• Title, Summary, Keyword: 수면

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Sleep Fragementation Decreases during the nCPAP Titration Night in Obstructive Sleep Apnea Syndrome (폐쇄성 수면무호흡증에서 지속적 상기도 양압술 압력 처방 검사 시 나타나는 수면분절의 감소)

  • Lee, Jin-Seong;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.15 no.2
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    • pp.82-86
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    • 2008
  • Objectives: Obstructive sleep apnea syndrome (OSAS) not only causes respiratory disturbances during sleep but also decreases the quality of nocturnal sleep through sleep fragmentation and sleep structure change. We aimed at comparing the changes in sleep fragmentation and structure between baseline (diagnostic) nocturnal polysomnography (NPSG) and nCPAP (nasal continuous positive airway pressure) titration trial. Methods: One hundred and three patients with a baseline night of respiratory disturbance index (RDI) of 5 or greater and reduced RDI score during nCPAP titration night were retrospectively selected for the study. Sleep fragementation and sleep structure between baseline NPSG and the NPSG during nCPAP titration were compared. Sleep fragmentation index (SFI) was defined as the total number of awakenings and shifts to stage 1 sleep divided by the total sleep time in hour. SFI and other polysomnographic parameters were statistically compared between the two nights. Results: SFI during baseline NPSG and nCPAP titration nights were $29.0{\pm}13.8$ and $15.2{\pm}8.8$, respectively, indicating a significant SFI decrease during nCPAP titration (t=9.7, p<0.01). SFI showed significant negative correlations with sleep efficiency (r=-0.60, p<0.01) and total sleep time (r=-0.45, p<0.01) and a positive correlation with RDI (r=0.28, p<0.01). Conclusion: Use of nCPAP, even during the titration, significantly decreases sleep fragmentation and improves sleep structure in OSAS patients. We suggest that SFI may be utilized as a measure of assessing OSAS severity and nCPAP efficacy.

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Sleep Architecture and Physiological Characteristics of Obstructive Sleep Apnea in Split-Night Analysis (수면분할 분석으로 본 수면무호흡증의 수면구조와 생리적 특징)

  • Kim, Eui-Joong
    • Sleep Medicine and Psychophysiology
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    • v.13 no.2
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    • pp.45-51
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    • 2006
  • Obstructive sleep apnea (OSA) syndrome disrupts normal sleep. However, there were few studies to evaluate the asymmetric distribution, the one of the important factors of normal sleep in OSA subjects. We hypothesized that asymmetry would be broken in OSA patients. 49 male subjects with the complaint of heavy snoring were studied with polysomnography. We divided them into two groups based on the apnea-hypopnea index (AHI) fifteen: 13 simple snoring group (SSN, average AHI $5.9{\pm}4.4$) and 32 OSA group (average AHI $47.3{\pm}23.9$). We compared split sleep variables between the first half and the second half of sleep within each group with paired t-test for the evaluation of asymmetry. Changes of sleep architecture of OSA were higher stage 1 sleep% (S1), total arousal index (TAI), AHI, and mean heart rate (HR) and lower stage 2 sleep% (S2), REM sleep%, and mean arterial O2 saturation (SaO2) than SSN subjects. SWS and wake time after sleep onset (WASO) were not different between two groups. In split-night analysis, OSA subjects showed higher S2, slow wave sleep% (SWS), spontaneous arousal index (SAI), and mean HR in the first half, and higher REM sleep% and mean SaO2 in the second half. Those were same pattern as in SSN subjects. Mean apnea duration and longest apnea duration were higher in the second half only in the OSA. No differences of AHI, ODI, WASO, and S1 were found between the first and the second half of sleep in both groups. TAI was higher in the first half only in the SSN. SWS and WASO seemed to be influenced sensitively by simple snoring as well as OSA. Unlike our hypothesis, asymmetric distributions of major sleep architecture variables were preserved in OSA group. Losing asymmetry of TAI might be related to pathophysiology of OSA. We need more studies that include large number of subjects in the future.

