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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Sleep Medicine and Psychophysiology
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Journal DOI :
KOREAN ACADEMY OF SLEEP MEDICINE
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Volume & Issues
Volume 1, Issue 2 - Dec 1994
Volume 1, Issue 1 - May 1994
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The Causes and Developmental Mechanism of Insomnia
Lee, Sung-Hoon ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 3~8
With the recent development of sleep medicine, insomnia has been perceived as a disease from a simple symptom. As there are various causes in a disease, proper treatment according to each cause is necessary for a more effective treatment In general, insomnia is classified into five categrories of physical, physiological, psychological, psychiatric and pharmacological aspects. However, such categorizations are often insufficient in treating insomnia. Furthermore understanding of the developmental mechanisms of insomnia is required. The function of sleep is developed and maintained through the balance of the reciprocal forces of sleep and arousal. These forces are contantly regulated by what is called a circadian rhythm. Sleep is induced by this rhythm which is affected by factors such as awakening time in the morning, amount of intellectual function, amount and time length of physical exercise and sunlight Insomnia could develop when this rhythm is delayed and leads to a "forbidden zone" which is a very difficult period for inducing sleep about two to four hours before the routine bedtime. Whereas sleep gradually develops in line with the circardian rhythm, arousal can occur very abruptly by any cause triggered by emotional discomfort or anxiety. Such characteristic and emotional factors as perfectionism, separation anxiety, secondary gain, insecurity, and negative cognition may provoke the inner anxiety and fear for insomnia, which can lead acute insomnia to a chronic one. As chronic insomnia is developed by multiple causes and factors, integrated approaches through analysis of above mentioned factors will be more effective in the treatment of insomnia than a simple administration of hypnotics.
Polysomnographic Evauation for Disorders of Initiating and Maintaining Sleep
Kim, Leen ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 9~19
Disorders of intitating and maintaining sleep(DIMS : insomnia) may be a symptom of some other disease or the basic, root problem in some patients. DIMS is usually treated by private physicians or psychiatrists, initially. Many physicians can do to improve the quality of life of the sleep disordered patients by appropriate evaluation and management For the effective management of DIMS patients, the accurate differential diagnosis is essential. In polysomnographic evaluation for insomnia, the physician should consider the aspects of cost-effectiveness to provide the maximal benefits for the patients. For the purpose of this, evaluation of DIMS complaints outside the sleep disorder clinic, indication for referral to a sleep disorder clinic, the role of polysomnopraphy in evaluating DIMS, and polysomnographic findings of different types of DIMS are discussed, together with possible way to diagnose them.
Psychophysiological Self Regulation -Focussed on Biofeedback-
Hwang, Ik-Keun ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 20~28
The field of applied biofeedback as one of psychophysiological self regulation techniques began in the united states in 1950s. Biofeedback may be described as information about the effects of a response that is given to the person making that response in order to improve ways of controlling that response. This article reviewed various definitions of biofeedback, learning models, mediating processes, instrumentations to be considered during biofeedback practice, treatment procedures and clinical applications.
An Introduction to Luria-Nebraska Neuropsychological Battery
Kim, Young-Chul ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 29~35
Overall purposes of neuropsychological tests are summarized as follows: 1) Indentifying brain damage in individuals who have symptoms of uncertain etiology; 2) Assessing the extent and nature of deficits for forensic purposes and planning appropriate intervention; 3) Evaluating the effects of intervention or rehabilitation; 4) Examining the effects of various types of brain damage across different populations; and 5) Testing theoretical propositions about brain-behavior relationship. Of the neuropsychological tests, the Luria-Nebraska Neuropsychological Battery(LNNB) is easily transportable, relatively inexpensive, and performable by trained technician. The Korean version of LNNB is now being designed and will be used clinically in the near future. Localization and equipotential theories of brain function had been prevalent until Luria's theory of brain function. Brain, composed of three brain units in the theory, is the functional system in which each brain area has specific function and produce the function-related behavior. LNNB consists of 11 clinical scales, 5 summary scales, 8 localization scales, and 28 factor scales.
Clinical Applications of Event-related Potentials
Kwon, Jun-Soo ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 36~46
The event-related potentials are difined as the changes in voltage that occur at paticular time before, during and after something that happens in the physical world or some psychological processes. The possibilities of clinical applications of ERP are considered because the endogenous potentials such as P3 and contingent negative variation(CNV) are determined by the psychological significance of the stimulus. The P3 is a positive wave that occurs when a subject detects an informative task-relevant stimulus. The P3 amplitude and latency are affected by the various factors as subjective probabilites, stimulus meaning and information transmission. It is suggested that P3 wave is associated with the decision making, cognitive or perceptual closure, memory updating and transfer of information to consciousness etc. Although the intracerebral origin of the P3 wave is not known, the P3 may have multiple intracerebral generators. The CNV is a slow potential shift occuring during the foreperiod, between warning and response signals, in a reaction time experiment. It is related to expectancy, preparation etc. The abnormal findings of P3 wave and CNV in various psychiatric disorders are also discussed.
