Sleep, Sleep Disorders, and Sexual Dysfunction

Jae Wook Cho,Jeanne F. Duffy 대한남성과학회 2019 The World Journal of Men's Health Vol.37 No.3

Good sleep is necessary for good health. Sleep health is increasingly recognized as important for physical and mental health by both the medical profession and the general public, and there is great interest in how to avoid and treat sleep disorders and problems. Recent research indicates that insufficient sleep, disrupted sleep, and sleep disorders affect many aspects of human health including sexual function. In fact, patients with urological disorders or erectile dysfunction (ED) may have a sleep disorder that contributes to their urological or sexual dysfunction. Obstructive sleep apnea, insomnia, shift work disorder, and restless legs syndrome are all common sleep disorders and are associated with ED and/or other urological disorders. Therefore, careful attention should be paid to the diagnosis and treatment of concomitant sleep disorders in patients with sexual dysfunction. In this review, we provide an overview of what sleep is and how it is assessed in the clinic or laboratory; our current understanding of the functions of sleep and sleep health; a description of common sleep disorders, as well as how they are diagnosed and treated; and how sleep and its disorders are associated with male sexual dysfunction. Sleep is considered to be a ‘third pillar of health’, along with diet and exercise. With an understanding of common sleep disorders and how they can impact male sexual function, the urologist can ensure that sleep disorders are considered as a contributor to sexual dysfunction in their patients in order to provide them with the optimal treatment for overall health.

청소년 수면장애의 임상적 특징, 진단과 치료

전홍준 대한의사협회 2023 대한의사협회지 Vol.66 No.4

Background: Sleep is vital for adolescents’ physical and emotional development; however, sleep disturbances and disorders frequently occur in this age group and affect their health and well-being. In this review, we investigated the prevalence, etiology, diagnosis, clinical characteristics, and treatment of sleep disorders observed among adolescents. Current Concepts: The diagnostic criteria for insomnia disorder among adolescents include difficulties in falling asleep, maintaining sleep, or waking up too early and feeling unrefreshed, which are observed at least 3 days per week over 3 or more months. Cognitive-behavioral therapy for insomnia typically includes identifying and addressing negative thoughts and behaviors associated with sleep and establishing a consistent sleep-wake schedule. Delayed sleep phase syndrome is diagnosed in individuals in whom sleep onset and wake times are persistently delayed by 2 or more hours beyond the desired or existing sleep schedule, which leads to excessive daytime sleepiness or impaired functioning. Behavioral interventions comprise sleep hygiene education, relaxation techniques, and phototherapy. Symptoms such as pronounced snoring, apnea observed by others, and gasping or pauses in breathing during sleep may indicate sleep apnea. Continuous positive airway pressure therapy is an effective treatment strategy for sleep apnea. A history of excessive daytime sleepiness and cataplexy suggests narcolepsy, and treatment options include pharmacotherapy, behavior modification, and lifestyle adjustments. Restless leg syndrome treatments include behavioral therapy, as well as anticonvulsant and dopamine receptor agonist administration. Discussion and Conclusion: Addressing sleep disorders is important to promote optimal health and well-being of adolescents and requires a multidisciplinary approach. Early detection, accurate diagnosis, and individualized treatment improve sleep and overall health outcomes and promote academic and social success.

A Case of Circadian Rhythm Sleep-Wake Disorder in Partial Blindness

김하욤,박진환,김정빈 대한수면연구학회 2018 Journal of sleep medicine Vol.15 No.1

Although it is well known that sleep disturbances can be developed in complete blindness, normally entrained circadian rhythm was observed in the majority of patients with partial blindness. Here, we describe a case with circadian rhythm sleep-wake disorder in partial loss of light perception. A 58-year-old man presented with difficulty in sleep initiation and excessive daytime sleepiness after retinal surgery. The electroretinography revealed partial impairment of light perception in the right side and preserved light perception in the left side. He was diagnosed as circadian rhythm sleep-wake disorder due to impaired light perception. While taking 2 mg of melatonin regularly at 9 every night, his sleep cycle and difficulty in sleep initiation were gradually improved and became fully normalized after 2 weeks. Circadian rhythm sleep-wake disorder could be developed even in partial blindness. Melatonin supplements could effectively improve the circadian rhythm sleep-wake disorder in partial blindness, like as in complete blindness.

