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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 18, Issue 2 - Dec 2011
Volume 18, Issue 1 - Jun 2011
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Sleep-Related Eating Disorder
Park, Young-Min ;
Sleep Medicine and Psychophysiology, volume 18, issue 1, 2011, Pages 5~9
Sleep-related eating disorder (SRED) is a newly recognized parasomnia that describes a clinical condition of compulsive eating under an altered level of consciousness during sleep. Recently, it is increasingly recognized in clinical practice. The exact etiology of SRED is unclear, but it is assumed that SRED might share features of both sleepwalking and eating disorder. There have been also accumulating reports of SRED related to the administration of various psychotropic drugs, such as zolpidem, triazolam, olanzapine, and combinations of psychotropics. Especially, zolpidem in patients with underlying sleep disorders that cause frequent arousals, may cause or augment sleep related eating behavior. A thorough sleep history is essential to recognition and diagnosis of SRED. The timing, frequency, and description of food ingested during eating episodes should be elicited, and a history of concurrent psychiatric, medical, sleep disorders must also be sought and evaluated. Interestingly, dopaminergic agents as monotherapy were effective in some trials. Success with combinations of dopaminergic and opioid drugs, with the addition of sedatives, has also been reported in some case reports.
Attention Deficit Hyperactivity Disorder and Sleep Problems
Park, Eun-Jin ;
Sleep Medicine and Psychophysiology, volume 18, issue 1, 2011, Pages 10~16
There has been a growing interest in sleep problems associated with attention deficit hyperactivity disorder (ADHD). In this paper, we reviewed the current literature on the underlying sleep problems associated with ADHD. Sleep problems are very common in children with ADHD. Patients with ADHD may have sleep difficulties including difficulty falling asleep, frequent night awakening, increased tiredness upon waking. Children with ADHD are associated to restless legs syndrome, periodic limb movement and sleep-disordered breathing. Screening for other psychiatric comorbidities and the side effects of medications, such as psychostimulants, is also necessary when considering sleep problems in ADHD. Sleep problems can cause a negative impact on the quality of life and emotional well-being both of children with ADHD and their parents. Many evidences suggest that assessment of sleep difficulties should be included in evaluating the patient of ADHD.
Narcolepsy in Children
Seo, Wan-Seok ;
Sleep Medicine and Psychophysiology, volume 18, issue 1, 2011, Pages 17~22
Childhood narcolepsy is one of the underdiagnosed diseases even the first symptoms often appear in childhood. Making diagnosis through history taking is not always easy because the symptoms of childhood narcolepsy are different from those of adulthood. Diagnostic laboratory tests such as sleep studies, tests for human leukocyte antigens, cerebrospinal fluid hypocretin measurement should be considered when the child has excessive daytime sleepiness without cataplexy. Treatment approach should be start as early as possible to avoid secondary academic, emotional difficulties. Both pharmacological and non-pharmacological management, and close cooperation between parents and school teachers should be maintained. In the near future, childhood narcolepsy can be a key to understand the pathogenesis of narcolepsy.
Prevalence and Clinical Features of Probable REM Sleep Behavior Disorder-An Epidemiological Study in Osan City
Choe, Young-Min ; Yoon, In-Young ; Kim, Ki-Woong ; Lee, Sang-Don ; Ju, Ga-Won ; Park, Joon-Hyuk ;
Sleep Medicine and Psychophysiology, volume 18, issue 1, 2011, Pages 23~28
Objectives: REM sleep behavior disorder (RBD) has received little attention in epidemiologic studies. This study aimed to determine the prevalence of probable REM sleep behavior disorder (pRBD) in the elderly population and its clinical features. Methods: A random sample of 1,588 was selected from a roster of 14,050 elderly population living in Osan city. The subjects were asked to fill out the REM sleep behavior disorder screening questionnaire (RBDSQ). Subjects whose score were 5 or higher on RBDSQ underwent a diagnostic phase of person-to-person assessment by experts in RBD. Results: Among 1,588 subjects, 886 elderly subjects participated in the screening phase and 123 subjects were assessed in the diagnostic phase. Eleven subjects were diagnosed as having pRBD, so prevalence was 1.5% (95% CI=0.70-2.30%). The frequency of depression and cognitive decline was significantly increased in patients with pRBD compared to subjects without pRBD, and there was no difference in sleep disturbances between two groups. Conclusions: Probable REM sleep behavior disorder is not rare in the elderly but frequently under-recognized. More attention should be paid to evaluation and treatment of RBD.
