• 동의생리병리학회지
• /
• 제31권2호
• /
• pp.83-93
• /
• 2017

This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.

• Journal of Korean Biological Nursing Science
• /
• 제11권1호
• /
• pp.23-31
• /
• 2009

Purpose: The purpose of the present study was to investigate the prevalence and related factors of sleep-wake disturbance (SWD) in Korean post-stroke patients. This study was the first to address post-stroke SWD in Korea using a structured questionnaire. Method: We investigated the prevalence of SWD and related factors including lesion location, stroke severity, presence of depression and fatigue. We assessed sleep-wake pattern including quality of sleep, sleep latency, wake episodes, wake time after sleep onset, daytime sleep episode and sleep time at daytime. Ninety stroke patients admitted to a university affiliated hospital in Seoul between the period September 2008 and January 2009 were included in the study. Result: Thirty five patients (38.9%) complained insomnia and 32 (35.6%) complained excessive daytime sleepiness (EDS). Quality of sleep (p=.000), sleep latency (p=.000) and total sleep time (p=.001) were significantly poorer in 16 patients with both insomnia and EDS than in the others. The related factors to insomnia were level of education (p=.030), depression (p=.007) and fatigue (p=.034), though related factors to EDS were stroke onset time (p=.049), stroke severity (p=.005), motor dysfunction (p=.035), dysphasia (p=.018), fatigue (p=.001) and lesion location (p=.019). Conclusion: Sleep-wake disturbance is a common problem in Korean stroke patients. Strategies to improve quality of sleep are urgently needed in the post-stroke patients.

• 한국항공운항학회지
• /
• 제32권1호
• /
• pp.91-102
• /
• 2024

This study aimed to investigate the sleep-wake patterns, social jetlag (SJL), and daytime sleepiness (DS) among air traffic controllers (ATCs) with rotating shifts. A total of 133 shift-rotating ATCs participated by completing self-report questionnaires regarding their sleep-wake patterns and DS. SJL, indicating the mid-sleep difference between workdays (W) and free days (F), was calculated for each shift. Night-shift workdays had the shortest sleep duration (SD) (5.28 hours), whereas free days following day shifts had the longest SD (6.66 hours). SJL for day and night shifts was 2.73 and 2.71 hours, respectively. The average DS score was 7.92 out of 24, with a 28.6% prevalence of DS. There was a negative correlation between SD following day shifts and SJL for the day shifts. Given these findings, it is recommended to implement effective interventions and work schedules to maintain consistent sleep patterns and minimize social jetlag to address sleep issues for shift-working ATCs.

• 대한상한금궤의학회지
• /
• 제11권1호
• /
• pp.153-167
• /
• 2019

Objective : To explore the meaning of Eumyangyeokchahunobok-byung (陰陽易差後勞復病) through two cases and finding the relationship with the DSM-5 sleep-wake disorder. Methods : Following a disease pattern identification diagnostic system based on Shanghanlun provisions (DPIDS), we analyzed cases with chronic fatigue and diplopia caused after sleep disorders. The patients were treated with the Soshiho-tang and Yijoong-tang. Results : The two herbal medicines showed remarkable improvement in the patients. The sleep disorders and the secondary pathologies were rapidly relieved within a month. Conclusions : The patterns of sleep disorders of the two patients were found to be very similar to the circadian rhythm sleep-wake disorders, as described in DSM-5. Although the etymology of the Chinese characters has not been clearly known yet, it was possible to present the original hypotheses on 更and 了due to clinical inference.