암 환자의 수면장애에 대한 비약물적 중재 연구동향 분석

오문주,김희선 대한종양간호학회 2022 Asian Oncology Nursing Vol.22 No.3

Purpose: This review aimed to explore current publication trends, major concepts, measurements, and intervention types regarding sleep-wake disturbance in cancer patients. Methods: Studies published up to 26 December, 2021 were examined through PubMed, EMBASE, The Cochrane Library, KMbase, CINAHAL, ScienceON and Google scholar using English and Korean keywords with appropriate definitions related to sleep-wake disturbances in cancer patients. A total of 3,542 articles were found and 73 articles introducing intervention to reduce sleep-wake disturbance were included in the final analysis. Results: Interventions for sleep-wake disturbance in cancer patients were classified into the following types: exercise interventions (38.1%), cognitive behavioral therapy (26.2%), complementary and alternative medicine intervention (19.0%), mindfulness-based stress reduction intervention (9.5%), herbal medication intervention (2.4%), dance intervention (1.2%), music intervention (1.2%) and mixed intervention (1.2%). Most of the interventions (52.1%) were performed on breast cancer patients. The Pittsburgh Sleep Quality Index was the most frequently used subjective measurement. Objective measurements to measure sleep quality or sleep disturbance included actigraphy and polysomnography. Sixty-four articles (87.7%) out of 73 found that interventions to reduce sleep-wake disturbance in cancer patients were effective. Conclusion: Nursing intervention to reduce sleep-wake disturbance is important in oncology nursing practice. This literature review emphasizes the need to develop more tailored and suitable interventions considering various cancer patients’ characteristics.

재활승마 프로그램 참여가 자폐성 장애인들의 수면에 미치는 영향

손성민(Sungmin Son),전병진(Byoungjin Jeon) 한국장애인재활협회 2017 재활복지 Vol.21 No.4

본 연구는 자폐성 장애인들의 수면 문제와 수면 패턴에 대한 선행연구를 기반으로 수면에 영향을 미칠 수 있으며, 지적장애인 거주시설에서 치료적 접근으로 적용 가능한 재활승마 프로그램을 규칙적으로 제공하여 대상자들의 수면에 미치는 영향을 연구하고자 하였으며, 자폐성 장애인들의 취침시간, 기상시간, 총 수면시간, 수면 중 깨는 빈도를 분석하여 기초자료로 제공하고자 한다. 본 연구의 연구대상은 경기도 Y시 지적장애인 거주시설에서 거주하고 있는 자폐성 장애인 10명이며, 2015년 03월 01일 부터, 05월 31일까지 총 12주간 재활승마 프로그램에 참여하였다. 재활승마 프로그램 참여에 따른 수면에 미치는 영향을 조사하기 위하여 수면 평가지를 통해 취침시간, 기상시간, 총 수면시간, 수면 중 깨는 빈도를 조사하였으며, 기술통계, 프리드만 검정(Friedman)을 실시하여 변화를 분석하였다. 분석 결과 통계적으로 유의미하게 취침시간이 빨라졌으며, 총 수면시간이 증가하였고, 수면 중 깨는 빈도가 감소하여 재활승마 프로그램이 대상자들의 수면에 긍정적인 영향을 미친다고 나타났다. 재활승마 프로그램 적용이 참여 대상자들의 수면에 긍정적인 요인으로 작용할 수 있어 시설에 거주하고 있는 자폐성 장애인들에게 시설 내 프로그램으로 활용될 수 있을 것이다. This study aimed to investigate the effect of the participation in rehabilitation horseback riding program on the sleep, and to provide the basic data by analyzing the sleep of individuals with autism spectrum disorders. This study subjects consisted of 10 individuals with autism spectrum disorders residing in a residential care facility for the people with intellectual disabilities. They participated in the 12 weeks rehabilitation horseback riding program regularly. To investigate the effects of participating this program on sleep, subjects’ sleep time, wake-up time, total sleep time and wake-up frequency during sleep were measured. Descriptive statistics and Friedman test were conducted to analyze the change the sleep. As a reulst of anlysis, it was found that the sleep time came earlier, the total sleep time increased, and the wake-up frequency during sleep reduced. Therefore, the rehabilitation horseback riding program participation was shown to have a positive effect on the subjects’ sleep. Since the application of this program can act as a positive factor in the sleep of the participations, it is expected to be used as an in-facility program for the residents with autism spectrum disorders.

뇌졸중 환자에서 흔한 수면 문제 및 수면 관리

지성주,전현규 대한뇌신경재활학회 2016 뇌신경재활 Vol.9 No.1

Sleep related breathing disorders comprises disorders related abnormal pattern and status of the gas exchange during sleep. It has been reported that abnormal sleep pattern could results in an autonomic dysfunction during sleep and ends up to increase possibility to induce stroke and cardiovascular disease associated with atherosclerosis. Stroke is a disorder, which could cause death and critical disability in the adulthood. Sleep related breathing disorders and stroke has causal relationship in each other, which could influence on recovery to each other. Systematic evaluation and management for sleep disorder after stroke might have clinical importance. This review will comprise of topics about sleep related disorders in stroke patients including epidemiology, relationship between stroke and sleep disorder, diagnosis, and management of frequent sleep disorder.

