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REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
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Sleep Medicine and Psychophysiology
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KOREAN ACADEMY OF SLEEP MEDICINE
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Volume & Issues
Volume 11, Issue 2 - Dec 2004
Volume 11, Issue 1 - Jun 2004
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Chronopharmacology in Clinical Medicine
Lee, Heon-Jeong ; Kim, Leen ;
Sleep Medicine and Psychophysiology, volume 11, issue 2, 2004, Pages 67~72
Circadian rhythm is a global phenomenon, the control mechanisms of which are manifested at every level of biological organization, from genes and intracellular mechanisms to networks of cell populations, and to all central neuronal systems at the organismic level. In pharmacotherapy, the pharmacokinetic parameters such as drug absorption and distribution, drug metabolism, and renal elimination show diurnal variations. The symptoms and signs in diseases like asthma, myocardiac infarction, angina pectoris, hypertension and stroke also show diurnal fluctuations. These observations require drug treatment considering the circadian rhythm of body function and disease. Circadian time has to be taken into account as an important variable influencing a drug's pharmacokinetics and/or its effects or side effects in clinical practice.
Digital Polysomnography：The Present and Future
Shin, Hong-Beom ; Jeong, Do-Un ;
Sleep Medicine and Psychophysiology, volume 11, issue 2, 2004, Pages 73~79
Digital polysomnography was developed to overcome the limitations of Rechtschaffen and Kales rule and to compensate the shortcomings of paper polysomnography. It enables easy access to and secure preservation of sleep records, and provides various displays of sleep data to enhance efficiency of visual scoring of sleep records. Rechtschaffen and Kales rule had been criticized for its ambiguity and lack of considerations in spatial information of EEG. As sleep records are acquired and processed in digital mode, they can be analyzed at microscopic and macroscopic levels. Digital analysis of sleep records provides the basis for development of new sleep measures. Sleep staging in digital polysomnography is based on the various analyses of EEG. Sleep apnea, hypopnea and periodic limb movement are detected automatically by digital analysis of respiratory signals and leg EMG. Digital polysomnography plays a complementary role to visual scoring and compensates the limitations of paper polysomnography. Digital polysomnography, including acquisition, processing and analysis of sleep records in digital mode, can be a great help in the development of sleep medicine, enabling the development of new sleep measures and the exchange of sleep records between sleep laboratories.
Changes in Multiple Sleep Latency Test Results according to Different Criteria of Sleep Onset
Lim, Se-Won ; Bok, Ki-Nam ; Lee, Heon-Jeong ; Kim, Leen ;
Sleep Medicine and Psychophysiology, volume 11, issue 2, 2004, Pages 80~83
Objectives: The multiple sleep latency test (MSLT) is commonly used as a valid objective measure of sleepiness. The procedure of MSLT is well standardized but the sleep onset criterion is somewhat variable. One epoch of stage 1 sleep is the most commonly used criterion, and the criterion of three epochs of stage 1 sleep is also used. The purpose of this study was to compare the two criteria used to determine sleep onset. Methods: We retrospectively analyzed 60 consecutive MSLT that were performed according to a standaridized protocol. We scored each test using the two different criteria for sleep onset and then statistically analyed the results. Results: Using the different criteria, 20 patients among 60 showed changes in mean sleep latency (33.3%). The extent of change ranged from 1.3% to 38.5% (mean 15.9%). Non-narcoleptic patients showed a significantly higher incidence of change than other sleep disorder patients. Conclusion: Changes in mean sleep latency occurred according to the different criteria of sleep onset. But the difference arising from different criteria was statistically not significant in patients with moderate to severe sleepiness. Considering that 1 epoch criterion for sleep onset is more sensitive in detecting clinically significant sleepiness, the authors suggest that the 1 epoch criterion is more reliable than the 3 epochs criterion.
The Relationship between Modified Mallampati Grade, Tonsillar Grade and Apnea-Hypopnea Index
Ahn, Byung-Hoon ; Choi, Jong-Won ; Park, Youn-Ho ; Song, In-Hyuk ; Nam, Young-Jin ; Song, Dal-Won ;
Sleep Medicine and Psychophysiology, volume 11, issue 2, 2004, Pages 84~88
Objectives: Obstructive sleep apnea (OSA) syndrome is diagnosed through history, physical examination, imaging studies and polysomnography. Clinical examination of this condition may point to hypertrophic tonsils and crowded oropharynx. The objective of this study is to investigate the usefulness of modified Mallampati grade (MMG) and tonsil grade (TG) in predicting the severity of obstructive sleep apnea. Methods: MMG and TG were divided into 4 and 5 groups, respectively, according to their severity. Medical records were collected from 94 patients who had received polysomnography and otorhinolaryngologic examination for snoring and sleep apnea at Keimyung University Dongsan Medical Center from March 2002 through April 2004. Patients were divided into two groups according to the apnea-hypopnea index (AHI)：control (n=24), and patients with sleep apnea (n=70). Results: Patients with higher MMG and TG had higher AHI, and MMG and TG proved to have a statistically significant correlation with AHI (p<0.05) Conclusion: MMG and TG were reliable predictors of OSA and helpful parameters in deciding treatment method.