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Sleep-Wake Cycles in Man (인간의 수면-각성 주기)

  • Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.147-155
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    • 1997
  • To assess the reliability of chronobiological models of sleep/wake regulation, it is necerssary that the models predict the data which has been studied in sleep research, and they should be generalized across all ages. To date, many adult human data on such models have accumulated, yet it is evident that a comprehensive theory of the biorhythmic aspects of sleep/wake states has not established. Circadian rhythms such as the time going to bed, sleep onset, slow wave sleep pressure, periodicity of REM sleep, daytime performance, and early evening alertness are resumed everyday. Even in adult humans, sleep is inherently polyphasic. In both the disentrained and entrained states, naps when allowed tend to recur in a temporally lawful manner. The monophasic sleep pattern of most industrial societies therefore appears to be purely of social origin. The endogenous biorhythmic nature of circasemidian sleep tendency is supported by the ubiquity of the phenomenon across all ages. The NREM/REM sleep cycle within sleep with its inherent physiological, endocrine, and neurochemical fluctuations represents the best-documented ultradian sleep rhythms. Also, a daytime ultradian variation in sleepiness with a periodicity similar to nocturnal NREM/REM cycle(BRAC hypothesis) is suggested. This review article provides a brief synoptic review of the evidences for circadian, circasemidian, and ultradian sleep/wake rhythms, and then the authour will suggest the issues which expedite fuller modeling of sleep/wake system, to be further discussed.

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Improvement of Sleep Environment using Intelligent Context Awareness System (지능형 상황인식 시스템을 통한 수면 환경 개선)

  • Shin, Seong-Yoon;Baek, Jung-Uk;Rhee, Yang-Won
    • Proceedings of the Korean Society of Computer Information Conference
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    • pp.129-132
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    • 2010
  • 작금의 현대 사회 사람들은 바쁜 일상생활로 인해 짧아진 수면과 불면증 등의 각종 수면장애를 겪고 있으며, 여러 가지의 요소로 인하여 수면의 방해를 받게 되면, 여러 질병 및 생활 장애를 겪을 수 있어 수면의 중요성은 날로 주목받고 있다. 본 논문에서는 수면을 이루는 침실의 수면 환경 데이터를 수집하여 얻어진 조건 데이터들과 수면간의 관계를 분석하고 이를 바탕으로 시뮬레이션 모델을 추출하여 개개인에 따른 최적의 환경을 제공할 수 있다. 따라서 수면 과정에 따라 신체의 감각 및 자극에 대한 반응을 알고, 사람의 신체 상황에 따른 차이점 및 안정적인 패턴 및 조건을 정의하며 수면 패턴을 분석 및 솔루션 제공을 할 수 있다. 또한 차후에는 수면의 특정 상황만 아니라 식사, 출근, 등과 같은 유기적인 생활(유비쿼터스 환경)의 한 부분에도 상황에 따른 적절한 실내 환경 변화를 제공해주어서 좀 더 쾌적한 일상생활을 영위할 수 있도록 도움을 주게 되는 측면으로 확대 하려한다.

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Studios on Development of Sleeping Patterns Sensing System (수면상태 감지 시스템 개발에 관한 연구)

  • Koo, Yoon-Seo;Lee, Ji-Hyoung;Ryu, Sang-Ouk;Kim, Kyung-Ho
    • Proceedings of the KIEE Conference
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    • pp.477-478
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    • 2007
  • 본 논문에서는 압력 온도 센서를 이용하여 수면자의 수면상태를 인식하고 이를 감지할 수 있는 수면상태 감지 시스템을 제안하였다. 기존의 수면상태를 측정하는 방법에 있어 문제점으로 들 수 있는 고가의 장비, 측정의 불편 등을 해소하기 위해 사용이 간단한 Straingage 타입의 압력센서와 프로브 타입의 온도센서를 이용하여 저비용의 효율적인 시스템을 구현 하였고, 수면 매트에 실세 적용하여 그 유효성을 평가하였다. 제안된 시스템은 압력 온도센서를 이용해 수면 매트부, 센싱데이터를 감지 수집하여 수신된 데이터를 증폭하는 수면상태 감지정보 시스템부로 구성되었다. 시스템 구축을 위해 먼저, 수면 매트부는 비접촉 방식의 압력 온도 센서를 사용하였고, 수면상태 감지정보 시스템부는 미세한 변화를 보이는 데이터를 차등 증폭기 원리를 이용하여 증폭하였다. 센서가 수면자에 의해 변환할 때 발생되는 아날로그 신호를 검출 증폭한 후 감지하는 시스템이다. 본 연구에서 세안한 수면상태 감지 시스템을 이용하여 개인생환 습관인 수면시간을 실시간으로 감지하고 데이터화하여 수면자의 수면 상태를 파악하여 건강한 수면을 위한 방법을 권고할 수 있다. 향후 감지된 데이터를 이용해 실시간으로 가족들의 수면상태를 알릴 수 있는 헬스케어 모바일 응용 서비스로도 활용이 기대된다.

