• Title/Summary/Keyword: sleepiness

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Compensation of Arousal Level Criteria by a Modified KSS Scale (수정된 KSS 측도에 의한 각성도 평가기준 보상법)

  • 고한우;김연호
    • Journal of Biomedical Engineering Research
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    • v.18 no.4
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    • pp.477-484
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    • 1997
  • In this paper, we proposed the compensation method to evaluate arousal level in different initial arousal states. Arousal level was measured by the relationship between IRI and Nz. Since Nz is affected by BI which is directly proportional to initial arousal state of subjects, the arousal level is underestimated To overcome this problem, we proposed the compensation method using modified Karolinska sleepiness scale, and determined compensation coefficients derived from this scale with five arousal levels. Applying these coefficients to portable arousal monitoring system, the proposed method in this paper could be useful for real-time evaluation and control of arousal level. As a result the developed system can detect and control the arousal state from initial drowsing sate.

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Cardiometabolic Effects of Obstructive Sleep Apnea and Treatment Effects of Oral Appliance: An Updated Review for Dentists

  • Kim, Hye-Kyoung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.43 no.3
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    • pp.61-69
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    • 2018
  • Obstructive sleep apnea (OSA) is a relatively common, but greatly underdiagnosed sleep-related breathing disorder, characterized by recurrent collapse of the upper airway during sleep. OSA has been associated with a variety of cardiometabolic disease, such as hypertension, coronary artery disease, cardiac arrhythmia, cerebrovascular disease and metabolic dysfunction. Neurocognitive impairment, including excessive daytime sleepiness, increased risk of motor vehicle accidents, is also related to OSA. Sleep fragmentation and related arousals during sleep lead to intermittent hypoxia, sympathetic activation, oxidative stress, systemic inflammation and metabolic dysregulation which provide biological plausibility to this pathologic mechanism. Extensive studies demonstrated that OSA is a modifiable risk factor for the above mentioned diseases and oral appliances (OAs), although continuous positive air pressure (CPAP) is a first-line therapy of OSA, are not inferior to CPAP at least in mild OSA, and may be an alternative to CPAP in CPAP-intolerant subjects with OSA. The goal of this article is to provide a current knowledge of pathologic link between OSA and cardiovascular disease, focusing on intermittent hypoxia, sympathetic activation, oxidative stress and metabolic dysregulation. Then, previous epidemiologic studies will be reviewed to understand the causal relationship between OSA and cardiovascular disease. Finally, the effects of OAs will be updated via recent metaanalyses compared to CPAP.

Clinical characteristics and treatment plan for patients with snoring and obstructive sleep apnea (코골이와 수면무호흡증 환자의 임상적 특징과 치료계획)

  • Jung, Jae-Kwang;Kim, Ki-Rim;Byun, Jin-Seok;Choi, Jae-Kap
    • The Journal of the Korean dental association
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    • v.53 no.4
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    • pp.249-258
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    • 2015
  • Snoring and obstructive sleep apnea are the representative sleep disordered breathings, caused by the temporary and repetitive constriction or obstruction of upper airway during sleep. They present with excessively vibratory noise and repetitive cease of respiration. These disorders commonly result in sleep disturbance and the subsequent daytime sleepiness, chronic fatigue. Furthermore, they can cause the serious and extensive complications including increased risk of hypertension, cardiac arrhythmia, cardiovascular disease, cerebrovascular accident, neurocognitive disturbance, traffic and occupational accidents, type II diabetes, childhood growth interruption, awakening headache and finally, relatively increased mortality rate. Because appropriate therapeutic intervention is best way for patients to relieve their symptoms and prevent their possible complications, it is very important for dentists to recognize their own role and responsibility in diagnosis and treatment of these disorders. For this, the present article provides the understanding of the clinical features, possible complications, various treatment modalities, and suitable treatment strategies for snoring and obstructive sleep apnea.

