• Journal of Korean Critical Care Nursing
• /
• v.16 no.2
• /
• pp.15-27
• /
• 2023

Purpose : This study aimed to examine the relationship between sleep quality and its influencing factors in patients with coronary artery disease (CAD). Methods : This descriptive correlational study included 130 patients with CAD admitted to the cardiology department of a general hospital in B City between September 2019 and February 2020. Data were collected using structured questionnaires and research instruments to measure sleep quality, anxiety, depression, chronotype, and daytime sleepiness. Results : The mean scores for sleep quality, daytime sleepiness, anxiety, and depression were 7.59±3.45, 6.45±3.46, 6.58±3.88, and 7.74±4.05, respectively. In terms of chronotypes, 10.8%, 48.5%, and 40.7% of the participants had evening-, intermediate-, and morning-type patterns, respectively. Sleep quality was significantly correlated with anxiety (r=0.38, p<.001), depression (r=.37, p<.001), and daytime sleepiness (r=.26, p =.002). Factors associated with sleep quality in patients with CAD included anxiety (β=.29), heart failure (β=.22), daytime sleepiness(β=.21), and sleeping alone (β=.19). Collectively, these factors had an explanatory power of 23.1% for sleep quality variance. Conclusion: Patients with CAD often experience poor sleep quality owing to various factors such as anxiety, daytime sleepiness, heart failure, and sleeping alone. It is recommended that healthcare providers objectively evaluate sleep and identify factors that influence sleep quality. This will enable the development of effective methods for sleep management as part of nursing care.

• Korean Journal of Clinical Laboratory Science
• /
• v.37 no.3
• /
• pp.216-219
• /
• 2005

We report a case of narcolepsy. A 25-year-old man has had excessive daytime sleepiness of about 10 years durations. He awakens daily feeling exhausted and continually falls asleep during the day while engaged in such situation like reading and watching television. He has exhibited cataplexy, a sudden loss of muscular tone, brought on by emotion, usually laughter. Polysomnogram revealed increased sleep stage 1, 2 and decreased deep sleep. Multiple sleep latency test (MSLT) showed that sleep latency was 1.33 minutes and there were 3 noted sleep onset rapid eye movement (SOREM) on 5 trials. The epworth sleepiness scale (ESS) was 17/24. Typing of HLA haplotype that was positive for the $DQB1^{\ast}0602$ allele, and hypocretin-1 (orexin A) could not be detected in cerebrospinal fluid (CSF). Brain MRI showed normal image. We diagnosed his case as narcolepsy based on history of cataplexy, and three occurances of SOREM, and positive of HLA haplotype.

• Sleep Medicine and Psychophysiology
• /
• v.22 no.1
• /
• pp.11-19
• /
• 2015

Objectives: Whether daytime sleepiness is proportional to the severity of sleep apnea in obstructive sleep apnea syndrome (OSAS) is controversial. In this study we investigated how insomnia severity affects the association between daytime sleepiness and sleep apnea severity in OSAS. Methods: The present study included 235 male subjects who were diagnosed with OSAS based on clinical history and nocturnal polysomnography. Pearson's correlation analysis was conducted among sleep and mood-related self-reported data, polysomnographic data and demographic data of all subjects. Based on Pittsburgh Sleep Quality Index (PSQI), the subjects were divided into 2 groups; group A (n = 75; $PSQI{\leq}5$) and group B (n = 160; PSQI > 5). Partial correlation analysis was performed between the Epworth Sleepiness Scale (ESS) and other data in both groups. Multiple linear regression analysis was conducted to investigate the factors which affected the ESS in group A. Results: Pearson's correlation analysis showed weak or non-existent correlations between ESS and apnea severity data such as apnea-hypopnea index (AHI) (r = 0.148, p = 0.023), apnea index (AI) (r = 0.137, p = 0.036), hypopnea index (HI) (r = 0.058, p = 0.377), oxygen desaturation index (ODI) (r = 0.149, p = 0.022) and arousal total index (ATI) (r = 0.129, p = 0.048). Positive correlations between ESS and apnea severity data such as AHI ($r_p=0.313$, p = 0.008), AI ($r_p=0.339$, p = 0.004), ODI ($r_p=0.289$, p = 0.015) and ATI ($r_p=0.256$, p = 0.031) were observed only in group A. Multiple regression analysis showed that AI (t = 2.996, p = 0.004) and BAI (t = 2.721, p = 0.008) were associated with ESS in group A. Conclusion: The correlation between daytime sleepiness and sleep apnea severity was shown only in group A. This result suggests that associations between daytime sleepiness in OSAS and sleep apnea severity will become prominent when controlling for insomnia-related variables.

