수면무호흡과 수면구조변인과의 상관관계

이희상,이성훈,이정권,김경수 大韓神經精神醫學會 1996 신경정신의학 Vol.35 No.5

연구목적 : 저자들은 수면호흡장애가 수면구조 및 수면과 관련된 여러 변수들과 어떤 관계를 갖고 있는지를 살펴봄으로써, 수면호흡장애가 수면에 미치는 영향을 알아보기 위해 본 연구를 수행하였다. 연구방법 : 코골기와 수면무호흡 증상으로 연정 뇌기능 수면 연구소에 수면다윈검사가 의뢰한 남녀환자 60명을 대상으로 하루밤 동안 수면다윈검사를 시행하였으며, 수면변수와 호흡변수간의 상관관계 SPSS-PC+ Version 3.1을 이용하여 Pearson 상관계수를 구하여 조사하였다. 연구결과 : 수면무호흡, 특히 폐쇄성 수면무호흡은 제 2단계 수면양과 유의한 정 상관관계를 보였으며 제3단계 수면 양, REM수면양과는 유의한 역 상관관계를 보였다. 또한 폐쇄성, 혼합형 수면 무호흡 저호흡 순으로 이들 횟수가 증가할수록 평균 혈중산소포화도가 떨어지는 양상을 보였으나 중추성 수면무호흡의 횟수와 평균 혈중산소포화도 사이에는 유의한 상관관계가 없는 것으로 나타났다. 코골기 삽화와 수면효율, 제2단계 수면양, 폐쇄성 수면 무호흡의 횟수, 혼합형 수면 무호흡의 횟수 등은 유의한 정 상관관계가 있는 것으로 나타났으나 REM수면 양과는 유의한 역 상관관계가 있는 것으로 나타났다. 결론 : 수면무호흡, 특히 폐쇄성 수면무호흡은 각성을 유발시켜 수면의 분절을 야기하며 평균 혈중 산소포화도를 떨어뜨리는 효과가 있음이 시사되었고 코골기와 폐쇄성 수면 무호흡이 유의한 상관관계를 보여 두 질환 사이에 밀접한 관계가 있음을 시사했다. Objectives : This research was performed in order to observe the effects of the sleep breathing disorder on the sleep by studying correlations between variables related to sleep breathing disorder and other variables related to sleep. Methods : We studied 60 patients with snoring and sleep apnea syndrome, using the polysomnography and investigated correlations between sleep variables and respiratory variables with Pearson's correlation coefficients. Results : Total number and total duration of obstructive sleep apnea were significantly correlated with total duration of stage 2 sleep and negatively correlated with stage 3 sleep and REM sleep. The more frequent obstructive mixed sleep apnea and hypopnea occured, the more the oxygen saturation decreased. However, no significant correlation between central sleep apnea and oxygen saturation was found. Frequency of snoring episode was significantly correlated with sleep efficiency, total duration of stage 2 sleep, and frequency of obstructive and mixed sleep apnea, but negatively correlated with total time of REM sleep. Conlusion : This study suggests that sleep apnea, especially, obstructive sleep apnea induces the fragmentation of sleep with frequent arousals and that there is significant correlation between episodic snoring and obstructive sleep apnea.

The Effects of the Stress on the Sleep Quality

( Joo Hee Shim ),( Seung Wan Kang ) 한국감성과학회 2015 추계학술대회 Vol.2015 No.-

Objective: The purpose of this study was to analyze the relationship between stress and sleep patterns in adults. Methods: 39 (29 men and 10 women) healthy volunteers with sleep difficulties were recruited to participate in the study. Participants reported on their sleep habits through questionnaires and sleep diaries. Objective sleep was estimated using polysomnography. Results: No significant differences were observed between stress and sleep stage, REM sleep, NREM sleep, Total wake Time (TWT), Sake After Sleep Onset (WASO). Stress was positively associated with Stanford Sleepiness Scale (SSS), Hypopnea Index (HI), sleep duration, Total Pittsburgh Sleep Quality Index (PSQI) score. Conclusions: We conclude that stress increased daytime sleepiness and Hypopnea during sleep. Increased stress might negatively affect the quality of sleep and increase the sleep requirement.