뇌졸중 이후의 수면장애

김대열 대한뇌신경재활학회 2015 뇌신경재활 Vol.8 No.2

Sleep-disordered breathing (SDB) and sleep-wake disorders (SWD) are frequent after stroke. Not only brain damage per se but also the consequences of stroke (immobilization, pain, hypoxia, depression etc) affect sleep wake cycle and breathing control. SDB and SWDs have a negative effect on rehabilitation outcome and quality of life after stroke. A high suspicion may lead to a diagnosis and subsequent treatment of sleep disorders after stroke and contribute to rehabilitation of these patients. This article summarizes the knowledge about the role of SDB and SWD after stroke, reviewing clinical characteristics, clinical outcome after stroke, diagnosis and treatment of various sleep disturbances.

비강압력신호를 이용한 수면호흡장애 환자의 수면/각성 분류

박종욱,정필수,강규민,이경중,Park, Jong-Uk,Jeoung, Pil-Soo,Kang, Kyu-Min,Lee, Kyoung-Joung 대한의용생체공학회 2016 의공학회지 Vol.37 No.4

This study proposes the feasibility for automatic classification of sleep/wakefulness using nasal pressure in patients with sleep-disordered breathing (SDB). First, SDB events were detected using the methods developed in our previous studies. In epochs for normal breathing, we extracted the features for classifying sleep/wakefulness based on time-domain, frequency-domain and non-linear analysis. And then, we conducted the independent two-sample t-test and calculated Mahalanobis distance (MD) between the two categories. As a results, $SD_{LEN}$ (MD = 0.84, p < 0.01), $P_{HF}$ (MD = 0.81, p < 0.01), $SD_{AMP}$ (MD = 0.76, p = 0.031) and $MEAN_{AMP}$ (MD = 0.75, p = 0.027) were selected as optimal feature. We classified sleep/wakefulness based on support vector machine (SVM). The classification results showed mean of sensitivity (Sen.), specificity (Spc.) and accuracy (Acc.) of 60.5%, 89.0% and 84.8% respectively. This method showed the possibilities to automatically classify sleep/wakefulness only using nasal pressure.

The High-Dose of Exogenous Melatonin Did Not Alter the Sleep-Wake Cycle in Anoxic Brain Injury Patients

Kanarskii Mikhail,Nekrasova Julia,Pradhan Pranil,Borisov Ilya,Korepina Olga,Kondratyeva Ekaterina,Nikitkina Angelina,Petrova Marina 대한수면학회 2022 sleep medicine research Vol.13 No.2

Disturbance in circadian rhythms and the sleep-wake cycle is typical for patients in the intensive care unit, which retards rehabilitation. To assess the effect of exogenous melatonin and simultaneous mitigation of intensive care unit environmental factors on sleep duration. We studied five patients with chronic disorder of consciousness caused by anoxic brain injury. In addition, we varied the level of melatonin secretion in blood plasma to assess melatonin’s bioavailability and elimination time. We evaluated the sleep-wake cycle using continuous videoelectroencephalogram monitoring with the addition of oculographic and myographic channels for 72 hours. All the patients received melatonin tablets on the second day, wore masks and ear plugs, and had no feeding and nursing manipulations at night on the second and third days. There was no significant difference in sleep time between the first, second, and third days. Future studies of the circadian rhythm should aim at gaining a deeper analysis of the characteristics of the sleep-wake cycle in patients with severe anoxic brain injury together with further research for possible ways to influence the circadian component of sleep.

불면증의 인지행동치료

이은 대한의사협회 2020 대한의사협회지 Vol.63 No.8

Sleep disturbances, including not being able to fall asleep easily/difficulty falling asleep, waking up frequently, or waking up too early and being unable to fall asleep again/resume sleep are diagnosed as insomnia if they cause significant disruption to daily life and are not caused by other sleep disorders such as pain or sleep apnea. Although insomnia is not considered a serious life-threatening condition, it has not only a high prevalence rate but also a high recurrence rate and tends to become chronic. Chronic insomnia patients tend to show common behavioral and cognitive patterns, typical of which are worrying about not being able to fall or stay asleep, excessive awakening because of this worry, limiting and reducing daytime activities or attempting to stay in bed for long periods to compensate for lack of sleep. These cognitive and behavioral characteristics are important contributing factors for the continuation of insomnia. To date, the most popular and effective treatment option/approach recommended by experts for insomnia is cognitive behavior therapy (CBT). CBT for insomnia consists of the following three non-pharmaceutical treatment elements: 1) behavioral elements such as stimulus control therapy, sleep restriction therapy, and muscle relaxation, 2) cognitive elements, and 3) educational elements focusing on sleep hygiene. However, there are barriers to insomnia patients receiving this treatment including accessibility and cost, despite the abundance of evidence demonstrating their effectiveness. Recently, online CBT for insomnia has become available as an alternative, and its emergence is providing a solution to the barriers to access.