• 수면정신생리
• /
• 제4권2호
• /
• pp.147-155
• /
• 1997

이제까지 제시된 수면/각성과 관련된 연구의 결과들이 아직은 부족하거나 일관성이 결여되어 있기 때문에 인간의 수면/각성 리듬에 대한 모텔은 확립되지 않았다. 주 수면시간, 서파 수면, 렘수면, 수면의 깊이, 아침에 깨어남, 각성 수준 등의 주 리듬은 일중리듬을 보여준다. 주 수면시간은 중심체온과 이전의 깨어있는 기간에 의해 결정되는 것으로 알려져 있다. 렘수면 발생의 경향은 통상적인 아침 기상시간 이후 오전 내내 높은 수준으로 남아있게 된다. 수면경향이 갖는 일중 반주기의 내인성 생물학적 특성은 모든 연령에서 독특하게 보여지는 현상이다. 오후의 졸리움이나 수면에 대한 증거는 수면잠복기 반복검사, 수면연장 연구, 비동승상태 연구, 자유질주 연구 등과 같은 여러 연구방법에서 보여진 오후의 졸리움, 수행능력, 다양한 수면장애의 병리적 특성, 그리고 시에스타 문화에서 증명된다. 일중 12 시간 수면리듬의 모델은 아직도 일중 반주기 리듬이 일중리듬이 고유한 이형식의 리듬으로 표현되는 것인지 아니면 별개의 독립적 인 현상인지에 대한 결론이 내려지지 않았기 때문에 확립되지 않았다. 수면-각성의 주기에는 하루에 3-4회, 즉 6-8 시간의 주기를 갖는 중간 단주기 리듬이 내재되어 있고, 또 성인의 야간수면은 90-120 분의 주기를 갖는 비-램 수면과 렘수면의 리듬미칼한 극단 주기적 교대를 보여준다. 그뿐 아니라 주간의 기본적인 휴식 -활동 주기는 야간의 렘 수면주기에 상응한다는 가설이 제시되기도 하였다. 수면의 단주기 리듬에 대한 연구는 전통적인 수면다원 검사, 낮잠 연구, 휴식 및 일상지속법 연구, 수면연장 연구, 보행감찰, 극 초단적 수면일정, 시간격리연구 등을 통해 시행되고 있다. 내재하는 다양한 신체의 리듬들이 어떻게, 또 어느 정도 상호작용하여 수면의 시작과 종결을 조절하며, 반일주기 수면경향의 본질은 어떠하고, 또 렘 주기와 수면과의 관계는 어떠한가에 대한 의문은 앞으로 해결해야 할 중요한 쟁점들이다.

• The Korean Journal of Physiology and Pharmacology
• /
• 제14권5호
• /
• pp.291-297
• /
• 2010

The sleep homeostatic response significantly affects the state of anesthesia. In addition, sleep recovery may occur during anesthesia, either via a natural sleep-like process to occur or via a direct restorative effect. Little is known about the effects of isoflurane anesthesia on sleep homeostasis. We investigated whether 1) isoflurane anesthesia could provide a sleep-like process, and 2) the depth of anesthesia could differently affect the post-anesthesia sleep response. Nine rats were treated for 2 hours with $ad$ $libitum$ sleep (Control), sleep deprivation (SD), and isoflurane anesthesia with delta-wave- predominant state (ISO-1) or burst suppression pattern-predominant state (ISO-2) with at least a 1-week interval. Electroencephalogram and electromyogram were recorded and sleep-wake architecture was evaluated for 4 hours after each treatment. In the post-treatment period, the duration of transition to slow-wave-sleep decreased but slow wave sleep (SWS) increased in the SD group, but no sleep stages were significantly changed in ISO-1 and ISO-2 groups compared to Control. Different levels of anesthesia did not significantly affect the post-anesthesia sleep responses, but the deep level of anesthesia significantly delayed the latency to sleep compared to Control. The present results indicate that a natural sleep-like process likely occurs during isoflurane anesthesia and that the post-anesthesia sleep response occurs irrespective to the level of anesthesia.

• Clinical and Experimental Pediatrics
• /
• 제50권8호
• /
• pp.711-717
• /
• 2007

Sleep is a vital, highly organized process regulated by complex systems of neuronal networks and neurotransmitters. Normal sleep comprises non-rapid eye movement (NREM) and REM periods that alternate through the night. Sleep usually begins in NREM and progresses through deeper NREM stages (2, 3, and 4 stages), but newborns enter REM sleep (active sleep) first before NREM (quiet sleep). A period of NREM and REM sleep cycle is approximately 90 minutes, but newborn have a shorter sleep cycle (50 minutes). As children mature, sleep changes as an adult pattern: shorter sleep duration, longer sleep cycles and less daytime sleep. REM sleep is approximately 50% of total sleep in newborn and dramatically decreases over the first 2 years into adulthood (20% to 25%). An initial predominant of slow wave sleep (stage 3 and 4) that peaks in early childhood, drops off abruptly after adolescence by 40% from preteen years, and then declines over the life span. The hypothalamus is recognized as a key area of brain involved in regulation of sleep and wakefulness. The basic function of sleep largely remains elusive, but it is clear that sleep plays an important role in the regulation of CNS and body physiologic processes. Understanding of the architecture of sleep and basic mechanisms that regulate sleep and wake cycle are essential to evaluate normal or abnormal development of sleep pattern changes with age. Reduction or disruption of sleep can have a significant impact on daytime functioning and development, including learning, growth, behavior, and emotional regulation.

