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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 2, Issue 2 - Dec 1995
Volume 2, Issue 1 - Jun 1995
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REM Sleep Behavior Disorder and Nightmares
Yoon, In-Young ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 3~12
In the International Classification of Sleep Disorders(ICSD), REM sleep behavior disorder(RBD) and nightmares are classified as 'parasomnias usually associated with REM sleep'. RBD can be defined as the intermittent absence of REM sleep EMG atonia and the appearance of the elaborate motor activity associated with dream mentation. Bilateral pontine tegmental lesions in cats induce RBD-like behavior, but in human cases, more than 60% are idiopathic. Polysomnograpy shows characteristic findings in REM sleep and treatment with clonazepam is highly effective. With nightmares as long, frightening dream decreasing with age, their persistence or apperance in adults is related with certain drugs, trauma, personality and psychotic episode. Psychotherapy, behavior techniques or medication is used for treatment, but all of nightmares do not require treatment.
Sleepwalking and Sleep Terrors
Park, Young-Woo ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 13~22
To provide the physician with adequate information to diagnose and treat sleepwalking and sleep terrors, the author reviewed clinical features, epidemiology, causative and precipitating factors, polysomnography, diagnosis, differential diagnosis, and treatment for these disorders. Sleepwalking and sleep terrors have been defined as disorders of arousal that occur early in the night and have their onset during stage 3 or 4 sleep. In both disorders, patients are difficult to arouse, and complete amnesia or minimal recall of the episode is frequent. Genetic, developmental, and psychological factors have been identified as causes of both sleepwalking and sleep terrors. Sleepwalking and sleep terrors typically begin in childhood or early adolescence and are usually outgrown by the end of adolescence. When sleepwalking or sleep terrors have a post-pubertal onset or continue to adulthood, psychopathology is a more significant causative factors. The behavior that occur from deep slow-wave sleep can be painful or dangerous to the individual and/or disturbing to those close to that individual. The assessment of patients suspected of having these conditions requires a thorough medical and sleep history. The most important consideration in managing patients with sleepwalking or sleep terrors episodes is protection from injury.
Primary Nocturnal Enuresis: An Overview
Song, Dong-Ho ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 23~30
Bedwetting is the most common urologic complaint among children. Wetting frequency decreases from birth to adolescence. Etiology is multifactorial : genetic, neuromuscular or urologic maturation, psychosocial stressors, toilet training, or biologic aspects. Treatment has been also multimodal : drugs to depress bladder activity, increase urethral resistance, or modulate sleep. and recently urine reduction modulation. All of these approaches reflect a lack of sufficient knowledge of the underlying pathophysiology of nocturnal enuresis. Recent researches have focused on sleep disturbances, bladder reservoir function, urine output, and a combination of the three. Sleep studies indicate that enuretic patients are normal sleepers, and enuresis can take place during any stage of sleep, but generally occurs when the bladder is filled to the equivalent of maximal daytime functional capacity. Bladder reservior capacity appears to be normal, and bladder instability is somewhat related with the pathology of nocturnal enuresis. However, enuretic patients have shown the lack of normal nocturnal increase in antidiuretic hormone levels, and nocturnal urine production increases up to 2-4 times volume of functional bladder capacity, which explains the need for bladder emptying. But behavioral approaches, especially Bell-alarm method, remain important in the treatment of primary enuresis.
Clinical Applications of Quantitative EEG
Youn, Tak ; Kwon, Jun-Soo ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 31~43
Recently, the methods that measure and analyze brain electrical activity quantitatively have been available with the rapid development of computer technology. The quantitative electroencephalography(QEEG) is a method of computer-assisted analyzing brain electrical activity. The QEEG allows for a more sensitive, precise and reproducible examination of EEG data than that can be accomplished by conventional EEG. It is possible to compare various EEG parameters each other by using QEEG. Neurometrics, a kind of the quantitative EEG. is to compare EEG characteristics of the patient with normative data to determine in what way the patient's EEG deviates from normality and to discriminate among psychiatric disorders. Nowadays, QEEG is far superior to conventional EEG in its detection of abnormality and in its usefulness in psychiatric differential diagnosis. The abnormal findings of QEEG in various psychiatric disorders are also discussed.
