Journal of Korean Biological Nursing Science

  • 제11권1호
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  • Pages.23-31
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  • 2009
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  • 2383-6415(pISSN)
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  • 2383-6423(eISSN)
한국기초간호학회 (Korean society of Biological Nursing Science)
권호 표지

뇌졸중 후 수면-각성장애

Sleep-Wake Disturbance in Post-stroke Patients

  • 투고 : 2009.02.26
  • 심사 : 2009.05.25
  • 발행 : 2009.06.30
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초록

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.

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참고문헌

  1. Banco, M., Espinosa, M., Arpa, J., Barreiro, P., & Rodriguez-Albarino, A. (1999). Hypersomnia and thalamic and brain stem stroke: A study of seven patients. Neurologia, 14, 307-314.
  2. Bassetti, C. L. (2005). Sleep and stroke. Semin Neurol, 25, 19-32. https://doi.org/10.1055/s-2005-867073
  3. Bassetti, C. L., & Aldrich, M. S. (2001). Sleep electroencephalogram changes in acute hemispheric stroke. Sleep Medicine, 2, 185-164. https://doi.org/10.1016/S1389-9457(00)00071-X
  4. Breslau, N., Roth, T., Rosenthal, L., & Andreski, P. (1996). Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young adults. Biol Psychiatry, 39, 411-418. https://doi.org/10.1016/0006-3223(95)00188-3
  5. Catsman-Berrevoets, C. E., & Harskamp, F. (1988). Compulsive presleep behaviour and apathy due to bilateral thalamic stroke. Neurology, 38, 647-649. https://doi.org/10.1212/WNL.38.4.647
  6. Choi-Kwon, S., Han, S. W., Kwon, S. U., & Kim, J. S. (2005). Poststroke fatigue: Characteristics and related factors. Cerebrovasc Dis, 19, 84-90. https://doi.org/10.1159/000082784
  7. Hamilton, M. (1960). A rating scale for depression. J Neurol Neurosurg Psychiat, 23, 56-62. https://doi.org/10.1136/jnnp.23.1.56
  8. Hermann, D. M., Siccoli, M., Brugger, P., & Wachter, K. (2008). Evolution of neurological, neuropsychological and sleep-wake disturbances after paramedian thalamic stroke. Stroke, 39, 62-68. https://doi.org/10.1161/STROKEAHA.107.494955
  9. Hohagen, F., Rink, K., Scharamm, E., Riemann, D., Weyerer, S., & Berger, M. (1993). Prevalence and treatment of insomnia in general practice. A longitudinal study. Eur Arch Psychiatry Clin Neurosci, 242, 329-336. https://doi.org/10.1007/BF02190245
  10. Hong, J., Ahn, J., Yun, Y., Park, J., Lee, S., Hahm, B., Kim, J., Han, O., & Cho, M. (2000). Sleep habits and insomnia-associated factors in the urban elderly: Demographic, health and psychobehavioral correlates. J Korean Neuropsychiatr Assoc, 39, 1111-1121.
  11. Kim, H. (2007). Neuroanatomy of Sleep-wake regulation and its application to pharmacotherapy. Korean J Psychopharmacol, 18, 133-142.
  12. Kim, J., & Choi-Kwon, S. (2000). Poststroke depression and emotional incontinence: Correlation with lesion location. Neurology, 54, 1805-1810. https://doi.org/10.1212/WNL.54.9.1805
  13. Kim, M., Cho, S., Lee, S., Jung, S., & Park, K. (1999). Elderly sleep pattern and disturbing factors before and after hospitalization. J Korean Acad Nurs, 29, 61-71. https://doi.org/10.4040/jkan.1999.29.1.61
