• KIPS Transactions on Computer and Communication Systems
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• v.12 no.5
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• pp.171-180
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• 2023

The three major sleep disorders in Korea are snoring, sleep apnea, and insomnia. Lack of sleep is the root of all diseases. Some of the most serious potential problems associated with sleep deprivation are cardiovascular problems, cognitive impairment, obesity, diabetes, colitis, prostate cancer, etc. To solve these problems, the Korean government provided low-cost national health insurance benefits for polysomnography tests in July 2018. However, insomnia patients still have problems getting treated in terms of time, space, and economic perspectives. Therefore, it would be better for insomnia patients to be allowed to test at home. The measuring device can measure six biosignals (eye movement, tossing and turning, body temperature, oxygen saturation, heart rate, and audio). A gyroscope sensor (MPU9250, InvenSense, USA) was used for eye movement, tossing, and turning. The input range of the sensor was in 258°/sec to 460°/sec, and the data range was in the input range. Body temperature, oxygen saturation range, and heart rate were measured by a sensor (MAX30102, Analog Devices, USA). The body temperature was measured in 30 ℃ to 45 ℃, and the oxygen saturation range was 0% for the unused state and 20 % to 90 % for the used state. The heart rate measurement range was in 40 bpm to 180 bpm. The measurement of audio signal was performed by an audio sensor (AMM2742-T-R, PUIaudio, USA). The was -42 dB ±1 dB frequency range was 20 Hz to 20 kHz. The measured data was successfully received in wireless network conditions. The system configuration was consisted of a PC and a mobile app for bio-signal measurement and data collection. The measured data was collected by mobile phones and desktops. The data collected can be used as preliminary data to determine the stage of sleep and perform the screening function for sleep induction and sleep disturbances. In the future, this convenient sleep measurement device could be beneficial for treating insomnia.

• Journal of Society of Occupational Therapy for the Aged and Dementia
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• v.12 no.2
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• pp.13-18
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• 2018

Objective : The purpose of this study is to confirm the basis for the effectiveness of sleep intervention for dementia progression. Method : PsycINFO, CINAHL, MEDLINE, PubMed, Science Direct, PEDro, Cochrane library was used to search for published papers from 2000 to 2017 using dementia, sleep, and randomized controlled trials (RCTs). Based on the results, author analyzed the papers that met the selection criteria. Result : Finally, five papers were selected. Among them, there were four papers showing that the effectiveness of the sleep intervention was not proven to be one. Conclusion : The results of this study can provide a basis for the sleep intervention effect of dementia patients. A program to actively intervene to prevent patients' behavior control and disease progression through solving sleep problems of dementia patients is needed.

• Journal of Oral Medicine and Pain
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• v.33 no.3
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• pp.257-267
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• 2008

The mentophysical disease causes diseases in digestive, respiratory, circulating systems, including chronic pain, through combined reactions from different individual characteristics, mental stress and temperamental factors. The most common symptom related to orofacial area is pain and the contributive factors include biological, behavioral, environmental, social, emotional, recognitive factors. These factors affect the course of the symptom according to individual's character and human nature. In pain, sleep acts as a contributive factor, and pain could bring about sleep disturbance and vice versa. Deterioration of sleep quality would act as a factor that aggravates mental stress. Therefore, relatively accurate and simple mental examinations and sleep quality test should be carried out for the patients with symptoms related to orofacial area. This study evaluated the mental state in relation to the sleep quality which could affect orofacial pain. The number of poor sleeper was 18 in male subjects, and 1 in female subjects and PSQI global index was higher in male($6.11{\pm}2.38$) than female($4.67{\pm}2.18$). SCL-90-R index showed no sex difference. Poor sleeper showed significantly high value in SOM, O-C, I-S, ANX, PHOB, PSY, GSI, PST. When SCL-90-R T scores were compared according to sleep quality, higher the subjective sleep quality score, O-C and I-S showed significant increase. As sleep disturbances score increased, PAR, PSY, PST showed statistically significant increase. In comparison of SCL-90-R T score according to daytime dysfunction, statistically significant increase in DEP, ANX, HOS, PHOB, PAR, GSI was observed. Therefore, the quality of sleep and psychological status have a high correlation. This is likely to influence chronic pain in the orofacial field. As a result, clinicians treating orofacial pain should evaluate the sleep quality and psychological status of the patient. Further studies of larger sample sizes including various age, occupation, and pain groups are necessary in order to apply the results to clinical practice.