Case Report of a Psychogenic Urinary Incontinence Patient with Hypersomnia Disorder (수면과다증을 동반한 심인성 요실금 환자 호전 1례)

  • Lee, Dong-keun;Son, Ah-hyun;Kang, Mi-jung;Shin, Hyeon-su
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.189-195
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    • 2016
  • Objective: This study evaluates the effects of traditional Korean medicine (including Guibi-tang) on a psychogenic urinary incontinence patient with hypersomnia disorder.Method: Herbal medicine, acupuncture, and moxibustion were carried out. The effect of the treatments was then evaluated via the Beck depression inventory (BDI), the Beck anxiety inventory (BAI), the symptom checklist-90-revised (SCL 90-R), the Epworth sleepiness scale (ESS), and the revised urinary incontinence scale (RUIS), as well as the number of urinations, incontinence levels, and sleeping times during the day.Results: After the treatments, both the urinary incontinence and hypersomnia symptoms showed improvement.Conclusion: This study suggests that traditional Korean medicine treatments are effective in caring for patients who suffer from psychogenic urinary incontinence with hypersomnia disorder.

A review of two theories of motion sickness and their implications for tall building motion sway

  • Walton, D.;Lamb, S.;Kwok, Kenny C.S.
    • Wind and Structures
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    • v.14 no.6
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    • pp.499-515
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    • 2011
  • Low-frequency building vibration is known to induce symptoms of motion sickness in some occupants. This paper examines how the adoption of a theory of motion sickness, in conjunction with a dose-response model might inform the real-world problem of managing and designing standards for tall building motion sway. Building designers require an understanding of human responses to low-dosage motion that is not adequately considered by research into motion sickness. The traditional framework of Sensory Conflict Theory is contrasted with Postural Instability Theory. The most severe responses to motion (i.e., vomiting) are not experienced by occupants of wind-excited buildings. It is predicted that typical response sets to low-dosage motion (sleepiness and fatigue), which has not previously been measured in occupants of tall-buildings, are experienced by building occupants. These low-dose symptoms may either be masked from observation by the activity of occupants or misattributed to the demands of a typical working day. An investigation of the real-world relationship between building motion and the observation of low-dose motion sickness symptoms and a degradation of workplace performance would quantify these effects and reveal whether a greater focus on designing for occupant comfort is needed.

Intake Status and Perception of Energy Drinks according to the Gender and Obesity of Some University Students in Chungnam Province (충남지역 일부 대학생의 성별과 비만도에 따른 에너지음료 섭취실태 및 인식)

  • Ko, Kab-Keum;Kim, Myung-Hee;Lee, Je-Hyuk
    • The Korean Journal of Food And Nutrition
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    • v.32 no.3
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    • pp.167-178
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    • 2019
  • The purpose of this study was to investigate the intake status of energy drinks, knowledge of caffeine and the perception on intake of energy drinks by university students. We surveyed 351 university students from October 25, 2017 to January 25, 2018. The subjects (70.9%) consumed energy drinks more than once. Male students consumed energy drinks more frequently than the female ones. A huge portion (68.3%) of the subjects consumed energy drinks to recover from fatigue and reduce sleepiness. Moreover, they consumed most of the energy drinks at home and the university library. The main anticipated efficacy of energy drinks was the relieving drowsiness. Respondents (86.3%) perceived that energy drinks could be hazardous to the health of human beings. The main risks of consuming energy drinks were sleep disorders, addiction problems and heart beating. The main recognized effects of energy drinks were relieved drowsiness and decreased fatigue. The major side effects were heart beating, nausea, vomiting, heartburn and sleeping disorders. This study suggests that nutritional education is needed to confirm the recommendation of daily intake for caffeine and to raise awareness about the side effects of energy drinks.

The Role of Aviation Medical Examiners in the Diagnosis, Treatment and Aeromedical Assessment of Patients with Allergic Rhinitis (알레르기 비염 진단 및 치료, 항공업무 적합성 평가에 있어 항공전문의사의 역할)