  14. Kim, O. S., Kim, A. J., Kim, S. W., Baik, S. H., & Yang, K. M. (2003). Fatigue, depression and sleeping in young adult and middle-aged. J Korean Acad Nurs, 33, 618-624. https://doi.org/10.4040/jkan.2003.33.5.618
  15. Kim, S., Oh, J., Song, M., & Park Y. (1997). Comparison of sleep and related variables between young and old adults. J Korean Acad Nurs, 27, 820-830.
  16. Laplane, D., Baulac, M., Widlo_cher, D., & Dubois, B. (1984). Pure psychic akinesia with bilateral lesions of basal ganglia. J Neurol Neurosurg Psychiat, 47, 377-385. https://doi.org/10.1136/jnnp.47.4.377
  17. Lee, S., Ahn, S., & Kim, M. (2005). A study on women's fatigue and sleeping disturbance. Korean J Women Health Nurs, 11, 163-168.
  18. Leppavuouri, A., Pohjasvaara, T., Kaste, M., & Erkinjuntti, T. (2002). Insomnia in ischemic stroke patients. Cerebrovasc Dis, 14, 90-97. https://doi.org/10.1159/000064737
  19. Lyden, P., Brott, T., Tilley, B., Welch, K., & Maascha, E. (1994). Improved reliability of the NIH stroke scale using video training. Stroke, 25, 2220-2226. https://doi.org/10.1161/01.STR.25.11.2220
  20. Nielsen, A., & Williams, T. (1980). Depression in ambulatory medical patients. Arch Gen Psychiatry, 37, 999-1004. https://doi.org/10.1001/archpsyc.1980.01780220037003
  21. Paik, Y., & Song, M. (2000). Sleep disturbing factors and the relative significance in sleep of hospitalized elderly patients. J Korean Gerontological Nurs, 2, 35-47.
  22. Palomaki, H., Berg, A., Meririnne, E., Kaste, M., Lonnqvist, R., Lehtihalmes, M., & Lonnqvist, J. (2003). Complaints of poststroke insomnia and its treatment with mianserin. Cerebrovasc Dis, 15, 56-62. https://doi.org/10.1159/000067127
  23. Roberts, R. E., Shema, S. J., Kaplan, G. A., & Strawbridge, W. J. (2000). Sleep complaints and depression in an aging cohort: A prospective perspective. Am J Psychiatry, 157, 81-8. https://doi.org/10.1176/ajp.157.1.81
  24. Rye, D., & Jankovic, J. (2002). Emerging view of dopamine in modulating sleep/wake state from unlikely source: PD. Neurology, 58, 341-346. https://doi.org/10.1212/WNL.58.3.341
  25. Shin, W., Sung, K., Lee, J., Jang, D., & Jung, K. (1999). Nocturnal dip in patients with cerebrovascular disease occurring during sleep: Prospective assessment by using ambulatory blood pressure monitoring. J Korean Neurol Assoc, 17, 333-339.
  26. Sohn, S. (2002). Relationship between fatigue and sleep quality in patients with cancer. J Korean Acad Adult Nurs, 14, 378-389.
  27. Sterr, A., Herron, K., Dijk, D., & Ellis, J. (2008). Time to wake-up: Sleep problems and daytime sleepiness in ling-term stroke survivors. Brain Inj, 22, 575-579. https://doi.org/10.1080/02699050802189727
  28. Terzoudi, A., Vorvolakos, T., Heliopoulos, I., Livaditis, M., Vadikolias, K., & Piperidou, H. (2009). Sleep architecture in stroke and relation to outcome. Eur Neurol, 61, 16-22. https://doi.org/10.1159/000165344
  29. Thase, M. E. (1998). Depression, sleep, and antidepressants. J Clin Psychiatry, 59(4), 55-65.
  30. Vock, J., Achermann, P., Bischof, M., Milanova, M., Muller, C., Nirkko, A., Roth, C., & Bassetti, C. (2002). Evolution of sleep and sleep EEG after hemispheric stroke. J Sleep Res, 11, 331-338. https://doi.org/10.1046/j.1365-2869.2002.00316.x