• Journal of the Korea Convergence Society
• /
• v.10 no.12
• /
• pp.465-476
• /
• 2019

This study was convergence study to determine sleep and its factors in university students on the basis of Spielman's 3P model. The participants were 191 graduate and undergraduate students who were scheduled to take the exam after 1~2 weeks. The related variables of quality of sleep were self-control, stress, test anxiety, smartphone dependence, and daytime sleepiness. Chi-square test and t-test were used to make a comparison of the quality of sleep between the good and the bad sleep quality group. Pearson's coefficient correlation analysis was performed for correlation between the quality of sleep and the general characteristics, self-control, stress, test anxiety, smartphone dependence, and daytime sleepiness. Stress and test anxiety as precipitating factors for sleep disturbance, smartphone dependency as a perpetuating factor for sleep disorder, and daytime sleepiness as a sleep-related factor were correlated with the quality of sleep; no statistically significant correlation was found with self-control as a predisposing factor in the biopsychological area. It is necessary to solve such problems with mental health as stress and test anxiety, which are factors for sleep disturbance, and smartphone dependency as a perpetuating factor for sleep disorder, in pursuit of higher quality of sleep for university students.

• Sleep Medicine and Psychophysiology
• /
• v.18 no.1
• /
• pp.40-44
• /
• 2011

Narcolepsy is a sleep disorder, which is characterized by excessive daytime sleepiness (EDS) that is typically associated with cataplexy, sleep fragmentation and other REM sleep-related phenomenon such as sleep paralysis and hypnagogic hallucination. Narcoleptic symptoms can be developed from various medical or neurological disorders. A 17-year-old male patient admitted for the evaluation of EDS which started three-month ago. He slept more than 18 hours a day with cataplexy and hypnagogic hallucination. He was obese with body mass index (BMI) of 30.4 kg/$m^2$. After admission he was newly diagnosed to the thyrotoxicosis. T3 391.2 ng/dL (60-181), free T4 4.38 ng/dL (0.89-1.76), TSH <0.01 ${\mu}IU$/mL (0.35-5.5) were measured. His pulse rate ranged 70-90 beats per minute and blood pressure ranged 150/100-120/70 mmHg. Polysomnography revealed many fragmentations in sleep with many positional changes (81 times/h). Sleep onset latency was 33.5 min, sleep efficiency was 47.9%, and REM latency from sleep onset was delayed to 153.6 min. REM sleep percent was increased to 27.1%. Periodic limb movement index was 13.4/h. In the multiple sleep latency test (MSLT), average sleep latency was 0.4 min and there were noted 3 SOREMPs (Sleep Onset REM sleep period) on 5 trials. We couldn't discriminate the obvious sleep-wake pattern in the actigraph and his HLA DQB1 $^*0602$ type was negative. His thyroid function improved following treatment with methimazole and propranolol. Vital sign maintained within normal range. Cataplexy was controlled with venlafaxine 75 mg. Subjective night sleep continuity and PLMS were improved with clonazepam 0.5 mg, but the EDS were partially improved with modafinil 200-400 mg. Thyrotoxicosis might give confounding role when we were evaluating the EDS, though sleep fragmentation was one of the major symptoms of narcolepsy, but enormous amount of it made us think of the influence of thyroid hormone. The loss of sleep-wake cycle, limited improvement of EDS to the stimulant treatmen, and the cataplexy not supported by HLA DQB1 $^*0602$ should be answered further. We still should rule out idiopathic hypersomnia and measuring CSF hypocretin level would be helpful.