  • Kim, Young Hyo
    • Korean journal of aerospace and environmental medicine
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    • v.30 no.2
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    • pp.66-69
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    • 2020
  • Since allergic rhinitis is a disease with a very high prevalence, it is common to find patients with allergic rhinitis among aviation workers. However, they are so afraid that the report of rhinitis will have a negative effect on the evaluation of one's work suitability. Therefore, aviation medical examiners (AMEs) must be able to accurately understand the nature of allergic rhinitis, and confidently explain that appropriate treatment of rhinitis has a positive effect on their performance. In the treatment of allergic rhinitis, there are some medications that may cause drowsiness, which may impair the accuracy and safety of the aviation service. Therefore, AMEs should accurately know safe drugs that do not cause drowsiness and prescribe them to patients. In addition, it is necessary to know exactly whether air workers may receive the latest treatments for allergic rhinitis, such as surgical treatment and immunotherapy, and be able to recommend these treatments appropriately. Therefore, in this paper, we first briefly describe the pathophysiology, genetics, causative antigen, symptoms, diagnosis, and treatment of allergic rhinitis. We also aimed to discuss safe medication and other treatment modalities for allergic rhinitis.

A Study of Upper Airway Resistance Syndrome : Clinical and Polysomnographic Characteristics (상기도저항 증후군에 대한 연구 : 임상 및 수면다원검사 특징)

  • Yang, Chang-Kook;Clerk, Alex
    • Sleep Medicine and Psychophysiology
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    • v.3 no.2
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    • pp.32-42
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    • 1996
  • Objectives : Upper airway resistance syndrome(UARS) is a sleep-related breathing disorder characterized by abnormal negative intrathoracic pressure during sleep. Abnormally increased negative intrathoracic pressure results in microarousal and sleep fragmentation which underlay UARS-associated complaints of daytime fatigue and sleepiness. Although daytime dysfunction in patients with UARS is comparable to that of sleep apnea syndrome, UARS has been relatively unnoticed in clinical setting. That is why UARS is apt to be excluded in diagnosing of sleep-related breathing disorders since its respiratory disturbance index and arterial oxygen saturation are within normal limits. The current study presents a summary of clinical and polysomnographic characteristics found in patients with UARS. The present study aims (1) to explore characteristics of patients diagnosed with UARS, (2) to characterize the polysomnographic findings of UARS patients, and (3) to enhance the understanding of UARS through those clinical and laboratory characteristics. Methods : This was a retrospective study of 20 UARS patients (male 15, female 5) and 30 obstructive sleep apnea (OSA) patients (male 21, female 9) at the Stanford Sleep Disorders Clinic. We diagnosed patients as having UARS when they met critenia, RDI < 5 characteristic findings of an elevated esophageal pressure($<-10\;cmH_2O$), frequent arousals secondary to an elevated esophageal pressure, and symptoms of daytime fatigue and sleepiness. We used polysomnographic value, which is standardized by Williams et al(1974), as normal control. Statiotical test were done with student t-tests. Results : (1) Mean age of UARS was $41.0\;{\pm}\;14.8$ years and OSA was $50.9\;{\pm}\;12.0$ years. UARS subject was significantly younger than OSA subject (p<0.05). (2) The total score of Epworth Sleepiness Scale (ESS) was UARS $9.7\;{\pm}\;6.3$ and OSAS $11.2\;{\pm}\;6.3$. There was no significant difference between two groups. (3) The mean body mass index was UARS $28.1\;{\pm}\;5.7\;kg/m^2$ and OSAS $32.9\;{\pm}\;7.0\;kg/m^2$. UARS had significantly lower meen body man index than OSAS subjects (p<0.05). (4) The polysomnographic parameters of UARS were not significantly different from those of OSA except RDI(p<0.001), $SaO_2$ (p<0.001) and slow wave sleep latency (p<0.05). (5) Compared with normal control, Total sleep time in UARS subjects was significantly shorter (p<0.001), sleep efficiency index was significantly lower (p<0.001), total awakening percentage was significantly higher (p<0.001), and sleep stage 1 (p<0.001) were significantly higher. (6) OSA patients showed poor sleep quality and distinct abnormal sleep architectures compared with normal control. Conclusions : Conclusions from the above results are as follows : (1) UARS patients were younger and had lower body mass index when umpared with OSA patients. (2) The quality of sleep and sleep architectures of the UARS and OSA patients are significantly different from those of normal control. (3) ESS scores and awakening frequencies of UARS are similar with those of OSA, suggesting that daytime dysfunction of UARS patients may be comparable to those of OSA patients. (4) The RDI and the $SaO_2$ which are important indicators in diagnosing sleep-related breathing disorders, of UARS subjects are close to normal value. (5) According to the the above results, we unclude that despite the absence of $SaO_2$ drops and the absence of an elevated number of apnea and hypopnea, subjects developed clinical complaints which were associated with laborious breathing, elevated Pes nadir, and frequently snoring. (6) Accordingly, we suggest including LIARS in the differential diagnosis list when sleep related breathing disorder is suspected clinically and overnight polysomnographic findings except snoring and frequent microarousal are within normal limits.