A Comparison of Nighttime Sleepiness, Performance, and Body Temperature between Morning-Type and Evening-Type Persons
Yoon, Jin-Sang ; Kook, Seung-Hee ; Shin, Il-Seon ; Shin, Man-Sik ; Choi, Young ; Lee, Mu-Suk ; Lee, Hyung-Young ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 47~59
Objectives: The main purpose of this study was to investigate the possible differences in sleepiness, performance, and body temperature during the night between morning(M) and evening(E) type subjects. Methods: After a survey study, to verify the validity and reliability of the Korean translation of the Home' and
Morningness-Eveningness Questionnaire(1976), 8 extreme M-type subjects(3males, 5 females) and 8 extreme E-type subjects(3 males, 5 females) were selected from the university student population who had participated in the survey study. All subjects underwent sleep latency test and a battery of performance tests at intervals of 2 hours through the night, from 23:00 to 07:00. Oral temperature of each subject was taken every hour from 21 : 00 to 8 : 00. Between the testing times, the experimenters ensured that subjects remained awake. Results: More profound sleepiness was found in the M-type compared to the E-type throughout the night, with significant differences in sleepiness occuring at 23:00 and 01:00 hours. Overall performance efficiency tended to be lower through, the night in the M-type than in the E-type on all tests. A difference in time of temperature minimum between the two types was not noteworthy. Rather, there appeared to be a substantial difference in temperature level during the declining phase, with the temperature of the M-type being lower than that of the E-type. Conclusions: These results indicate the existance of a temporal relationship between sleepiness, perfonnance and body temperature during night work. Since the M-type exhibited greater sleepiness and lower performance efficiency overnight than the E-type, it may be assumed that the E-type is more suitable for and tolerable to night work. There was some discussion of the limitations in generalizing these results together with some suggestions for future studies.
Application of Clinical Features and the Degree of Oxygen Desaturation as a Screening Test for the Obstructive Sleep Apnea Syndrome
Ko, Jae-Kwang ; Kim, Leen ; Suh, Kwang-Yoon ; Shin, Dong-Kyun ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 60~67
Objectives: The Obstructive sleep apnea syndrome is characterized by snoring, observed apnea during sleep and excessive daytime sleepiness. The overnight polysomnographic recording is used to investigate patients with possible obstructive sleep apnea syndrome. But the overnight polysomnographic recording is time consuming, expensive, and labor-intensive. Recently in diagnosis of obstructive sleep apnea syndrome, several simple screening tests have been suggested. Methods: This study was performed to assess the probability of application of clinical features and the degree of oxygen desaturation as a screening test for the obstructive sleep apnea syndrome. The sensitivity and specificity of the self-report of clinical features including snoring, observed apnea during sleep, excessive daytime sleepiness and insomnia were tested. And the degree of oxygen desaturation measured by oximetry in 42 subjects were compared with the overnight polysomnographic recording results. Results: In the prediction of apnea index more than 5, the sensitivity of observed apnea during sleep, snoring, excessive daytime sleepiness and insomnia were 96.8%, 93.5%, 38.7%, 25.8% and the specificity of those clinical features were 182%, 36.4%, 100%, 72.7%, respectively. In the prediction of apnea index more than 5, the sensitivity and specificity of the combination of more than three self-report clinical features were 54.8% and 90.9%. The degree of oxygen de saturation and maximal apnea duration in the group of apnea index more than 5 were significantly different from those in the group of apnea index below 5(P<0.001). And the apnea index was significantly correlated with the degree of oxygen desaturation and maximal apnea duration(P<0.001). Conclusion: These results suggest that application of clinical features alone as a screening test for the obstructive sleep apnea syndrome is inadequate because of it's high rate of false positive and false negative results. The degree of oxygen desaturation measured by oximetry is possibly applicable to screening test and follow up evaluation of treatment efficacy for the obstructive sleep apnea syndrome.