• Korean Journal of Clinical Pharmacy
• /
• v.34 no.1
• /
• pp.21-29
• /
• 2024

Background: Daytime sleepiness, a common phenomenon among adolescents focused on academics, has negative effects on aspects such as growth and overall learning. However, research on various drugs and diseases affecting daytime sleepiness is lacking in the reality. Therefore, this study aims to investigate the factors influencing daytime sleepiness in adolescents with daytime sleepiness. Methods: This study was conducted through a survey of 2,432 middle and high school students, aged 14 to 19. The questionnaire consisted of information on socio-demographic characteristics, overall health status, and sleep patterns. The Pediatric Daytime Sleepiness Scale (PDSS), translated into Korean, was used to assess daytime sleepiness. Daytime sleepiness was measured by calculating the total score for each item of the PDSS, and divided into two groups based on the cutoff value of 19, which was the upper quartile. Results: We analyzed a total of 1,770 students including 799 boys and 971 girls. Students with a PDSS score of 19 or higher made up 33.3% of boys and 66.7% of girls. In multivariate analyses, females, smoking, poor self-reported health level, sleep after 12 am, not feeling refreshed in the morning, headache, muscle pain, and scoliosis increased the risk of daytime sleepiness significantly. The AUROC of PDSS, including significant factors in multivariate analyses, was 0.751 (95% CI 0.725~0.776). Conclusions: Daytime sleepiness in adolescents affects growth, academic performance, and emotional stability. Therefore, it is important to manage medications, diseases, and other factors that affect daytime sleepiness on a social level.

• Sleep Medicine and Psychophysiology
• /
• v.21 no.2
• /
• pp.80-84
• /
• 2014

Introduction: Sleep has numerous important physiological and cognitive functions that may be particularly important to elite athletes. Sleep deprivation can have significant effects on athletic performance. However, there are few published data related to the amount of sleep obtained by elite athletes. We investigated sleep patterns of Korean women golfers using sleep-related questionnaires. Methods: For this study, 98 Korean university women golfers and 46 age- and sex-matched controls were recruited. All subjects were asked to complete the self-administered sleep questionnaire consisting of questions about habitual sleep patterns (sleep onset time, sleep latency, awakening time in the morning, day time napping time), exercise habits, Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISS), Pittsburgh Sleep Quality Index (PSQI), validation of the Perceived Stress Scale (PSS), and Beck Anxiety Inventory (BAI). Results: The sleep onset time was significantly earlier (pm 23 : $05{\pm}00$ : 52 and 00 : $14{\pm}00$ : 51 ; t = 5.287, p < 0.001), the waking time was later (am 07 : $21{\pm}01$ : 09 and 6 : $35{\pm}00$ : 32; t = -2.715, p = 0.008), the weekday total sleep time was greater ($417.77{\pm}78.18$ minute and $351.52{\pm}77.83$ minute ; t = 4.406, p = 0.001), and the daytime nap time was greater ($77.73{\pm}41.28$ minute and $20.22{\pm}33.03$ minute ; t = 7.623, p < 0.001) in the golf athletes compared to the controls. The PSQI scores were significantly lower, but estimated sleep latency and ESS, ISS, PSS, and BAI scores were not different among the two groups. Conclusion: This study suggests that Korean university women golfers have good sleep patterns resulting in no difference in sleep-related stress compared to age- and sex-matched control students.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.40 no.9
• /
• pp.1208-1214
• /
• 2011