Diagnosis of Sleep Disorders Through Sleep Questionnaires
Lee, Sung-Hoon ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 44~54
It is very difficult to evaluate sleep disorders by simple history taking, because which covers very comprehensive areas such as psychobiosocial fields. Although polysomnography is used for the method of final diagnosis, systemic history taking and sleep question-aires are still critically important especially in evaluation of insomnia. Proper informations through sleep questionnaires can provide very precise data for effective treatment as well as exact diagnosis. Sleep questionnaires consist of largely four kinds of questionnaires, which are screening questionnaire of sleep disorders, sleep diary and questionnaire of sleep hygine, diagnostic questionnaire for specific sleep disorder and questionnaire of special symptoms of sleep disorders including insomnia, daytime sleepiness, cognitive function, mental symptom and personality, parasomnia, physical illness and sexual function. However, for more conclusive diagnosis especially in excessive daytime sleepiness nocturnal polysomnography and multiple sleep latency test should be performed.
Sleep-Related Respiratory Disturbances
Moon, Hwa-Sik ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 55~64
During sleep, relatively major respiratory physiological changes occur in healthy subjects. The contributions and interactions of voluntary and metabolic breathing control systems during waking and sleep are quite different Alterations of ventilatory control occur in chemosensitivity, response to mechanical loads, and stability of ventilation. The activities of intercostal muscles and muscles involved in regulating upper airway size are decreased during sleep. These respiratory physiological changes during sleep compromise the nocturnal ventilatory function, and sleep is an important physiological cause of the nocturnal alveolar hypoventilation. There are several causes of chronic alveolar hypoventilation including cardiopulmonary, neuromuscular diseases. Obstructive sleep apnea syndrome (OSAS) is an important cause of nocturnal hypoventilation and hypoxia. Coexistent cardiopulmonary or neuromuscular disease in patients with OSAS contributes to the development of diurnal alveolar hypoventilation, diurnal hypoxia and hypercapnia. The existing data indicates that nocturnal recurrent hypoxia and fragmentation of sleep in patients with OSAS contributes to the development of systemic hypertension and cardiac bradytachyarrhythmia, and diurnal pulmonary hypertension and cor pulmonale in patients with OSAS is usually present in patients with coexisting cardiac or pulmonary disease. Recent studies reported that untreated patients with OSAS had high long-term mortality rates, cardiovascular complications of OSAS had a major effect on mortality, and effective management of OSAS significantly decreased mortality.
Thyroid Indices in Patients with Panic Attack
Kim, Young-Chul ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 65~72
The author compared indices of thyroid function in 76 patients with panic attack and 80 control subjects. And SCL-90-R was performed to evaluate the relationship between the psychiatric symptoms and thyroid indices in the patients with panic attack The results were as follows: 1). No siginificant differences in T3, T4 or TSH were found between the two groups. But T3 level was significantly lower in male panic patients than male controls(p<0.005). 2) The T3 level was significantly lower in male panic patients who had higher depression socre than average in SCL-90-R(p<0.025). 3) The TSH level was significantly lower in patients with higher anxiety(p<0.001) and phobia(p<0.05) score and in female panic patients(p<0.001) with higher anxiety and phobia score than average in SCL-90-R. 4) The phobic symptom(p<0.001) was siginificantly higher and the T3 level(p<0.005) was lower in the male than the female patients with panic attack.