The Influence of the Amount of Mandibular Advancement in the Application of Mandibular Advancement Device for Obstructive Sleep Apnea Patients
Kim, Young-Kyun ; Yoon, In-Young ; Kim, Jeong-Whun ; Lee, Chul-Hee ; Yun, Pil-Young ;
Sleep Medicine and Psychophysiology, volume 18, issue 1, 2011, Pages 29~34
Objectives: The purposes of this study were to estimate the effect of mandibular advancement device (MAD) and to evaluate the influence of the advancement amount of mandible in the application of MAD for obstructive sleep apnea (OSA) patients. Methods: From the patients who were diagnosed as OSA by polysomnographic study at Seoul National University Bundang Hospital from January 2007 to February 2009, the patients who chose MAD as treatment option were included in this study. All the patients’ data including clinical records and polysomnographic studies (both pre- and post-treatment) were reviewed and analyzed. Results: Successful results were obtained in 65 patients of 86 patients (75.6%). In the follow-up period, mild discomfort of anterior teeth or temporomandibular joint (TMJ) were described in 28 patients, especially in the cases the amount of mandibular advancement were more than 7.0 mm. There was no direct relationship between the amount of mandibular advancement and clinical outcome. Conclusion: MAD was effective treatment option for the OSA patients regardless of severity. For the prevention of potential dental complications, the amount of mandibular advancement should be considered at the time of MAD treatment.
Association Study between Per3 Gene Polymorphism and Diurnal Preference
Kang, Seung-Gul ; Choi, Tae-Young ; Yoon, Ho-Kyoung ; Park, Young-Min ; Kim, Leen ; Lee, Heon-Jeong ;
Sleep Medicine and Psychophysiology, volume 18, issue 1, 2011, Pages 35~39
Objective: Diurnal preference is an attribute reflecting whether people are alert and preferring to be active either early or late in the day. It also referred to as chronotype or morningness-eveningness trait. The PER3 genes have been known to influence diurnal preference. In this study, we have investigated the associations between the PER3 gene polymorphisms and diurnal preference in a healthy young population, controlling for the social and environmental confounding factors. Methods: The participants in this experiment included 299 unrelated medical college students (M=191, F=108), with a mean age of 22.9 years. Diurnal preference was measured by a single administration of the 13-item Composite Scale for Morningness (CSM). Genotyping of the PER3 VNTR (rs57875989) was performed using polymerase chain reaction. A two-tailed alpha of 0.05 was chosen. Results: The mean
SD score on the CSM scale for all subjects was 31.90
6.39. There was no significant difference in total CSM score between gender groups, although females showed a trend towards higher morningness score. Although PER3 5R/5R showed the tendency towards high CSM scores, there were no significant differences on CSM scores among genotypes and allele status of PER3 VNTR (rs57875989). Conclusions: We could not confirm that the PER3 VNTR is associated with diurnal preference in a Korean healthy young population. The future studies need to investigate the association between diurnal preference and other polymorphisms of PER3 gene in larger sample of Korean young healthy population.
Excessive Daytime Sleepiness Case Confounding with Thyrotoxicosis
Chung, Jae-Kyung ; Kim, Eui-Joong ;
Sleep Medicine and Psychophysiology, volume 18, issue 1, 2011, Pages 40~44
Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/
. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01
/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1
type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1
should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.