서울시 중고등학교 학생들의 수면 양상과 수면에 대한 인식

김지현,이향운,문희수 대한수면연구학회 2014 Journal of sleep medicine Vol.11 No.1

Objectives:To investigate the sleep patterns of Korean adolescents and the subjective perception on their sleep pattern and daytime functioning related to sleep status.Subjects and methods:The questionnaire survey was done in 2007 for students in middle and high schools located in Mokdong region in Seoul.The questionnaire included sleep/wake schedules both on school days and weekends, various questions regarding sleepiness and other sleep complaints, and morningness-eveningness scale. Results:The third year of middle school, the first and second year of high school students were enrolled. A total of 1,252 students (boy: 65.3%) participated in the survey. The average bedtime was 12:46 AM, and 1:13 AM, respectively and the wake up time was 6:24 AM and 8:35 AM, respectively on school days and weekends. Total sleep time was 6.6 ±1.1, 5.89±1.1 and 5.65±0.9 hours on school days for students in the third year of middle school, the first year and the second year of high school, respectively. While 57% of students answered that they have sufficient sleep, only 36.7% of students reported they sleep sufficiently almost always. High school students reported shorter optimal sleep duration than middle school students. One third of students had a problem of daily or school life due to sleepiness. Conclusion: This study showed sleep deprivation on school days and compensating catch-up sleep on weekends in middle & high school students in Seoul.The perception of their sleep seems to be affected not only by current sleep status but also by the school year probably related to academic pressure.

노인의 수면양상과 관련요인에 관한 연구

오진주,김신미,송미순 서울대학교 간호대학 간호과학연구소 1997 간호학 논문집 Vol.11 No.1

Sleep is an essential component in health and the quality of life of individual. Normally, sleep pattern changes with advancing age. These changes often result in sleep impairment and become a major stressor in elderly. Even though the elderly is the fastest growing population, sleep impariment among elderly has not been well documented, few studies have been conducted related to the sleep of the elderly in Korea. The purpose of this study is to explore sleep pattern, related factors, and sleep satisfaction among healthy community-dwelling elderly, in order to present basic informations regarding Korean elder's sleep. 170 subjects over 60-yer-old were participated in the study. The survey questionnaire was developed by translation and modification of two well-known sleep questionnaires which originally developed by Monroe(1967) and Ellis, et al.(1982). Pilot study was done liefore final contents of a questionnaire was organized. SPSS/PC+ was utilized for data analysis. Results as follows: 1. Sleep pattern changes were reported by 75% of the subjects: decline in sleep time: frequent awakening: difficulty in falling asleep; lack of deep sleep; falling asleep early and getting up early; sleepy; decline in early morning sleep; irregular sleep habit; early retiring in bed. 2. Most of the subjects reported to fall asleep between 9-11pm, and get up between 4-6am. Forty point one percent of the subjects stated that they have problems in falling asleep. More than 70% reported their sleep to be satisfied. Sixty one point eight responded that they hardly or never take a nap. 3. Regarding sleep-disturbing factors, physical factor(30.1%), emotional factor(44.2%), environmental factor(41.0%) were reported. 4. Nineteen point two of the subjects practiced some types of strategies for better sleep. But a few(12.8%) used hypnotics, mainly in occasional base. 5. Variables showed statistically significant differences in sleep satisfaction were; getting up right away upon waking; frequency of awakening during night time sleep; difficulty in falling asleep; feeling rested upon waking int eh morning ; difficulty in going back to sleep upon awakening during night time sleep. From the results of this study, it can be concluded that the elderly in the community do have some sleep impairment but do not practice adequate strategies for better sleep. Further research are needed to develop better sleep measurement tool, to compare sleep pattern with other age groups and to develop nursing intervention.

중환자실 환자의 수면

박진 대한수면연구학회 2021 Journal of sleep medicine Vol.18 No.2

Sleep disturbances are common among patients admitted to the intensive care unit (ICU); however, these issues tend to receive less attention because critical care is prioritized in seriously ill patients. Recent studies have reported that sleep disturbances in patients admitted to the ICU are associated with delirium, weakened immunity, long-term cognitive decline, and persistent sleep disorders. Sleep disturbances in the ICU are attributable to the disease per se and also to the ICU environment that is not conducive to good sleep. Continuous exposure to light and noise are major environmental risk factors that disrupt the circadian rhythm and interfere with deep sleep. Sleep analysis using polysomnography in patients admitted to the ICU typically reveals increase in sleep latency, sleep fragmentation, and decreased stage N3 and rapid eye movement sleep, which are associated with poor prognosis even in patients with severe neurological conditions, including traumatic brain injury and intracranial hemorrhage. Polysomnography is the gold standard for objective evaluation of sleep; however, its applicability is limited in ICU settings, and novel methods such as continuous electroencephalographic spectral analysis and actigraphy have recently been proposed in clinical practice. Efforts to reduce nighttime light and noise (which are modifiable environmental factors) can improve sleep quality. In this article, the author reviews the studies that discuss characteristics of sleep disturbances, the associated risk factors and their correlation with prognosis among patients admitted to the ICU, as well as possible strategies to improve sleep quality in this patient population.

