandibluar advancement (MMA) is a good option for OSA patients with muscular or skeletal problems. Although the prevalence of OSA is increasing, the proportion of the patient treated by dentist is still very law. Dentists need to understand the mechanism of OSA and develop abilities to treat OSA patients with dental problems. The purpose of this paper is to give a brief overview about OSA and the dentist's role in OSA patients.

• Korean Journal of Occupational Health Nursing
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• v.8 no.2
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• pp.162-168
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• 1999

To investigate industrial fatigue and low back pain, the questionaire survey for subjective symptoms of fatigue and low back pain was carried out 305 nurses in general hospital in Korea. Nurses participated to this study were divided into low back pain group(LBP) and control group, according to the self-reports by written questionaires. The subjective sysptoms of fatigue comprised three groups of 10 items each, representing dullness and sleepiness(level of cerebral activation), difficulty in concentration(level of motivation) and bodily projection of fatigue. The resultant data were processed for $x^2$-test, t-test to confirm the associations. The results were as follows: 1. 28 items of fatigue subjective symptoms exept two item, 'feel thirsty and 'feel ill', were directly associated with low back pain. 2. The percentage of fatigue complaint were significantly higher in LBP group than control. 3. Of the 30 items of fatigue subjective symptoms, the highest percentage was accounted for 'legs feel heavy', 'eye strain', 'feel stiffness in the neck or the shoulders' followed by 'feel like lying', 'whole body feels tired', 'feel a pain in the low back', 'feel drowsy' and in the order of sequence. 4. The average weighted score for the first group of fatigue items(dullness and sleepiness) was the largest among three groups and was followed by the second group(difficulty in concentration) and the third group (bodily projection of fatigue) in the order of sequence, suggesting the heavier mental and shift work stress of the female workers.

• Journal of the Korean Institute of Intelligent Systems
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• v.26 no.6
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• pp.464-470
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• 2016

In this paper, we propose an improved face detection algorithm and determination method for drowsiness status of driver from the opening and closing frequency of the detected eye. For this purpose, face, eyes, nose, and mouth are detected based on conventional Viola-Jones face detection algorithm and spatial correlation of face. Here the spatial correlation of face is performed by DFP(Detect Face Part) based on seven characteristics. The experimental results on Caltect face image database revealed that the detection rates of noise particularly showed the improved performance of 13.78% in comparison to that of the previous Viola-Jones algorithm. Furthermore, we analyze the driver's drowsiness determination cumulative value of the eye closed state as a function of time based on SVM (Support Vector Machine) and PERCLOS(Percentage Closure of Eyes). The experimental results confirmed the usefulness of the proposed method by obtaining a driver's drowsiness determination rate of 93.28%.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.2
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• pp.196-204
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• 2003

Objectives: It is known that sedative hypnotics would make cross tolerance with alcohol and deteriorate quality of sleep in alcoholics. Light therapy is effective non-pharmacological intervention for sleep disturbance in circadian phase disorders, jet-lag, shift-work and age-related sleep disorders. Authors would investigate the effects of morning light therapy on sleep of patients with alcohol dependence during recovery state without withdrawal symptoms. Methods: 13 patients with alcohol dependence who have not any alcohol withdrawal symptom were recruited. Light therapy during 1 hour in the morning had been administered by 2500 Lux light box through serial 3 days. Sleep state of subjects were assessed by sleep log and the subjective satisfaction at sleep was by 100 mm visual analogue scale. Sleepiness, depressive mood, anxiety were evaluated by 100mm visual analogue scale at 8 AM, 2 PM and 8 PM. For assessment of performance ability that would be associated with sleepiness and vigilance, trail making test A, B and digit symbol substitution test were performed by two times on base line and 4th day. Univariate repeated-measures ANOVAs were performed for each measures except performance tests which were analysed by paired t-test. Results: Sleep latency and sleep efficiency were significantly improved with light therapy and satisfaction at sleep was. There was no significant difference in sleepiness at 2 PM with light therapy but sleepiness at 8 AM significantly decreased and at 8 PM increased. The time to complete Trail making test and digit symbol substitution test were significantly shortened at 4th day compared with baseline. Fatigue at 8 AM were not significantly changed with light therapy but at 2 PM and 8 PM significantly decreased. Depressive mood and anxiety were not significantly changed with light therapy. Conclusion: Although this study had some limitations, it showed that light therapy would be effective modality on sleep disturbance of patients with alcohol dependence who have recovered from alcohol withdrawal symptoms. It is proposed that short term light therapy could be used clinically for alcoholics with insomnia. In the future, long term controlled studies using more objective tools for sleep are required to further investigate the effect of light therapy in alcoholics.

• Sleep Medicine and Psychophysiology
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• v.16 no.1
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• pp.10-15
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• 2009

Sleep problems and disorders are common in patients with cancer. Sleep of the cancer patients is affected by various factors, including thermoregulatory changes associated with chemotherapy and radiotherapy, cancer related symptoms, such as pain, fatigue, and emotional difficulties. As one of the most common symptoms in cancer patients, fatigue is positively correlated with sleep difficulties. Cytokine is also frequently associated with chemotherapy and radiotherapy. It provokes excessive daytime sleepiness and hypersomnia. Medications for controlling pain, depression, and anxiety can affect sleep of the cancer patients. Medications as well as behavior therapy are reported to be effective for controlling sleep problems, and the physicians need to be accustomed to use the modalities appropriately. This paper reviews causative factors, evaluation, and management of sleep problems and disorders, experienced by cancer patients.