Dream Content Analysis of Koreans in Their Twenties Using Hall/Van de Castle System
Chang, Sok-Ha ; Lee, Heon-Jeong ; Kim, Leen ;
Sleep Medicine and Psychophysiology, volume 11, issue 2, 2004, Pages 89~94
Objectives: In the past, latent dreams were emphasized in the psychiatric field, but these days the interest in manifest dreams is increasing as ego psychology develops. Hall and Nordby proposed that there are similarities between manifest dreams and real life. The Hall/Van de Castle System is a method of dream content analysis, which considers both the quantitive and qualitive analytic aspects of manifest dreams. Methods: The dreams of 232 males and females (M：F=127：105；mean age=21.02.7) were collected through the Most Recent Dream Method. Collected data were analyzed using the Hall/Van de Castle System. Results: Female subjects tended to be more detailed and meticulous in reporting their dreams. The dreams of male subjects showed a higher percentage in self-negativity (2=6.64, df=1, p=0.004), and the dreams of female subjects showed a higher percentage in group character (2=6.64, df=1, p=0.0099), dreamer-involved success (2=3.12, df=1, p=0.048), and good fortune (2=4.52, df=1, p=0.034). Conclusion: This study suggests the norm of dream content of Korean college students, and it presents the differences between Korean males and females, and between Korean college students and American college students. This study may contribute to further studies on dream content analysis.
Seasonal Variations of Mood and Behavior in Korean Medical Students
Kim, Sung-Jae ; Lee, Heon-Jeong ; Choi, Hyun-Seok ; Jung, Hyun-Gang ; Kim, Bong-Ju ; Kim, Ju-Yeon ; Lee, Young-Woo ; Cho, Dong-Hyuk ; Lee, Min-Soo ; Joe, Sook-Haeng ; Kim, Leen ;
Sleep Medicine and Psychophysiology, volume 11, issue 2, 2004, Pages 95~99
Objectives: Although many studies on seasonal variations in mood and behavior have been carried out in foreign countries, no such study has previously been undertaken in Korea. The goal of this study was to estimate the frequency of seasonal variations in mood and behavior among Korean medical students. Methods: 297 medical students from Korea University College of Medicine participated in this study. The subjects were surveyed with a Korean translation of the Seasonal Pattern Assessment Questionnaire (SPAQ), and their responses were evaluated for seasonal patterns of mood and behavioral change, including seasonal affective disorder (SAD) and subsyndromal seasonal affective disorder (S-SAD), derived from the case-finding criteria of Kasper et al. Results: The mean global seasonality score was 6.6 (SD=3.6). 83.5% (N=248) of the subjects reported some changes in behavior and mood associated with the seasons. Only 3.7% (N=11) reported no behavioral changes across the seasons. Total prevalence rates were 15.2% for SAD, and 2.7% for S-SAD. The estimated frequencies were 3.0% for summer SAD, 2.7% for summer S-SAD, 11.4% for winter SAD, and 5.8% for winter S-SAD. The prevalence rates for winter SAD or S-SAD were higher than the prevalence rates for summer SAD or S-SAD. Conclusion: These results suggest that seasonal variations in mood and behavior are common among Koreans. The higher prevalence rate of winter SAD or S-SAD than summer SAD or S-SAD is consistent with most western studies and stands in contrasts to studies in other Asian countries, such as Japan and China.
Autonomic Neurocardiac Function in Patients with Major Depressive Disorder - Using a Heart Rate Variability Test Battery -
Park, Young-Su ; Lee, Kang-Joon ; Kim, Hyun ; Chung, Young-Cho ;
Sleep Medicine and Psychophysiology, volume 11, issue 2, 2004, Pages 100~105
Objectives: Major depression is associated with an increased risk of cardiovascular mortality. One possible explanation for this association is that major depression influences autonomic neurocardiac regulation. However, previous studies on the relationship between heart rate variability (HRV) and major depression have revealed conflicting results. The purpose of this study is to clarify that major depressive patients compared to healthy controls show a reduction in HRV as an expression of reduced modulation of vagal activity to the heart. Methods: According to DSM-IV, the time and frequency domain HRV indices (5-min resting study) of 30 patients with major depressive disorder were compared with those of 30 healthy controls. Standardized HRV tests enable quantitative estimation of autonomic nervous system function. Results: After controlling for age and gender, subjects with major depression showed a higher heart rate and significantly lower modulation of cardiovagal activity compared to controls. The total power (TP) band, very low frequency (VLF: 0.003-0.04 Hz) band, low frequency (LF: 0.04-0.15 Hz) band, and high frequency (HF: 0.15-0.4 Hz) band were significantly reduced in subjects with major depression compared to control subjects. Conclusion: Patients with major depression may suffer from functional disturbances in the interaction between the sympathetic and parasympathetic autonomic systems.
A Case of Childhood Obstructive Sleep Apnea Syndrome
Shin, Hong-Beom ; Lee, Yu-Jin ; Jeong, Do-Un ;
Sleep Medicine and Psychophysiology, volume 11, issue 2, 2004, Pages 106~109
Adenotonsillar hypertrophy is the leading cause of childhood obstructive sleep apnea. Obstructive sleep apnea syndrome in childhood, however, can occur from various causes such as obesity or craniofacial abnormalities. Childhood obstructive sleep apnea syndrome can be accompanied by enuresis, parasomnias and behavior problems. For patients with the symptoms of snoring and apnea, obstructive sleep apnea should be suspected and diagnosed properly. In addition, the evaluation of complications and proper treatment are indispensable. When the cause of childhood obstructive sleep apnea is adenotonsillar hypertrophy, symptoms can be improved by surgical methods. If the cause is other than adenotonsillar hypertrophy, such as obesity, it should be treated with other therapeutic modalities, like nasal continuous positive airway pressure (nCPAP), weight reduction and modification of life style. This paper reports a case of nCPAP used to manage severe sleep apnea when it was not resolved after adenoidectomy and tonsillectomy. Differential diagnosis of narcolepsy in a case with excessive daytime sleepiness and reflections on accompanying enuresis and parasomnia were also described.