Factors related with quality on sleep of daytime workers

Bu-il Kim,Seong-yong Yoon,Jin-seok Kim,Kuck-Hyeun Woo,Seong-yong Cho,Ho Lee,Jong-min An 대한직업환경의학회 2018 대한직업환경의학회지 Vol.30 No.-

Background: This study was conducted to identify the sleep status of daytime workers who do not work in shifts. This study analyzed factors affecting sleep duration and sleep quality. Methods: This study was conducted on 1171 daytime workers at a manufacturing workshop. We used a selfadministered questionnaire to investigate demographic variables, work type, working period, musculoskeletal symptoms and the Pittsburgh Sleep Quality Index to assess sleep. Regular health checkup was conducted for the worker’s clinical examination. Results: The mean sleep duration was 6.36 h and the mean score on the Pittsburgh Sleep Quality Index was 4.46. Work type and obesity were related to sleep duration. Age, obesity and musculoskeletal pain were significantly related to sleep quality. The prevalence ratio of researcher group for short sleep duration was 1.27 (95% confidence interval: 1.02–1.58). The prevalence ratio of those aged 50 years and over was 0.47 (0.25–0.91) and of those in their 40s was 0.56 (0.35–0.91) for poor sleep quality compared to those in their 20s. The prevalence ratio of the obesity group for poor sleep quality was 1.53 (1.10–2.12). The prevalence ratio of musculoskeletal pain group for poor sleep quality was 1.92 (1.29–2.84). Conclusions: Age, obesity and musculoskeletal pain were factors affecting the poor quality on sleep of daytime workers. In addition, work type related to short sleep duration.

Short-term maintenance on a high-sucrose diet alleviates aging-induced sleep fragmentation in drosophila

이상혁,김은영 한국통합생물학회 2021 Animal cells and systems Vol.25 No.6

Sleep is a fundamental behavior in an animal’s life influenced by many internal and external factors, such as aging and diet. Critically, poor sleep quality places people at risk of serious medical conditions. Because aging impairs quality of sleep, measures to improve sleep quality for elderly people are needed. Given that diet can influence many aspects of sleep, we investigated whether a high-sucrose diet (HSD) affected aging-induced sleep fragmentation using the fruit fly, Drosophila melanogaster. Drosophila is a valuable model for studying sleep due to its genetic tractability and many similarities with mammalian sleep. Total sleep duration, sleep bout numbers (SBN), and average sleep bout length (ABL) were compared between young and old flies on a normal sucrose diet (NSD) or HSD. On the NSD, old flies slept slightly more and showed increased SBN and reduced ABL, indicating increased sleep fragmentation. Short-term maintenance of flies in HSD (up to 8 days), but not long-term maintenance (up to 35 days), suppressed aging-induced sleep fragmentation. Our study provides meaningful strategies for preventing the deterioration of sleep quality in the elderly.

Assessing the Sleep-wake Pattern in Cancer Patients for Predicting a Short Sleep Onset Latency

Kikyoung Yi,Joohee Lee,Sungook Yeo,Kyumin Kim,Seockhoon Chung 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.2

