• 제목/요약/키워드: Sleep: sleep disturbance

검색결과 371건 처리시간 0.027초

폐쇄성 수면무호흡증에서 지속적 상기도 양압술 시행이 교감신경계 활성도에 끼치는 영향 : 심전도 스펙트럼 분석 (Effects of Nasal Continuous Positive Airway Pressure Application on Sympathetic Activation : Power Spectrum Analysis of Electrocardiogram in Obstructive Sleep Apnea Syndrome)

  • 윤탁;박해정;김의중;정도언
    • 수면정신생리
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    • 제7권1호
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    • pp.43-50
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    • 2000
  • 목 적: 폐쇄성 수면무호흡증은 일반인구의 $2{\sim}5%$ 정도에서 발견될 정도로 흔한 질환이며, 특히 심혈관계 질환이 병발되는 경우가 많아 치료의 중요성이 점차 증가되고 있는 질환이다. 폐쇄성 수면무호흡증과 심혈관계 질환간의 관계는 명확하지 않으나 자율신경계가 매개 작용을 할 것으로 추정되고 있다. 폐쇄성 수면무호흡증에서의 교감신경계 활성도가 증가되어 있다는 연구들이 이를 뒷받침 해준다. 또한, 폐쇄성 수면무호흡증의 치료 방법인 지속적 상기도 양압술이 자율신경계를 변화시키는 것으로 알려져 있다. 그러나, 현재까지 폐쇄성 수면무호흡증 환자에서 지속적 상기도 양압술 치료 전후에 자율신경계의 변화를 측정한 연구는 많지 않으며, 결과도 일정하지 않다. 본 논문에서는 스펙트럼 분석 방법을 사용하여 폐쇄성 수면무호흡증의 환자의 심전도를 분석함으로써 지속적 상기도 양압술 전후의 자율신경계 변화를 고찰하였다. 방 법: 임상적으로 폐쇄성 수면무호흡증이 의심되어 수면 다원검사실에 의뢰된 환자들 중 병력청취, 이학적 / 신경학적검사와 야간 수면다원검사 시행결과 수면무호흡증으로 진단 된 17명을 연구대상으로 하였다. 기본 측정일과 지속적 상기도 양압술 시행일 모두 디지털 수면다원검사기로 기록을 저장하였으며, 양압술 시행일에는 무호흡 해소를 위한 처방압력을 결정하기 위한 목적으로 수면다원기록 시행 전 시간에 걸쳐 양압술을 시행하였다. 수면다원기록 판독은 국제판독기준에 따랐다. 그후 기본 측정일과 양압술 시행일 각각의 2단계 수면, 렘수면에서 잡음이 없는 300개의 연속된 심박동 기록을 선택하였다. 이를 대상으로 한 스펙트럼 분석에서 VLF(very low frequency) power, LF(low frequency) power, HF(high frequency) power, LHR(LF/HF ratio) 값을 산출하였다. 그리고, 심박동 변량(R-R variance)과 심박동 평균값도 산출하였다. 기본 측정일과 양압술 시행일 모두에서 수면다원기록과 동시에 혈중산소포화도($SaO_2$)도 측정하여 비교하였다. 제 변인의 값은 Wilcoxon signed ranks test로 통계 처리하였다. 결 과: 모든 대상군에서 양압술 시행으로 무호흡이 해소되었다. 양압술 시행일의 2단계 수면에서 기본 측정일의 2단계 수면에 비해 VLF power(p<0.05), LF power(p<0.01) 그리고 R-R variance(p<0.05)가 감소하였다. 렘수면의 LF power도 감소하였다(p<0.05). 최저 혈중산소포화도(p<0.01)와 평균 혈중산소포화도(p<0.01)의 증가도 관찰되었다. HF power, LHR, 심박동 변량 그리고 심박동 평균값의 유의한 차이는 없었다. 결 론: 본 연구에서는 처방압력 결정을 위한 양압술 시도 중에도 교감신경계 활성도가 즉각적으로 감소하는 것을 폐쇄성 수면무호흡증에서 관찰할 수 있었다. 부교감신경계의 활성도 변화는 유의하게 나타나지 않았으며, 이는 수면무호흡증에서 나타나는 혈동력학적인 변화가 교감신경계의 활성도의 증가와 관련이 있을 가능성을 시사해준다. 지속적 상기도 양압술을 처음 사용하는 날부터 폐쇄성 수면무호흡증 환자에서 즉각적이고 효율적으로 교감신경계 활성도가 감소하는 결과를 고려할 때, 임상적으로는 지속적 상기도 양얍술을 장기간 적용시 폐쇄성 수면무호흡증의 치료 뿐 만 아니라, 폐쇄성 수면무호흡증에서 병발하는 심혈관계 질환을 예방하고 치료에 도움을 줄 가능성도 시사된다.