• Journal of agricultural medicine and community health
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• v.25 no.1
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• pp.51-63
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• 2000

Ten Dongs were selected according to the systematic cluster sampling in Koryong Gun, and the survey was conducted on 571 women in the age between 30-69 years. The first survey was performed for 6 days between August 27 to September 1, 1999 with the investigation rate of 60.3%, and the second survey was performed in November with the investigation rate of 91.8%. The contents of survey included demographic characteristics, health behaviors, dyspepsia symptom score, sleeping induction time and the degree of sleep satisfaction, and degree of stress in the subjects. The dyspepsia symptom score was in the average 13.4 points out of a total 44 points and was the highest in the 50-59 year-old age group with 13.9 points. The sleep induction time was in the average of 35 minutes and was the highest in the 50-59 year-old age group with 40.9 minutes; the degree of sleep satisfaction was in the average of 7.9 points and was the lowest in the 50-59 year-old age group with 7.5 points. The stress score was in the average of 18.3 points and was highest in those subjects in their 40's and 50's with 18.7 points. When the correlation among the stress score, the degree of sleep satisfaction and dyspepsia symptom score was analyzed, the results showed that he stress score and the degree of sleep satisfaction showed a significant negative correlation and that the stress score and dyspepsia symptom score showed a significant positive correlation. Also, a significant negative correlation was found between the degree of sleep satisfaction and dyspepsia symptom score. According to each age group, a significant correlation was revealed among the stress score, dyspepsia symptom score and the degree of sleep satisfaction in those subjects over 40 years of age compared to those subjects who were younger than 40 years of age. As for educational level, the correlation among the stress score, the degree of sleep satisfaction and dyspepsia symptom score was higher in those subjects with less than middle school education compared to those subjects with more than high school education. When those factors that effects on the dyspepsia symptom score were analyzed with multiple regression, the results showed that the level of stress and chronic diseases were selected as significant variables. When those factors that affected on the degree of sleep satisfaction were analyzed, the sleep induction time and presence of chronic diseases and stress were selected as significant variables. Those women in their 50's who live in rural areas showed the highest level of stress, lowest the degree of sleep satisfaction, and highest level of dyspepsia, indicating that they need stress management. Also, since stress was showed to be a significant variable effecting on dyspepsia or the degree of sleep satisfaction, it is concluded that health promotion is possible through stress management. More studies are needed in the future on coping resources that would strengthen coping against stress, and by conducting studies on stress and related factors on community people, the measures of mental health promotion need to be developed.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.404-415
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• 1998

Background: Sleep apnea syndrome, which occurs in 1~4 % of the adult population, frequently has different cardiovascular complications such as hypertension, ischemic heart disease, cardiac arrythmia as well as sleep-wake disorder such as excessive daytime hypersomnolence or insomnia. Mortality and vascular morbidity are reported to be significantly higher in sleep apnea syndrome patients than in normal population. According to the recent studies, autonomic dysfunction as well as hypoxemia, hypercapneic acidosis, and increased respiratory effort, may playa role in the high prevalence of cardiovascular complications in patients with sleep apnea syndrome. However the cause and mechanism of autonomic neuropathy in patients with sleep apnea syndrome are not well understood. We studied the existence of autonomic neuropathy in patients with sleep apnea syndrome and factors which influence the pathogenesis of autonomic neuropathy. Method: We used the cardiovascular autonomic neuropathy(CAN) test as a method for evaluation of autonomic neuropathy. The subjects of this study were 20 patients who diagnosed sleep apnea syndrome by polysomnography and 15 persons who were normal by polysomnography. Results: Body mass index and resting systolic blood pressure were higher in sleep apnea group than control group. Apnea index(Al), respiratory disturbance index(RDI) and snoring time percentage were significantly higher in sleep apnea group compared with control group. But there were no significant differences in saturation of oxygen and sleep efficiency in two groups. In the cardiac autonomic neuropathy test, the valsalva ratio was significantly low in sleep apnea group compared with control group but other tests had no differences between two groups. The CAN scores and corrected QT(QTc) interval were calculated significantly higher in sleep apnea group, but there were no significant correlations between CAN scores and QTc interval. There were no significant data of polysomnography to correlate to the CAN score. It meant that the autonomic neuropathy in patients with sleep apnea was affected by other multiple factors. Conclusion: The cardiovascular autonomic neuropathy test was a useful method for the evaluation of autonomic neuropathy in patients with sleep apnea syndrome and abnormalities of cardiovascular autonomic neuropathy were observed in patients with sleep apnea syndrome. However, we failed to define the factors that influence the pathogenesis of autonomic neuropathy of sleep apnea syndrome. This study warrants futher investigations in order to define the pathogenesis of autonomic neuropathy in patients with sleep apnea syndrome.