Caffeine, a psychoactive stimulant, has been implicated in the modulation of learning and memory functions due to its action as a non-selective adenosine receptors antagonist. On the contrary, some side effects of caffeine have been reported, such as an increased energy loss and metabolic rate, decrease DNA synthesis in the spleen, and increased oxidative damage to exerted on LDL particles. Therefore, the aim of this study was to develop a safe stimulant from natural plants mixture (Aralia elata, Acori graminei Rhizoma, Chrysanthemum, Dandleion, Guarana, Shepherd's purse) that can be used as a substitute for caffeine. Thirty SD rats were divided into three groups; control group, caffeine group (15.0 mg/kg, i.p.), and natural plants mixture group (NP, 1 mL/kg, p.o.). The effect of NP extract on stimulant activity was evaluated with open-field test (OFT) and plus maze test for measurement of behavioral profiles. Plasma lipid profiles, lipid peroxidation in LDL (conjugated dienes), total antioxidant capacity (TRAP) and DNA damage in white blood, liver, and brain cells were measured. In the OFT, immobility time was increased significantly by acute (once) and chronic (3 weeks) supplementation of NP and showed a similar effect to caffeine treatment. Three weeks of caffeine treatment caused plasma lipid peroxidation and DNA damage in liver cells, whereas there were no changes in the NP group. NP group showed a higher plasma HDL cholesterol concentration compared to the caffeine group. The results indicate that the natural plants mixture had a stimulant effect without inducing oxidative stress.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.10
• /
• pp.7078-7088
• /
• 2015

This study examined effects of health behaviors and sleep related factor on cognitive function in the elderly hypertensive patients. Data were collected through a face to face interview survey with structured questionnaire form 140 elderly with hypertension ($age{\geq}65years$) from February 5 to May 1, 2013. Research instruments included Pittsburgh Sleep Quality Index(PSQI), Epworth Sleepiness Scale(ESS) and Korean version the Mini-Mental State Examination(MMSE-K). Cognitive function was negatively related to degradation in quality of sleep(r=-.29, p<.001). Sleep duration were negatively related to body mass index(r=-.18, p=.032) and degradation in quality of sleep(r=-.59, p<.001). Sleep duration was positively related to daytime sleepiness(r=.22, p=.008). Hierarchical multiple regression showed that age, education levels and living arrangement were associated with cognitive function(F=8.56, p<.001, Adjusted $R^2=.14$). After controlling for demographic characteristics and health behaviors, degradation in quality of sleep(${\beta}=-.27$, p=.008) was identified as significant predictors of cognitive function. This final model explained 17.0% of the cognitive function in the elderly hypertensive patients(F=4.09, p<.001). Therefore, as a strategy improving cognitive function of the elderly with hypertension, therapeutic intervention should be developed to improve quality of sleep considering age, education levels and living arrangement.

• Korean Journal of Health Psychology
• /
• v.16 no.3
• /
• pp.557-575
• /
• 2011

This study tried to examine the characteristics of attention deficits in patients with Obstructive Sleep Apenea(OSA) with different age levels, and to examine which indices of polysomnograms might be related to the indices of attention deficits in OSAs. Two age-level groups and a normal control group were subjected to two computerized attention tests, including a continuous performance test(CPT) and a change blindness task(CBT). In addition, the three groups were subjected to a Polysomnography to extract several sub-indicators of polysomnogram, and an Epworth Sleepiness Scale which measures subjective sleepiness. As results, the OSAs showed significantly more omission and commission errors in CPT, and they showed lower accuracy in CBT compared to the normal group. The results of a correlational analysis showed that attention deficits in OSA are significantly correlated with arterial oxygen saturation among sub-indicators of polysomnograms. In conclusion, OSAs seems to be less attentive, having difficulties in response inhibition, and having deficiencies in noticing important environmental changes. Age seems to make these deficiencies even worse. Especially, the relationship between attention deficiency and hypoxia which could cause irreversible cerebrum damage has an implication in cognitive impairment prevention through early treatment.