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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 in Panic Disorder and Nocturnal Panic Attack
Ha, Ju-Won ; Eun, Hong-Bae ; Lim, Se-Won ;
Sleep Medicine and Psychophysiology, volume 18, issue 2, 2011, Pages 57~62
Sleep disturbance is a one of common complaints among patients with panic disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of panic disorder yet. Several previous studies suggested that the sleep disturbance in panic disorder is mediated by nocturnal panic attack. In terms of the pathophysiology of panic disorder, nocturnal panic attack seems to be closely associated with the sleep problems in panic disorder. In this article, the authors reviewed various previous studies about sleep of panic disorder and intended to give importance of evaluating sleep disturbances and nocturnal panic attack in panic disorder for both clinical and research purpose.
Diagnostic and Clinical Differences in Obstructive Sleep Apnea Syndrome and Upper Airway Resistance Syndrome
Choi, Young-Mi ;
Sleep Medicine and Psychophysiology, volume 18, issue 2, 2011, Pages 63~66
It has been controversial whether upper airway resistance syndrome (UARS) is a distinct syndrome or not since it was reported in 1993. The International Classification of Sleep Disorders classified UARS under obstructive sleep apnea syndrome (OSAS) in 2005. UARS can be diagnosed when the apnea-hypopnea index (AHI) is fewer than 5 events per hour, the simultaneously calculated respiratory disturbance index (RDI) is more than 5 events per hour due to abnormal non-apneic non-hypopneic respiratory events accompanying respiratory effort related arousals (RERAs), and oxygen saturation is greater than 92% at termination of an abnormal breathing event. Although esophageal pressure measurement remains the gold standard for detecting subtle breathing abnormality other than hypopnea and apnea, nasal pressure transducer has been most commonly used. RERAs include phase A2 of cyclical alternating patterns (CAPs) associated with EEG changes. Symptoms of OSAS can overlap with UARS, but chronic insomnia tends to be more common in UARS than in OSAS and clinical symptoms similar with functional somatic syndrome are also more common in UARS. In this journal, diagnostic and clinical differences between UARS and OSAS are reviewed.
Sleep and Schizophrenia
Lee, Jin-Seong ;
Sleep Medicine and Psychophysiology, volume 18, issue 2, 2011, Pages 67~71
Schizophrenia is a chronic, currently incurable, and devastating syndrome. Although sleep disturbances are not primary symptoms of schizophrenia, they are important aspects of schizophrenia. Difficulties initiating or maintaining sleep are frequently encountered in patients with schizophrenia. Many schizophrenics report low subjective sleep quality. Measured by polysomnography, increased sleep latency as well as reduced total sleep time, sleep efficiency, slow wave sleep, and rapid eye movement sleep latency (REM latency), are found in most patients with schizophrenia and appear to be an important aspect of the pathophysiology of this disorder. Some literatures suggest that worsening sleep quality precedes schizophrenic exacerbations. Co-morbid sleep disorders such as obstructive sleep apnea (OSA) and restless legs syndrome (RLS), and sleep-disrupting behaviors associated with schizophrenia may lead to sleep disturbances. Clinicians should screen the patient with sleep complaints for primary sleep disorders like OSA and RLS, and carefully evaluate sleep hygiene behaviors of all patients with schizophrenia who complain of sleep disturbances.
Sleep Disorder and Socioeconomic Burden
Kang, Eun-Ho ;
Sleep Medicine and Psychophysiology, volume 18, issue 2, 2011, Pages 72~75
Sleep disorders such as insomnia, obstructive sleep apnea (OSA), and restless legs syndrome (RLS) are very common disorders and may cause significant burden in terms of individual as well as societal aspects. Sleep insufficiency from such sleep disorders may cause deleterious effects on daily work life and may be associated with other major medical or psychiatric disorders including cardiovascular disease, diabetes mellitus, depression, and anxiety disorder. Various motor or occupational accident may result from the sleep problems. In addition, recent researches provide the method to evaluate the lost productivity time in terms of absenteeism and presenteeism. Moreover, several studies on cost-effectiveness of treatment of sleep disorders show that it is cost-effective.