The Effects of Circadian Rhythm in Subjective Alertness on the Occurrence of Traffic Accidents
Yu, Bum-Hee ; Cho, Doo-Young ; Jeong, Do-Un ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 68~75
In order to examine the effects of circadian rhythm in subjective alertness on the occurrence of traffic accidents, the authors investigated the occurrence rate of traffic accidents adjusted to traffic volume in Seoul and the relative rate of fatal accidents versus total traffic accidents in Korea at different times of day in 1991. We analyzed these data in relation with the circadian rhythm in subjective alertness. The results were as follows. Both the occurrence rate of traffic accidents adjusted to traffic volume and the relative rate of fatal accidents versus total traffic accidents were the highest at 3-4 a.m., known as the time period of the lowest subjective alertness. They were negatively correlated with subjective alertness (p<0.05, p<0.001). In conclusion, it is suggested that the circadian rhythm of subjective alertness should have a significant effect on the occurrence of traffic accidents despite many confounding factors such as driving environments.
Event Related Potential and Neuropsychological Tests
Lee, Sung-Hoon ; Koo, Ae-Sook ; Woo, Jong-Ho ; Kim, Byung-Gun ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 76~86
Objectives: This research was performed in order to observe the neuropsychological implication and functional anatomical source of event related potentials(ERP) by studying of correlations between event related potentials and neuropsychological tests. Methods: The latency and voltage of P100 of visual evoked potential (VEP), and N120 and P300 of event related potentials were studied in 56 patients and their correlations with neuropsychological tests were computed. Results: The tests showing significant correlation with latency P100 were visual continous performance test(VCPT) and contingent continous performance test(CCPT) without any significant correlation with voltage of P100. In latency of N120 category test and verbal IQ of KWIS showed significant correlation, and in voltage of N120, finger tapping test, VCPT, CCPT and digit symbol test displayed significant correlations. The latency of P300 had significant correlation with trail making A test and Stroop test. In the voltage of P300 significant correlations were shown with trail making B test, digit symbol test and Wechsler memory scale, finger tapping test, stroop test, VCPT and CCPT. Conclusion : N120 may be considered to reflect the function of medial frontal lobe and P300 may be considered to be developed from the subcortical connection of medial temporal lobe, hippocampus, thalamus, basal ganglia and medial frontal lobe.
P3 in the Auditory Event-Related Evoked Potential of Schizophrenia(I) -P3 in the Schizophrenics-
Oh, Dong-Jae ; Chang, Hwan-Il ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 87~98
Objectives: To examine a defect in inhibitory gating of auditory evoked response in schizophrenics, to compare P3 latency and amplitude in negative and positive schizophrenics, and to assess the association of P3 with family history of the psychiatric disorders, electroconvulsive therapy, and clinical features. Methods: 54 schizophrenics(male 31, female 23) and 75 controls(male 33, female 42) were tested with event-related potential paradigm designed to elicit P3 response and Frankfurter Beschwerde Fragebogen. Results: In schizophrenics, the latency of P3 was significantly more delayed and the amplitude of P3 was significantly more reduced than in the controls. Significant differences in P3 latency and amplitude between negative and positive schizophrenics were not found. And significant difference in the P3 latency and amplitude between schizophrenics with family histories of psychiatric disorder and those without family histories of psychiatric disorder was not found also. The P3 latency and amplitude was not significantly related with electroconvulsive therapy and other clinical features such as age, duration of illness, onset of inllness, number of admission, and doses of antipsychotics etc. Conclusion: These results suggested that schizophrenics had a dysfunction in the process of selective attention and that P3 was not significantly related with family history of the psychiatric disorders, positive and negative symptoms, electro1convulsive therapy, and clinical features in schizophrenics.
A Case of REM Sleep Behavior Disorder Confirmed with Polysomnography
Jeong, Do-Un ; Yoon, In-Young ;
Sleep Medicine and Psychophysiology, volume 1, issue 1, 1994, Pages 99~106
The authors report a case of REM sleep behavior disorder which occurred in a 69-year-old business man. He began experiencing episodic "acting out" behavior of his dream at the age of 66. The episodes tended to be associated with dream contents, mainly being chased or threatened. Before that, his sleep was relatively quiet despite occasional nightmares, midsleep arousal, and shallowness. Injuries resulted from leaping out of bed, jumping onto furnitures, and grabbing and biting the spouse's arm. Most recent dream-incurred laceration of chin required 5 sutures. Medical and psychiatric history revealed no significant findings except that he had been overanxious all his life within himself with others' reputation of himself as pleasant and easy-going. A nocturnal polysomnogram showed repeatedly intermittent increase of chin and/or leg muscle tones during otherwise characteristic REM sleep period. The overnight video recording revealed head lifting and limb movements during REM sleep periods. Brain MRI and EEG were normal. Job-related stress was presumed to be an etiological possibility. Clonazepam 0.25-0.5mg nightly almost completely relieved the symptoms.