• 수면정신생리
• /
• 제14권1호
• /
• pp.5-12
• /
• 2007

Sleep changes substantially with age. There is a phase advance in the circadian sleep cycle and increased waking after sleep onset. The elderly people wake more frequently during the night and experience fragmented sleep and excessive daytime sleepiness. The prevalence of sleep disorders increases with age, and the composition of sleep disorders in the elderly differs from that in the young. The most frequently encountered sleep disorders are psychophysiologic insomnia, sleep disturbance due to dementia, sleeprelated respiratory disorder, restless legs syndrome and periodic limb movement disorder, and REM sleep behavior disorder. To treat the elderly sleep problem appropriately, it is important to know how sleep pattern changes as we age and to understand the cause of sleep-related symptoms. This article will review the sleep physiology and common sleep disorders in the elderly.

• 대한간호학회지
• /
• 제39권3호
• /
• pp.422-432
• /
• 2009

Purpose: In this study rest-activity rhythm, sleep pattern and quality of life of patients with restless legs syndrome were compared with those of a normal group. Methods: The participants in this study were 36 patients with restless legs syndrome diagnosed by a neurologist and 36 participants in the normal group. An actigraph, sleep diary, Pittsburgh Sleep Quality Index and Insomnia Severity Index scale were used as measurement tools for the study. Chi-square test, Lamda test, t-test and Kendall's correlation with SPSS 12.0 program were used to analyze the data. Results: Patients with restless legs syndrome had a higher rest-activity rhythm curve of Least 5 hr's activity(L5) and Most 10 hr's activity(M10) than those of normal group and sleep problems included decreased sleep efficiency and increased sleep latency, wake time and number of awakenings. The scores for the subscales of quality of life in patients with restless legs syndrome were lower than the normal group for general health, physical functioning, role limitations due to emotional problems, role limitation due to physical problems, social functioning, bodily pain, vitality and mental health. Conclusion: The results suggest that further studies are needed to identify rest-activity rhythm according to symptom severity and to develop nursing interventions which consider rest-activity rhythm.

• 수면정신생리
• /
• 제13권1호
• /
• pp.15-21
• /
• 2006

배 경：이 연구에서는 한국 대학생들의 취침시각, 기상시각, 취침시간을 평일과 휴일로 나누어 조사하였다. 또한, 성별, 연령, 학년이 한국 대학생들의 취침시각, 기상시각, 취침시간, 평일-휴일 간 수면 차이 등에 미치는 영향을 살펴보았다. 방법：한국내 4년제 대학 12개의 대학생들을 대상으로 평일과 휴일의 수면양상을 설문 조사하였다. 총 1,825명(여자 1,416명, 남자 409명, $18{\sim}30$세, 평균 연령 $21.1{\pm}2.2$세)의 결과를 분석하였다. 결과：한국 대학생들은 평일보다 휴일에 50분 늦게 취침하고(평일 00시 49분；휴일 01시 40분；t=39.67, p<0.001), 1시간 58분 늦게 일어나며(평일 07시 52분；휴일 09시 50분；t=39.46, p<0.001), 1시간 8분 더 오래 취침하였다(t=13.33, p<0.001). 남학생들에 비해 여학생들이 평일과 휴일 모두에서 일찍 자고(t=7.10, p<0.01；t=6.04, p<0.01), 일찍 일어나며(t=8.96, p<0.01；t=3.89, p<0.01), 평일 취침시간이 적었다(t=1.99, p<0.01). 또한, 여학생들에서 남학생들에 비해 휴일의 기상시각이 더 연장되고(t=3.41, p<0.01) 취침시간이 더 증가하였다(t=3.68, p<0.01). 학년이 증가할수록 평일 취침시각, 평일 기상시각, 휴일 취침시각이 느려졌고(${\beta}=0.1009$, p<0.01；${\beta}=0.1022$, p<0.01；${\beta}=0.1096$, p<0.01), 휴일 취침시간이 줄어들었으며(${\beta}=-0.0990$, p<0.01), 휴일과 평일의 기상시각 차이나 취침시간 차이가 줄어들었다(${\beta}=-0.0906$, p<0.01；${\beta}=-0.1115$, p=0.02). 결론：한국 대학생들은 평일에 비하여 휴일에 취침시각과 기상시각이 늦고 취침시간이 길었다. 이 결과는 한국 대학생들의 평소 일정이 생물학적인 수면각성 주기에 비해 앞으로 당겨져 있어 평일에 수면이 부족함을 의미한다. 또한, 평일과 휴일의 기상시각과 취침시간의 차이는 여학생과 저학년에서 더욱 두드러져, 수면각성주기 이탈과 수면부족이 여학생과 저학년에서 더욱 심하다는 것을 시사하였다.