The Correlation between Severity of Sleep Apnea, Sleep and Mood Related Scales, and Activity During Sleep in Obstructive Sleep Apnea Syndrome Patients
Han, Kyu-Hee ; Soh, Min-Ah ; Ha, Jee-Hyun ; Ryu, Seung-Ho ; Yu, Jae-Hak ; Park, Doo-Heum ;
Sleep Medicine and Psychophysiology, volume 18, issue 2, 2011, Pages 76~81
Objectives: This study aims to analyze the association between the severity of sleep apnea, sleep and mood related scales, and activity during sleep in obstructive sleep apnea syndrome (OSAS) patients. Methods: 176 drug-free male patients confirmed as OSAS (average age=
years) were selected through nocturnal polysomnography (NPSG). OSAS was diagnosed with apnea-hypopnea index (AHI) >5, mean AHI was
. Sleep related scales were Stanford Sleepiness Scale (SSS), Epworth Sleepiness Scale (ESS), Pittsburg Sleep Quality Index (PSQI) and Morningness-Eveningness Scale (MES). Mood related scales were Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI) I, II and Profile of Mood States (POMS). NPSG was performed overnight with both wrist actigraphy (WATG). Parameters produced from WATG were total activity score, mean activity score and fragmentation index. We analyzed the correlation between each scale, AHI scored from NPSG and activity score analyzed from WATG. Results: ESS showed significant positive correlation with PSQI, BDI, BAI and STAI I, II, respectively (p<0.01). SSS showed significant positive correlation with PSQI and BAI (p<0.05, p<0.01). BAI showed significant positive correlation with total activity score, mean activity score and fragmentation index (p<0.05, p<0.01, p<0.05).Total activity score showed significant positive correlation with ESS and BAI, respectively (p<0.05). Fragmentation index showed significant positive correlation with ESS, PSQI and BAI (p<0.05, p<0.01, p<0.05). AHI, indicator of sleep apnea is showed no significant correlation with each sleep and mood related scale. Conclusion: The degree of daytime sleepiness tends to be associated with night sleep satisfaction, depression and anxiety, and the activity during sleep rather than the severity of sleep apnea.
The Usefulness of the Berlin Questionnaire as a Screening for Obstructive Sleep Apnea in a Sleep Clinic Population
Kang, Hyeon-Hui ; Kang, Ji-Young ; Lee, Sang-Haak ; Moon, Hwa-Sik ;
Sleep Medicine and Psychophysiology, volume 18, issue 2, 2011, Pages 82~86
Objectives: The Berlin Questionnaire (BQ) has been used to help identify patients at high risk of having sleep apnea in primary care. But it has not been validated in a sleep clinic for Korean patients. The aim of this study is to evaluate the usefulness of the BQ as a screening tool for obstructive sleep apnea (OSA) for Korean patients in a sleep clinic. Methods: The BQ was prospectively applied to 121 subjects with OSA suspicion who visited to our sleep clinic. All subjects performed overnight polysomnography. OSA was defined as an apnea-hypopnea index (AHI)
. We investigated the sensitivity, specificity, positive and negative predictive values of the BQ according to severity by AHI. Results: In 121 subjects, 73.6% were males, with a mean age of
years. Twenty-five (20.6%) patients did not have OSA (AHI<5), 30 (25%) patients had mild OSA (
and <15), 26 (21.4%) had moderate (
and <30), and 40 (33%) had severe OSA (
). The BQ identified 69.4% of the patients as being at high risk for having OSA. The sensitivity and specificity of the BQ were 71.9% and 40%, for
, 75.8% and 38.2% for
, 77.5% and 34.6% for
, respectively. The positive and negative predictive values of the BQ were 82.1% and 27.0% for
, respectively. Positive and negative likelihood ratios were 1.2 and 0.7, and the overall diagnostic accuracy of the BQ was 65.3%, using an AHI cut-off of 5. Conclusion: Due to modest sensitivity and low specificity, the BQ does not seem to be an appropriate tool for identifying patients with obstructive sleep apnea in a sleep clinic population.
Snoring Clinic Visitors' Knowledge of Obstructive Sleep Apnea Syndrome
Lee, So-Jin ; Lee, Jin-Seong ; Shin, Hong-Beum ; Cho, Sang-Yong ; Rhee, Chae-Seo ; Jeong, Do-Un ;
Sleep Medicine and Psychophysiology, volume 18, issue 2, 2011, Pages 87~94
Objective: OSAS (obstructive sleep apnea syndrome) is a common disorder and its consequences are often serious. It is important to detect the disorder early in the course for proper treatment. This study is to grasp the snoring clinic visitors' knowledge level of OSAS. Method: One hundred and seventy-nine visitors at the of snoring clinic of Seoul National University Hospital were surveyed by questionnaire about reasons of visit and knowledge of treatment methods of snoring and OSAS, diagnostic method, OSAS-related symptoms, and complications. Results: Most of the respondents (89.4%) "have already heard about OSAS" and the major sources of information was the mass media (58.1%) such as television and radio. More than half (60.3%) were aware that snoring is closely related to OSAS. More than half (59.8%) recognized that a nocturnal polysomnograpy was necessary for proper diagnosis. Two thirds (67%) of the respondents noted surgery as a treatment for snoring. More than half (55.9%) answered that they would follow the doctor's advice on the treatment choice. Only 12.3% of respondents "have heard about nCPAP". No one chose nCPAP (nasal continuous positive airway pressure) as a treatment for either snoring or OSAS. About one third (34.6%) of the respondents were aware that OSAS is related to hypertension. Only 12.8% noted that OSAS is related to diabetes mellitus. Conclusion: Visitors at the snoring clinic were found to have substantially limited knowledge of health risks and proper treatments of OSAS. We suggest that it is crucially important to educate patients and offer easy-to-understand information on snoring and OSAS. We predict that provision of educaiton and information to patients and general public will faciliate the diagnosis and treatment of snoring and OSAS and reduce the related disorders such as hypertension, stroke, and diabetes mellitus.