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우리 나라 성인 중 73.4%가 불면증 경험

  • KOREA ASSOCIATION OF HEALTH PROMOTION
    • 건강소식
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    • v.24 no.4
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    • pp.11-11
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    • 2000
  • 수면은 우리 삶의 많은 부분을 차지하는 중요한 삶의 영역이다. 그러나 여러 가지 원인으로 인하여 많은 현대인들이 수면의 즐거움을 제대로 누리지 못하고 있다. 미국의 경우 수면 장애에 의한 졸리움증으로 생기는 사회적ㆍ개인적 손실의 규모를 연간 약 150억 달러로 추정하고 있을 정도다. 우리나라 성인 중에 수면 장애의 하나인 불면증을 경험한 사람의 비율은 73.4%나 될 정도로 광범위하게 나타나고 있지만 정작 그 해결책을 찾지 못하고 있는 실정이다. 수면장애에는 크게 불면증을 보이는 수면 장애, 낮에 과도한 졸리움을 일으키는 수면 장애, 자다가 이상한 행동을 보이는 수면 장애로 구분되어지는데 우리가 일상에서 인식하는 수면 장애는 불면증 정도로 그치는 것이 일반적이다. 더욱이 이러한 수면 장애를 해결하는 방법의 이해 부족으로 수면제나 담배, 술 등에 의존하기 쉽고 단순히 잠을 자야 한다는 강박관념에 시달려 오히려 증상을 악화시키는 경우가 많다. 그러나 수면 장애를 올바르게 이해하고 있다면 그 해결 방안은 의외로 간단하다. 우리의 몸속에 있는 생체 시계의 주기를 규칙적으로 맞추어 가는 것이 중요하다. 또한 수면은 신체적인 요소보다는 정신적인 요소가 많이 작용하기 때문에 무엇보다도 편안한 마음가짐과 무의식적인 수면 유도가 필요하다. ('이달의 건강길라잡이'에 관한 자세한 내용은 건강길라잡이 홈페이지(http://healthguide.hihasa.re.kr)에 있습니다.)

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A Clinical and Polysomnographic Study of Parkinson's Disease Patients with Sleep Benefit (수면이득이 있는 파킨슨병 환자의 임상특징 및 수면다원검사에 대한 연구)

  • Chun, Dong-Yeol;Yang, Chang-Kook;Kim, Jae-Woo;Yoo, Seung-Yoon;Hahn, Hong-Moo
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.102-108
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    • 2000
  • Objectives: Parkinson's disease (PD) patients may experience fluent mobility upon awakening from a night's sleep, which is called sleep benefit (SB). Although SB is a phenomenon closely associated with sleep, sleep features of PD are not well characterized. The objectives of this study were, first, to investigate if there are any clinical characteristic features between patients with SB and without SB (NSB), and second, to examine if SB patients are associated with any specific sleep variables compared with NSB patients. Methods: Thirty-three PD patients (14 men and 19 women) participated in this study. All subjects were interviewed to examine whether or not they had SB and overnight polysomnography was performed at the sleep center. Various clinical variables were collected through medical record review. Results: The 331 PD patients were divided into 16 SB group (48.5%) and 17 NSB group (51.5%). SB patients were younger (p<0.02), had higher sleep efficiency (p<0.05), and showed shortened sleep latency (p<0.02) as compared with NSB patients. However, no difference was found between SB and NSB with respect to gender, duration or stage of PD, antiparkinsonian medications prescribed, and predominant motor symptoms. SB did not clearly relate to a specific sleep stage and other sleep variables except sleep efficiency and sleep latency. Although primary snoring was more prevalent in SB patients (p<0.05), other sleep disorders were seen with equal frequency in SB and NSB groups. Conclusion: Our results suggest that good sleep efficiency, shortened sleep latency, and age may have an effect on morning motor function (i.e., SB) in Parkinson's disease.