Development of Screening Test for Prediction of Sleep Apnea Syndrome
Lee, Sung-Hoon ; Lee, Hee-Sang ; Lee, Jeung-Gweon ; Kim, Kyung-Soo ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 73~81
Objective : Patients with sleep apnea should be diagnosed with polysomnography(PSG). However, it is not easy to recommend PSG for all patients suspected with sleep apnea in practice. Therefore, we tried to develop the screening test for referral of PSG. Method : 140 patients with snoring and sleep apnea syndrome were studied by the PSG. Sleep apnea questionnaire. Zung's scale for depression. Stanford Sleepiness Scale(SSS), insomnia scale and neuropsychological test were administered. Also, blood pressure, height, weight and neck circumference were measured and some histories were taken. Correlations between respiratory disturbance index(RDI) and various parameters mentioned above and discriminant coefficients of the parameters to RDI were computed. And, we investigated sensitivities of screening tests for selection of the patients with RDI above 20. Results : Using six parameters(neck circumference, systolic blood pressure before sleep, degree of alcohol drinking, frequency of breath-holding during sleep, degree of dry mouth during sleep, sleep apnea score), the patients with RDI above 20 could be discriminated in 92.8% sensitivity. In case of more than two among six parameters(neck circumference of above 40cm, systolic blood pressure of above 125mmHg, frequent alcohol drinking, frequent breath-holding during sleep, frequent dry mouth during sleep, sleep apnea score of above 35), same patients could be discriminated in 87.6% sensitivity. And, in case of more than one among four parameters(neck circumference of above 40cm. systolic blood pressure of above 125mmHg, frequent alcohol drinking, body weight of above 80kg), discrimination sensitivity was 83.5%. Conclusions : Patients with RDI above 20 could be discriminated by above parameters with high sensitivity. Therefore, the screening test using above parameters can be applied in selection of the patients with sleep apnea for PSG in practice.
Psychophysiologic States of Insomnia Patients -Pre-Sleep Arousal, Self Efficacy, Sleep Hygiene Awareness and Practice, Depression, and Anxiety-
Oh, Kang-Seob ; Lee, So-Hee ; Lee, Si-Hyung ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 82~90
Objectives : Insomnia is significantly influenced by the pre-sleep arousal, self efficacy, sleep hygiene, depression and anxiety. The authors tried to explore how these factors are related with the clinical features of sleep. Methods : Fifty three patients diagnosed as insomnia by DSM-IV criteria were studied. They filled up the pre-sleep arousal scale(PSAS), sleep efficacy scale(SES), sleep hygiene awareness and practice scale, BDI, and state and trait anxiety scales. Results: 1) The mean values of sleep-related variables were as follows : Sleep latency,136.89 minutes ; frequences of awakening during a night, 2.28 ; minutes to get back to sleep, 42.70 ; total sleep time, 180.19 minutes ; duration of illness, 72.00 months. 2) The mean scores of scales were as follows : PSAS(cognitive), 22.40 ; PSAS(somatic), 17.32 ; SES, 20.16 ; sleep hygiene knowledge, 25.96 ; caffein knowledge, 59.78 ; sleep hygiene practice, 42.12 ; BDI. 18.2 ; state anxiety, 41.24 ; trait anxiety ; 44.50. 3) In the subjects with superimposed depression, the mean frequency of awakening during a night and the mean pre-sleep arousal scale score were higher than in those without depression. 4) Frequency of awakening were correlated positively with a PSAS(a tight tense feeling in your muscle) and sleep hygiene awareness. PSAS(cognitive) were correlated positively with a PSAS(somatic). BDI correlated positively with a PSAS item(a jittery, nervous feeling in your body)and a SES item (not allow a poor night's sleep to interfere with daily activities). Anxiety scales were correlated positively with sleep hygiene practice scale sleep, and PSAS were correlated negatively with SES. Conclusions : The mean scores of PSAS, SES, sleep hygiene awareness and practice scale, BDI, state and trait anxiety scales of insomniacs were correlated either positively or negatively in insomnia patients. These factors seem to contribute to the development and maintainence of insomnia.
A Case of 24-Year-Old Woman with Recurrent Hypersomnic Complaint
Yoon, In-Young ; Jeong, Do-Un ;
Sleep Medicine and Psychophysiology, volume 2, issue 1, 1995, Pages 91~96
A 24-year-old woman complained of recurrent episodes of hypersomnia lasting on the average about 15 days with mild mood alternation such as depression and irritability. During interepisode interval, she was free of any symptoms. Depending on the absence of excessive eating and hypersexuality, she was clinically diagnosed as recurrent monosymptomatic hypersomnia or the incomplete form of Kleine-Levin syndrome. When nocturnal polysomnography and multiple sleep latency test were performed 10 days after her recovery from a hypersomnic episode, reduced slow wave sleep % and pathologic daytime sleepiness were still noted. The authors suggest that the clinical recovery in recurrent monosymptomatic hypersomnia precede electrophysiological normalization by several days.