• Sleep Medicine and Psychophysiology
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• v.18 no.1
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• pp.23-28
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• 2011

Objectives: REM sleep behavior disorder (RBD) has received little attention in epidemiologic studies. This study aimed to determine the prevalence of probable REM sleep behavior disorder (pRBD) in the elderly population and its clinical features. Methods: A random sample of 1,588 was selected from a roster of 14,050 elderly population living in Osan city. The subjects were asked to fill out the REM sleep behavior disorder screening questionnaire (RBDSQ). Subjects whose score were 5 or higher on RBDSQ underwent a diagnostic phase of person-to-person assessment by experts in RBD. Results: Among 1,588 subjects, 886 elderly subjects participated in the screening phase and 123 subjects were assessed in the diagnostic phase. Eleven subjects were diagnosed as having pRBD, so prevalence was 1.5% (95% CI=0.70-2.30%). The frequency of depression and cognitive decline was significantly increased in patients with pRBD compared to subjects without pRBD, and there was no difference in sleep disturbances between two groups. Conclusions: Probable REM sleep behavior disorder is not rare in the elderly but frequently under-recognized. More attention should be paid to evaluation and treatment of RBD.

• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.67-70
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• 2008

Overlap syndrome can be defined as a coexistence of chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS). The association of COPD and SAHS has been suspected because of the frequency of both diseases. Prevalence of COPD and SAHS is respectively 10 and 5% of the adult population over 40 years of age. However, a recent study has shown that the prevalence of SAHS is not higher in COPD than in the general population. The coexistence of the two diseases is only due to chance. SAHS does not affect the pathophysiology of COPD and vice versa. Prevalence of overlap syndrome is expected to occur in about 0.5% of the adult population over 40 years of age. Patients with overlap syndrome have a more profound hypoxemia, hypercapnia, and pulmonary hypertension when compared with patients with SAHS alone or usual COPD patients without SAHS. To treat the overlap syndrome, nocturnal noninvasive ventilation (NIV) or nasal continuous positive airway pressure (nCPAP) can be applied with or without nocturnal oxygen supplement.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.5-8
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• 2002

Stroke is a leading cause of death in most developed countries and some developing countries including South Korea. It is well known that stroke has is related in some way with several sleep disorders. At first, the onset time of stroke varies according to circadian rhythm. Early morning is the most prevalent time and late evening the least. The changes of blood pressure, catecholamine level, plasminogen activity and aggregation of platelet during sleep have been suggested as possible mechanisms. Sleep apnea (SA), a representative disorder in the field of sleep medicine, is found in more than 70% of acute stroke patients compared to 2-5% of the general population. Various sleep related breathing disorders occur after stroke and snoring is a distinct risk factor for stroke. So the relationship between stroke and SA is obvious, but the cause and effect are still not clearly known. Also, stroke may cause many sleep related problems such as insomnia, hypersomnia, parasomnia and changes in sleep architecture. Patients, family members and even medical personnel often ignore stroke-related sleep problems, being concerned only about the stroke itself. The clinical impacts of sleep problems in stroke patients may be significant not only in terms of quality of life but also as a risk factor or prognostic factor for stroke. More attention should be paid to the sleep problems of stroke patients.

• Sleep Medicine and Psychophysiology
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• v.11 no.1
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• pp.17-21
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• 2004

Nasal congestion is one of the most common symptoms of medical complaints. Snoring is caused by vibration of the uvula and the soft palate. Nasal obstruction may contribute not only to snoring and obstructive sleep apnea (OSA) but also impair application of continuous nasal positive airway pressure (CPAP), which is the most widely employed treatment for OSA. Total or near-total nasal obstruction leads to mouth breathing and has been shown to cause increased airway resistance. However, the exact role of the nasal airway in the pathogenesis of OSA is not clear and there is no consensus about the role of nasal obstruction in snoring and sleep apnea. Some reports have failed to demonstrate any correlation between snoring and nasal obstruction. On the other hand, opposing reports suggest that nasal disease may cause sleep disorders and that snoring can be improved after nasoseptal surgery. Reduced cross-sectional area causes increased nasal resistance and predisposes the patient to inspiratory collapse of the oropharynx, hypopharynx, or both. Discrete abnormalities of the nasal airway, such as septal deformities, nasal polyps, and choanal atresia and with certain mucosal conditions such as sinusitis, allergic rhinitis and inferior turbinate hypertrophy can cause snoring or OSA. Thus, these sources of nasal obstruction should be corrected medically or surgically for the effective management of OSA and adjunctive for CPAP.