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Changes in Multiple Sleep Latency Test Results according to Different Criteria of Sleep Onset (수면시작 기준의 차이에 의한 수면잠복기반복검사결과의 변화)

  • Lim, Se-Won;Bok, Ki-Nam;Lee, Heon-Jeong;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.11 no.2
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    • pp.80-83
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    • 2004
  • 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.

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Clinical Characteristic and Respiratory Disturbance Index as Correlates of Sleep Architecture in Obstructive Sleep Apnea Syndromes Diagnosed with Polysomnography (수면다원기록법으로 확진된 폐쇄성 수면무호흡증 환자의 임상특성, 그리고 호흡장애지수와 수면 구조간의 상관관계)

  • Kim, Seog-Joo;Park, Doo-Heum;Kim, Yong-Sik;Woo, Jong-Inn;Ha, Kyoo-Seob;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.113-120
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    • 2001
  • Objectives: Obstructive sleep apnea syndrome is common and may produce various symptoms and serious complications. A substantial number of research articles on obstructive sleep apnea syndrome have been published in Korea. However, we found such limitations as lack of sufficient sample size and lack of polysomnography-proven cases. Therefore, we aimed at studying clinical features and sleep structure in a sufficient number of Korean patients with obstructive sleep apnea syndrome diagnostically confirmed with polysomnography. Methods: We studied 801 subjects referred to the Division of Sleep Studies, Seoul National University Hospital, who were diagnosed as having obstructive sleep apnea syndrome with polysomnography. Subjects were excluded if they had central sleep apnea syndrome, periodic limb movement disorder, narcolepsy or REM sleep behavior disorder. Foreign patients were also excluded. First of all, we studied the clinical features of the subjects. Secondly, we compared sleep-related parameters of the study subjects with those of age/sex-matched normal values. Thirdly, correlations of respiratory disturbance index (RDI) with each of the sleep-related parameters were calculated. Results: Among the 801 subjects, 668 were male subjects (83.4%) and 133 female subjects (16.4%). Their mean age was 46.6 years (${\pm}13.5$). The mean body mass index (BMI) was 25.8 (${\pm}3.8$) and subjects with BMI was over 28.0 accounted for 22.8% of the total. Fifty subjects (6.2%) were found to take benzodiazepines. Mean RDI and mean nocturnal oxygen saturation of all subjects was 31.2 (${\pm}24.4$) and 94.5% (${\pm}3.6$), respectively. In comparison with normal values, the subjects showed longer sleep latency, lower sleep efficiency, decreased total slow wave sleep % (TSWS %), and decreased total REM sleep % (TREM %)(p<0.01 in all). RDI had a negative correlation with each TSWS % and TREM % (p<0.01, p<0.01). However, RDI did not have significant correlation with either sleep latency or sleep efficiency. Conclusion: In this study, 6.2% of patients diagnosed as having obstructive sleep apnea syndrome were found to take benzodiazepines, although they are generally considered to be of litte benefit or even dangerous because of the respiratory suppressing effect. The proportion of obese subjects was only 22.8% and Korean patients with obstructive sleep apnea syndrome seem to be less obese than those described in foreign journals. This study also suggests that the severity of obstructive sleep apnea syndrome may have a more significant effect on sleep architecture defined as TSWS % and TREM % than on sleep efficiency.

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Sleep Stage Analysis by using Polysomnogram and Spindle Wave (다원수면검사와 방추파에 의한 수면단계 분석)

  • 김원식;박세진;김진선;김건흠
    • Proceedings of the ESK Conference
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    • pp.386-390
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    • 1997
  • SAC 847 컴퓨터를 통해서 뇌파를 기본으로 턱과 다리의 근전도, 몸의 뒤척임, 심전도, 혈중 산소 농 도, 안전도 등을 동시에 기록하는 다원수면검사(polysomnogram)를 전자기가 차폐된 수면실에서 실시하 였고 수면단계기록 국제기준에 의한 수면단계와 최근 새롭게 제시되고 있는 수면의 경과에 따른 수면방 추파(sleep spindle)의 변동추적에 의한 수면단계 판정방법을 비교 분석하였다. 또한, 수면경과에 따른 .beta. .alpha. .theta. .delta. 파형의 발생빈도를 제시하고 평가하였다. 이러한 수면단계 분석은 종합 수면생리신호의 일환으로 인간공학적인 쾌적침대개발에 활용될 수 있을 것이다.

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