렘수면 행동 장애와 퇴행성 신경계 질환

천상명 대한수면연구학회 2009 Journal of sleep medicine Vol.6 No.1

REM sleep behavior disorder (RBD) is characterized by dream-enacting violent behavior during REM sleep, which usually start at the age of older than 50. Patients with idiopathic RBD (IRBD) show various features similar to parkinsonian disorders and many of patients are known to be developing symptoms of neurodegenerative disorders in the course of disease. These close associations suggest that clinicians need to know the potential risk of developing parkinsonism and pay more attention to various features beyond sleep complaint when they manage the IRBD patient.

폐쇄성 수면 무호흡증 환자에서 수면 설문지와 호흡곤란지수의상관성에 대한 비교 연구

박상준,박기형,신동진,박현미,이영배,성영희 대한수면연구학회 2008 Journal of sleep medicine Vol.5 No.2

Background : The obstructive sleep apnea (OSA) syndrome is a potentially disabling condition characterized by excessive daytime sleepiness, disruptive snoring, frequent arousals and nocturnal hypoxemia. Self-reported sleep scales and questionnaires are easy to perform and useful method to evaluate the OSA patients. Each sleep scale and questionnaires are reported as a good screening tool for detection of OSA before polysomnographic evaluation. But there were no report about correlation between sleep scale and severity of OSA patients. We studied each sleep scales and questionnaires to confirm the correlation between each sleep questionnaire and the severity of OSA patients. Methods : Retrospectively consecutive 147 patients who carried out overnight polysomnogram from January 2005 to June 2007 were enrolled. All of the patients data were reviewed their sleep questionnaires which had done before polysomnographic evaluation. Sleep questionnaires were consisted of Epworth Sleepiness Scale (ESS), Stanford Sleepiness Scale (SSS), Insomnia Severity Index (ISI), Berlin questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Index (BDI). OSA patients were divided into 3 groups according to severity by their respiratory disturbance index (RDI) score. Results : The OSA patients divided into normal, mild, moderate, severe group by their RDI score; Among sleep questionnaires, Berlin questionnaire and BDI had significantly correlated to OSA severity (P<0.05). Between them, Berlin questionnaire showed most positive correlation to OSA severity by RDI score (P<0.005). Conclusions : Our results revealed that Berlin questionnaire is a most significant scale for prediction of severity of OSA.

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.

폐쇄수면무호흡 환자에서 졸음운전 관련 교통사고 예방을 위한 제안

선우준상,조재욱,임수환,김대영,구대림,임희진,김혜윤,김경민,양광익,대한수면연구학회 대한수면연구학회 2021 Journal of sleep medicine Vol.18 No.3

Obstructive sleep apnea (OSA) is known to be associated with various health concerns, including sleepiness, fatigue, cognitive dysfunction, diminished quality of life, hypertension, cardiovascular diseases, and stroke. OSA-induced sleepiness at the wheel reduces vigilance and driving performance, which significantly increase the risk of motor vehicle accidents. Sleepiness-induced motor vehicle accidents are characterized by high morbidity and mortality. OSA is a well-established significant risk factor for drowsy driving-related motor vehicle accidents, which can be prevented through appropriate treatment. However, currently no clinical guidelines or regulations are available for evaluation or management of the risk of motor vehicle accidents in patients with OSA in Korea. In this review, we discuss the risk of motor vehicle accidents in patients with OSA, the effects of positive airway pressure therapy as a preventive measure to reduce this risk, and the published recommendations for OSA in other countries with regard to fitness to drive. We propose recommendations for screening, evaluation, and treatment of OSA with regard to the risk of motor vehicle accidents, which would serve as useful practical guidelines for sleep specialists in clinical practice. Further research is warranted to establish optimal strategies for effective improvements in OSA-related traffic safety.

렘수면행동장애 환자의 꿈 회상 빈도와 수면의 질

성민재,정아름,박혜리,최수정,주은연 대한수면연구학회 2017 Journal of sleep medicine Vol.14 No.2

Objectives: The dream recall and sleep of patients with rapid eye movement sleep behavior disorder (RBD) were not sufficiently studied. We hypothesized that RBD patients have frequent dream recall with poor sleep quality, and investigated the relationship between the dream recall frequency and sleep quality in RBD patients compared to controls. Methods: We analyzed 81 drug naïve patients [RBD (+), 64.6±8.3 y, 57 males] and 81 age and gender matched patients with sleep disturbances without RBD [RBD (-), 63.7±7.3 y, 57 males]. All completed Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), Epworth sleepiness scale and Beck depression inventory. The 5-point rating scale was used to categorize dream recall frequency of most recent month (0=never, 4=very frequent). Results: In RBD (+), dream recall frequency was much higher [frequent dreaming, 77.2% vs. 35.4%], and subjective sleep quality was much better [PSQI, 6.36±3.26 vs. 8.71±4.69]. Insomnia severity was much less in RBD (+) (ISI, 9.13±5.86) than RBD (-) (12.43±7.62). No significant differences were found in sleep parameters except lower N2 sleep % in RBD (+). The relationship between dream recall frequency and sleep was not significant in RBD (+), yet, a positive correlation was noted in RBD (-). Conclusions: RBD (+) had better sleep quality despite higher frequency of dream recall compared to RBD (-). Also dream recall was not related to their sleep quality in RBD (+), which suggests that RBD patients may have different sleep perception about their sleep and sleep quality.