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A Study on Adult Women's Sleep Disorder and Depression (성인여성의 수면장애와 우울에 관한 연구)

  • Kim, Jeong-Sun
    • Korean Journal of Adult Nursing
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    • v.15 no.2
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    • pp.296-304
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    • 2003
  • Purpose: This study is to study sleep disorder, sleep pattern, and depression in adult women, and to offer basic data for a program of the improvement of women's health and nursing intervention. Method: A structured questionnaire was carried out from September 1, 2001 to October 30, 2001 on the subject of 441 females, who are above 18 years old and lived in Seoul. This research tool measured insomnia with APA's insomnia scale(1994), sleep pattern and sleep disorder factors scale(Shin et al(1999)'s), and depression with Radloff's CES-D scale (1977). The data were analyzed with a SPSS program for descriptive statistics, ${\chi}^2-test$, and t-test. Result: The result were as follows; 1) 35.1% of all participants have insomnia. 2) Sleep disorder group appeared shorter($50.98{\pm}29.41min$.) than normal group($73.03{\pm}38.7min$.) in daytime sleepiness(p=0.001). 3) Factors of sleep disorder were stress(76.6%), worry(55.6%), without reason(39.6%), and noise outside(37.4%). 4) In relation between sleep disorder and depression, group with sleep disorder($20.20{\pm}11.06$) marked higher depression score than normal group($14.25{\pm}8.81$)(p<0.0001). Conclusion: Based upon these finding, sleep disorder in adult women was influenced by psychological factors, group with sleep disorder showed a higher depression score than normal group, and which indicated correlation with sleep disorder and depression. This study shows that nursing intervention on women's sleep disorder and depression is needed and further research be done to verify the results.

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Inflammatory Cytokine Level in Patients with Obstructive Sleep Apnea and Treatment Outcome of Oral Appliance Therapy

  • Oh, Jae-Tak;Chung, Jin-Woo
    • Journal of Oral Medicine and Pain
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    • v.41 no.3
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    • pp.126-132
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    • 2016
  • Purpose: The aims of this study were to analyze the association between inflammatory cytokine and obstructive sleep apnea (OSA), and to evaluate treatment outcome and changes of plasma inflammatory cytokine levels after oral appliance therapy. Methods: Twenty-seven subjects who visited Department of Oral Medicine in Seoul National University Dental Hospital were performed nocturnal polysomnography and analyzed plasma C-reactive protein (CRP), interleukin (IL)-$1{\beta}$, IL-6, IL-10, and tumor necrosis factor (TNF)-${\alpha}$ levels. Each subject was evaluated with Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). The subjects were classified into 12 OSA patients (apnea-hypopnea index [AHI] >5) and 15 control (AHI ${\leq}5$) groups. The OSA group was treated with mandibular advancement device (MAD) for 3 months and re-evaluated nocturnal polysomnography and plasma inflammatory cytokine levels. Results: Plasma TNF-${\alpha}$, IL-10, and IL-6 levels were significantly higher in OSA patients compared to controls. Total AHI showed significant positive correlations with plasma IL-6 and TNF-${\alpha}$ levels. Percentage time of $SpO_2$ <90 and lowest $SpO_2$ were significantly correlated with plasma TNF-${\alpha}$ level. ESS showed significant positive correlation with plasma IL-10 level. Total AHI, percentage time of $SpO_2$ <90, lowest $SpO_2$, and mean $SpO_2$ were significantly improved after the MAD therapy. Plasma TNF-${\alpha}$ level was significantly decreased after MAD therapy. Conclusions: We suggest that MAD therapy is an effective treatment modality for patients with OSA and can decrease plasma cytokine level.