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항문암 수술 후 혈중 항뮬러관 호르몬 저하 및 자궁내막이 얇은 난임 환자의 한약치료 자연임신 1례 (Korean Medical Treatment’s Report about a Spontaneous Pregnancy with Low Anti-Müllerian Hormone (AMH) Level and Thin Endometrium Infertility after Anorectal Cancer Surgery)

  • 고지은;유명숙
    • 대한한방부인과학회지
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    • 제29권3호
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    • pp.68-77
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    • 2016
  • Objectives: This paper is to report a spontaneous pregnancy with low AMH level and thin endometrium infertility after Korean medical treatments.Methods: A 38-year old patient who had low AMH level, thin endometrium, sleep disturbance and anxiety happened after anorectal cancer surgery was treated by korean medicine such as herb medications per day for 6 months. And we observed the effects of treatments by improvement of symptoms checking endometrium ultrasonography.Results: After treatments, Symptoms of anxiety and sleep disturbance were improved. The number of ovarian follicle and endometrium thickness were upgraded during artificial pregnancy trials. Finally the patient was a spontaneous pregnancy after failures of one intrauterine insemination and one in vitro fertilization trial.Conclusions: This case shows that the korean medicine has effective option for a patient with low AMH level and thin endometrium infertility. Further ultrasonography would be valid measurements to check the effectiveness of oriental treatments as well as symptoms.

습관성 코골이 환자의 측방두부규격방사선사진과 수면다원검사 연구 (Study of Cephalometry and Polysomnogrphy in Habitual Snorers)

  • 정성창
    • Journal of Oral Medicine and Pain
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    • 제23권1호
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    • pp.75-84
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    • 1998
  • The Purpose of this Study was to examine the anatomic differences in the upper airway according to severity of respiratory disturbance index of habitual snorers. Forty-three male habitual snorers, aged 28-68, were examined by polysomnography and divided into 4 groups according to severity determined by polysomnography. Anatomic differences in the upper airway were assessed by lateral cephalograms in upright position, and epidemiological surveys were done by using questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 35 patients (81.4%) complained the loudness of snoring as severe as be heard outside of the room. 2. According to the results of polysomnography, the number of the primary snoring patients was 7(16.3%), mild obtrusive sleep apnea 7(16.3%), moderate 7(16.3%), and severe 22(51.2%). 3. The respiratory disturbance index (RDI) of subjects was 39.5$\pm$24.4 and the body mass index(BMI) was 26.2$\pm$2. 4. More inferiorly positioned hyoid bone according to the degree of respiratory disturbace index (RDI) was observed. (p<0.001) 5. The width of superior oropharyngeal airway space was according to the degree of RDI. (p<0.001)

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갱년기 여성의 안면홍조에 대한 이선탕가미방(二仙湯加味方)의 증상 완화 효과 및 안전성 평가를 위한 임상연구 (Clinical Trial to Evaluate the Hot Flush Relief Efficacy and Safety of Yiseontang-gami in Climacteric Women with Hot Flushes)

  • 정수경;김동일
    • 대한한방체열의학회지
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    • 제7권1호
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    • pp.1-13
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    • 2009
  • Purpose: To evaluate the hot flush relief efficacy of Yiseontang-gami in climacteric women with hot flushes, a vasomotor symptom. Methods: The 20 subjects who signing on the clinical trial written consent by self-will is registered this clinical trial after decided suitable by selection and exception standard, after take a medical experiment and checkup according to clinical trial plan. Registered subject should valuated by settled schedule after take the testing medicine(Yiseontang-gami)during thirty-day. The evaluating indexes of this trial are hot flush VAS, hot flush frequency, hot flush consistence time, sweating VAS, palpitation VAS, sleep disturbance VAS, MRS, MENQOL, PGA. Results: The results were as follows 1. 4 subjects dropped out of the clinical trial and 16 subjects completed it. 2. After Yiseontang-gami treatment, hot flush VAS, hot flush frequent, sweating VAS, Palpitation VAS, sleep disturbance VAS improved significantly. 3. After Yiseontang-gami treatment, hot flush consistence time was not improved significantly. 4. After Yiseontang-gami treatment, blood test value were not different significantly. Conclusion: In this clinical trial we consider that Yiseontang-gami is suitable treatment for the hot flushes and related symptoms.