폐쇄성 수면무호흡증 환자의 과도한 주간졸음의 예측인자

이다인,이호원,강병욱,김준영,김정수,박성파 대한수면연구학회 2008 Journal of sleep medicine Vol.5 No.1

Excessive daytime sleepiness (EDS) is a well-recognized consequence of obstructive sleep apnea. EDS is considered an important health problem leading to impaired concentration, accidents, and poor quality of life. The aim of this study is to evaluate EDS and know the correalation between EDS and polysomnographic findings. 150 patients who visited our sleep clinic for snoring or sleep apnea were studied. Among them, 93 patients were included who had no history of previous diagnosis and treatment of OSA (Obstructive sleep apnea) and whose AHI (Apnea-Hypopnea Index) was more than 5 checked on polysomnography (PSG) had newly diagnosed as OSA. They completed sleep questionnaires and overnight PSG. The association between EDS and other data from PSG and demographic data were further assessed by correalation analysis. There were 93 patients comprising 75(80.1)% males and 18(19.9)% females. Their mean age was 44±1.4years, and co-morbidity index was 0.2±0.5. EDS was demonstrated in 34(36.6%). The EDS correlated poorly with PSG variables, demographic data, and comorbidity. To assess the EDS appropriately, further studies including follow up PSG would be needed.

수면 중 통증 발기 2례

조규호,김혜인,허경,조양제 대한수면연구학회 2016 Journal of sleep medicine Vol.13 No.2

Sleep-related painful erection (SRPE) is characterized by deep penile pain accompanied with erection occurring rapid eye movement (REM) movement period. Two (47-year-old and 40-year-old, respectively) male visited with the complaint of painful penile erection occurring during sleep. They had no problems with erection during daytime sexual activities except for mild premature ejaculation in one patient. Urologic inspections revealed no focal abnormalities. Polysomnography with simultaneous penile erection monitoring showed several episodes of awakening with painful erection which are time-locked to onset of REM sleep periods. According to the diagnostic criteria in international classification of sleep disorders, each patient was diagnosed to have chronic, severe SRPE. Despite of a low prevalence of SRPE, this condition should be considered in a patient who presents with nocturnal penile. A polysomnography accompanied with penile erection recording may help confirm diagnosis.

수면질환을 진단할 때 병력과 수면 설문지의 역할

이호원 대한수면연구학회 2009 Journal of sleep medicine Vol.6 No.1

Although sleep disorders medicine is a relatively young discipline, there has been a dramatic increase in knowledge about understanding of the diagnosis, pathophysiology, and treatment of sleep disorders in the past 20 years. It is now possible to objectively diagnose most sleep disorders and specific treatments can be instituted. However, despite advances in our understanding of sleep disorders, accurate diagnosis and treatment always requires a detailed understanding of the patient's sleep/wake cycle and medical history. This overview discusses the role of history taking and questionnaires in diagnosing sleep disorders, such as obstructive sleep apnea, restless leg syndrome, and narcolepsy, which are frequently confronted in primary care

액티와치로 측정한 객관적 짧은 수면시간, 주관적 짧은 수면시간, 정상 수면시간 불면증 아형의 임상적 특성

최수정,조현진,주은연 대한수면연구학회 2022 Journal of sleep medicine Vol.19 No.1

Objectives: This study aims to examine the clinical differences between objective short sleep insomniacs (OSSI) and subjective short sleep insomniacs (SSSI). Methods: We enrolled 79 patients (aged 27–74 years) with chronic insomnia disorder (CID) who underwent overnight polysomnography (PSG) and completed sleep-related questionnaires as well as habitual sleep time. All of them completed actigraphy (ACT) recording for one week prior to the PSG study. Objective sleep duration for one-week average sleep was calculated by ACT, and subjective sleep duration was counted through self-reported habitual sleep time. We divided the subjects into three groups; OSSI (<6 h/night), SSSI (objective sleep ≥6 h/night and subjective sleep <6 h/ night), and normal sleep duration insomniacs (NSDI, subjective sleep ≥6 h/night). Results: The three groups namely OSSI, SSSI, and NSDI had 25 (31.6%), 36 (45.6%), and 18 (22.8%) subjects, respectively. The SSSI were significantly older and had higher daytime sleepiness than the OSSI. According to the PSG results, the OSSI showed shorter sleep latency (11.86 min vs. 39.69 min) and N2 sleep % (59.43% vs. 67.96%), and longer rapid eye movement sleep % (20.79% vs. 15.47%) than that in the NSDI. There was no difference in treatment response between groups. Conclusions: 45.6% of CID patients underestimated their sleep relative to objective sleep. However, there were no differences in total sleep time on PSG between groups. The OSSI showed younger age and more daytime sleepiness, and the SSSI showed poorer sleep quality than the NSDI. These findings suggest that long-term ACT recording in a casual environment would be useful to monitor objective sleep in patients with CID, particularly, in subjectively short sleep insomniacs.

폐쇄성 수면무호흡증후군의 진단

김지언 대한수면연구학회 2006 Journal of sleep medicine Vol.3 No.1

The evaluation of obstructive sleep apnea syndrome (OSAS) should include a through sleep history and a physical examination that includes the respiratory, cardiovascular, and neurologic system. The gold standard approach to diagnosing OSAS is in-laboratory, technician-attended polysomnography (PSG). PSG is should be performed if there is any clinical clues of OSAS such as snoring with apnea, excessive daytime sleepiness, obesity, and so on. There has been considerable controversy about definition of hyponea. If one read a sleep study report, it is important to know both the definition of hyponea and the technology used to detect air flow. Attended in-laboratory PSG has a number of potential disadvantages, including cost, limited availability, and the fact that some patients may sleep poorly in thelab environment. Portable monitoring has been proposed as a substitute for PSG in diagnostic assessment of patients with suspected OSAS.