Objective: We investigated the sleep parameters and clinical factors related to short sleep onset latency (SL) in cancer patients. Methods: We retrospectively reviewed the medical records of 235 cancer patients. Patient Health Questionnaire-9, State and Trait Anxiety Inventory (State subcategory), Insomnia Severity Index (ISI), Cancer-related Dysfunctional Beliefs about Sleep, and Fear of Progression scale scores and sleep related parameters including sleeping pill ingestion time, bedtime, sleep onset time, and wake-up time were collected. We also calculated the duration from sleeping pill ingestion to bedtime, sleep onset time, and wake-up time; duration from wake-up time to bedtime and sleep onset time; and time spent in bed over a 24 hours period. Results: Among patients not taking sleeping pills (n = 145), early wake-up time (adjusted odds ratio [OR]: 0.39, 95% confidence interval [CI] 0.19−0.78), early sleep onset time (OR: 0.50, 95% CI 0.27−0.93), and low ISI score (OR: 0.82, 95% CI 0.71−0.93) were identified as expecting variables for SL ≤ 30 minutes. Longer duration from wake-up time to bedtime (OR: 2.49, 95% CI 1.48−4.18) predicted SL ≤ 30 minutes. Among those taking sleeping pills (n = 90), early sleep onset time (OR: 0.54, 95% CI 0.39−0.76) and short duration from pill ingestion to sleep onset time (OR: 0.05, 95% CI 0.02−0.16) predicted SL ≤ 30 minutes. Conclusion: Cancer patients who fell asleep quickly spent less time in bed during the day. Thus, before cancer patients with insomnia are prescribed sleeping pills, their sleep parameters should be examined to improve their SL.

고광도 빛이 시설내 여성 치매 노인의 수면에 미치는 효과

김신미 대한간호학회정신간호학회 1999 정신간호학회지 Vol.8 No.2

Sleep impairment with agitated behavior is common in the demented elderly. The gravity of sleep and behavioral disturbances is evident from the fact that night time agitation is the primary cause of institutionalization of the demented elderly. Both problems are related to circadian rhythm changes and decreased exposure to zeitgebers. Bright light is known to be a strong zeitgeber of human circadian rhythm. Consequently, bright light has been emerged as a possible therapeutic alternative for the problems of sleep and behavioral disturbances. The purpose of this study was to examine the effect of evening bright light delivered by fluorescent lamps on female demented elderly with disturbed sleep patterns, accompanied by agitated behavior, in a community care facility. The study was conducted in cross-over trial with twenty-one subjects and outcome variables derived from tympanic temperature, sleep, agitation and cognition were analyzed. The results were as follows : 1. Temperature : Treatment effect was not statistically significant for the mean, peak, nadir, and amplitude (P>0.10). No statistically significant changes of the occurrence numbers of peak 4PM were found after treatment, but the occurrence numbers of nadir at 4 AM increased significantly (P=0.09) after treatment. 2. Sleep : Treatment effect was not statistically significant for the sleep period at night, total sleep time, wake after sleep onset, percentage of sleep during night, sleep time at night, wake up time in the morning. Nap time (P=0.01) and nap numbers(P=0.02) decreased significantly after treatment. 3. Agitation scores decreased significantly after treatment(P=0.00). 4. Cognition scores were not changed significantly after treatment(P=0.82). Evening bright light has significantly decreased the agitated behavior of the demented elderly, but were found to be effective on only a few outcome measures of temperature and sleep-activity rhythm, and ineffective on cognition. It can be concluded tat bright light is a potent therapeutic intervention for the sleep and behavioral disturbances of the demented elderly.

The Severity of Sleep Disordered Breathing Induces Different Decrease in the Oxygen Saturation During Rapid Eye Movement and Non-Rapid Eye Movement Sleep

최은경,박두흠,유재학,유승호,하지현 대한신경정신의학회 2016 PSYCHIATRY INVESTIGATION Vol.13 No.6

ObjectiveaaTo investigate how differences in oxygen saturation between non-REM (NREM) and REM sleep in patients according to the severity of sleep apnea. MethodsaaWe studied 396 male patients diagnosed with simple snoring or obstructive sleep apnea syndrome (OSAS) on nocturnal polysomnography. Patients were divided into groups by the OSAS severity. We compared the average oxygen saturation between REM and NREM sleep in each group. ResultsaaIn the simple snoring group, average oxygen saturation was significantly greater during REM than during NREM sleep. In the severe OSA group alone, average oxygen saturation was greater in NREM than in REM sleep. The difference of NREM-REM average oxygen saturation correlated significantly with AHI in the severe OSA group. ConclusionaaMore severe hypoxemia was seen in REM than NREM sleep in the severe OSAS group. The differential oxygen decrease between REM and NREM sleep is likely due to the differentially occurring sleep breathing events in each sleep stage according to the SDB severity. The more AHI increases in the severe OSAS patients, the more prominent the hypoxemia of REM sleep compared with NREM sleep is likely to appear. This suggests that the pressure of continuous positive airway pressure should be increased to control the hypoxemia of REM sleep in extremely severe OSAS.