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천식 환자에 있어서 최대호기 유속의 자가 모니터링을 이용한 복약지도의 유용성 (Clinical Outcome of Educational Program Using Self-monitoring of Peak Expiratory Flow Rate for Asthma Patients)

  • 이명복;신현택;김선영
    • 한국임상약학회지
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    • 제9권2호
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    • pp.97-102
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    • 1999
  • The effects of pharmacist's intervention for asthma patients using self-monitoring of peak expiratory flow rate in medication teaching model was evaluated for 3 months in improving clinical outcomes including emergency visits, hospitalizations, antibiotics use, symptoms and sleep disturbance. Twenty seven patients were enrolled in study and twenty three patients completed the follow-up schedules. The selected patients were given the pre-designed instruction for medication including appropriate use of medication, metered-dose inhaler(MDI) technique, identifying and controling asthma triggers and recognizing early signs of deterioration. There were significant improvements in clinical outcomes, in terms of emergency visits, hopitalizations, antibiotics use, symptoms and sleep disturbance. There were also significant improvements in the MDI use, environmental control, and medication knowledges. There was a progressive increase in peak expiratory flow rate during the three-month intervention. In conclusion, pharmacist's intervention using self-monitoring of peak expiratory flow rate has a significant impact on improving clinical outcomes in asthma patients.

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치매환자의 기억장애 (Memory Impairment in Dementing Patients)

  • 한일우;서상훈
    • 수면정신생리
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    • 제4권1호
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    • pp.29-38
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    • 1997
  • 치매는 기억력을 포함한 다양한 영역의 인지기능의 손상을 특징으로 하는 질병군으로 정의된다. 그러므로 현재 치매진단을 위하여 사용되고 있는 대부분의 진단기준들은 치매의 진단에 있어 기억 장애를 필수요소로 포함하고 있다. 기억력의 감퇴는 노화과정의 결과로서 나타날 수 있다. 치매와는 달리 노화에서의 기억력의 감퇴는 노화에 따른 정상으로 간주되며 사회적 그리고 직업적 기능의 영역에서 심각한 어려움이나 손상을 초래하지 않는다. 우울증 또한 기억장애를 동반할 수 있다. 하지만 치매와는 달리 우울증에서는 언어성 지연회상과 재인기억의 감소는 나타내지 않는다. 치매환자들에서의 기억장애도 병소의 위치에 따라 다른양상으로 나타날 수 있다. 피질성치매에서의 기억장애는 정보의 부호화와 기억강화과정의 이상에 의해 초래된 것인데, 피질하치매에서의 기억장애는 인출의 장애에 의한 것이다.

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혈액투석 환자의 우울 예측 요인 (Factors Predicting Depression in Hemodialysis Patients)

  • 한상숙;김영희
    • 대한간호학회지
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    • 제35권7호
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    • pp.1353-1361
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    • 2005
  • Purpose: This study was done to provide fundamental data for developing a depression prediction model by discovering main factors that affect depression in patients who do maintenance hemodialysis. Method: The subjects were 191 patients doing maintenance hemodialysis selected from outpatient dialysis clinics at 9 major general hospitals, The Instrument tools utilized in this study were adapted from depression, fatigue, sleep disturbance, stress, adaptation, symptoms, daily activities, and role limitation and thoroughly modified to verify reliability and validity. The collected data was analyzed with a SPSS-PC 11.0 Window Statistics Program for real numbers, percentage, average, standard deviation, and multiple regression. Results: The correlation factor for depression was (M=2.54) fatigue(M=3.12), sleep disturbance (M=2.82), stress(M=3.04), adaptation(M=2.53), daily activities(M=2.24), symptoms(M=2.37), and role limitation(M=2.24). The strongest factor that affected depression was explained by symptoms of the patients who performed hemodialysis. The analysis of the factors that affected depression revealed a $58.4\%$ prediction in symptoms, stress, role limitation, and adaptation. Conclusion: It has been confirmed that the regression equation model(Depression=7.351 + .266$^{\ast}$symptoms + .260$^{\ast}$stress -.l89$^{\ast}$adaptation + .057$^{\ast}$fatigue) of this research may serve as a prediction factor for depression in Hemodialysis Patients.

갱년기 여성의 안면홍조에 대한 이선탕가미방(二仙湯加味方)의 증상완화 효과 및 안전성 평가를 위한 임상연구 (Clinical Trial to Evaluate the Hot Flush Relief Efficacy and Safety of Yiseontang-gami in Climacteric Women with Hot Flushes)

  • 정수경;김동일
    • 대한한방부인과학회지
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    • 제21권3호
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    • pp.75-89
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    • 2008
  • Purpose: To evaluate the hot flush relief efficacy of Yiseontang-gami in climacteric women with hot flushes, a vasomotor symptom. Methods: The 20 subjects who signing on the clinical trial written consent by self-will is registered this clinical trial after decided suitable by selection and exception standard, after take a medical experiment and checkup according to clinical trial plan. Registered subject should valuated by settled schedule after take the testing medicine(Yiseontang-gami)during thirty-day. The evaluating indexes of this trial are hot flush VAS, hot flush frequency, hot flush consistence time, sweating VAS, palpitation VAS, sleep disturbance VAS, MRS, MENQOL, PGA. Results: The results were as follows 1. 4 subjects dropped out of the clinical trial and 16 subjects completed it. 2. After Yiseontang-gami treatment, hot flush VAS, hot flush frequent, sweating VAS. Palpitation VAS, sleep disturbance VAS improved significantly. 3. After Yiseontang-gami treatment, hot flush consistence time was not improved significantly. 4. After Yiseontang-gami treatment, blood test value were not different significantly. Conclusion: In this clinical trial we consider that Yiseontang-gami is suitable treatment for the hot flushes and related symptoms.

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An Exploratory Study of the Effect of Ongyeong-tang Administration on Insomnia Disorder in Patients with Neurological Diseases: A Retrospective Chart Review Study

  • Seungwon Kwon;Han-Gyul Lee;Woo-Sang Jung;Sang-Kwan Moon;Ki-Ho Cho
    • 대한한방내과학회지
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    • 제43권6호
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    • pp.1122-1133
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    • 2022
  • Objectives: The aim of this study was to retrospectively evaluate the efficacy and safety of Ongyeong-tang (OGT) in the treatment of insomnia in patients afflicted with neurological diseases, according to the medical records of one medical institution. OGT is a herbal prescription that originates from the "Synopsis of Prescriptions of the Golden Chamber" and has been used for menopausal symptoms, uterine diseases, skin diseases, insomnia, and other neuropsychiatric symptoms. Methods: Medical records of patients who visited Kyung Hee University Korean Medicine Hospital from January 1, 2021 to June 30, 2022, received outpatient or inpatient treatment, and met the inclusion criteria were used in this study. Results: Twenty-four patients satisfied the inclusion criteria and were included. The Pittsburgh Sleep Quality Index-Korean version (PSQI-K) score was used to evaluate the outcomes before and after treatment. After an average of 14.42±9.2 days of OGT extract intake, 20 patients (83.3%) experienced improvement. The remaining four (16.7%) had no change in their symptoms, but none demonstrated worsening of symptoms. The total PSQI-K score showed a statistically significant decrease from 13.08±4.54 to 10.42±4.58 (p<0.001). Sleep quality, sleep duration, sleep disturbance, use of sleeping medications, and daytime dysfunction also showed statistically significant improvements. Conclusions: Administration of OGT extract may be a relatively safe and effective therapeutic option for insomnia in patients with neurological diseases.

Spectral Analysis on the Noise of Automobile Ball Bearing Plant

  • Jeong, Dong-Gyu;Ko, Duck-Young;Kim, Young-Se
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2002년도 ITC-CSCC -1
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    • pp.474-477
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    • 2002
  • Hearing loss caused by exposure to industrial machine noise results in devastating disability that is mostly preventable. And recent researches indicate that the noise may also induce hypertension and cardiovascular disease. In addition the sleep polygraph provides many indicators of sleep disturbance by the noise. In this paper we make an analysis on ball bearing machine noise, a kind of the industrial noise. The analysis of Its power spectrum is based on FFT(Fast Fourier Transform). And then the spectral results of the noise are compared with that of the spectrum for an auditory signal. The signal is measured from the pronunciation of two Koreans. Finally we suggest the most important stratagem to prevent the noise for worker's health and efficiency.

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