• Journal of muscle and joint health
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• v.5 no.1
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• pp.39-56
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• 1998

This study was an quasi-experimental study, done to identify factors Influencing the reduction of symptoms in patients with fibromyalgia. The primary purpose of the study was to develop a Self-Help Program suitable for patients with fibromyalgia in Korea. The secondary purpose was to identify the effects of a Self-Help Program which included stretching exercise. This study was carried out between Feb. 24 and July 8, 1997 and patients in the study Included out patient diagnosed with fibromyalgia based on the criteria developed by the American College of Rheumatology(1990) and H, University which is a tertiary patient care clinic for Rheumatism. The experimental group included 38 patients who were residents of Seoul or Kyungi province, and a control group of 38 patients who were residents of other areas. The control patients were matched to the experimental group patients and they were selected considering the number of tender points on the Fibromyalgia Impact Questionnaire score and a score of self-efficacy. The experimental group participated in a Self-Help Program based on the American Arthritis Foundation(1995) guidelines. The program participants participated in a small group which consisted of 12-15 members attending the program once a week, for 6 weeks with each program lasted two to two and a half hours. The stretching exercise was carried out in each patient's home every day following the video tape exercise provided by the researcher, and the researcher provided encouragement and concern to the patients by calling them once a week. The number times the exercise was performed was divided by the number of participants to calculate the percentage of performance and determine the amount of exercise. Self-efficacy was measured by the Self-Efficacy Scale developed by Lorig et al. (1989) for arthritis patients. The degree of pain was converted to scores based on the Visual Analog Scale, the number of tender points was converted to scores based on the criteria of the ACR(1990) and of Yunus. Depression was measured by CES-D and physical disability, sleep disturbance, fatigue, and anxiety of patients with fibromyalgia were measured by the Fibromyalgia Impact Questionnaire. The level of the exercise performance was converted to scores using the number of times the exercise was performed following the video tape prepared by Association of Rheumatology Health Professionals. Data were analyzed by SPSS windows and the results ire described below. 1. The experimental group which participated in the Self-Help Program showed higher efficacy scores than the control group when both groups were analyzed for depression and the number of tender points as common variables(F=9.146, p=.003). 2. The experimental group which participated in the Self-Help Program showed lower scores than the control group, for pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety. These symptoms of fibromyalgia can all be seen to have subsided(F=9.483, p=.003 : F=32.680, p=.001 ; F=11.104, p=.001, F=5.344 : p=.024, F=7.630 : P=.007, F=15.6512, p=.003 : F= 7.5412, p=.008). 3. In the experimental group, the self-efficacy score for the first three weeks showed a positive correlation with the exercise-performance score for four to six weeks (r=.387, p=.043). 4. In the experimental group, the relationship between the level of exercise-performance and the reduction of symptoms showed a significant correlation only to physical disability(r= -.500, p=.001). 5. In the experimental group, the relationship between the self-efficacy score and pain, the number of tender points, depression, physical disability, fatigue, sleep disturbance and anxiety score showed inverse correlations and thus, a reduction of symptoms occured when the self-efficacy score increased(r=-.325, p=.004 ; r= -.253, p=.027, r=-.452, p=.001 : r=-.434, p=.001 ; r=-.316, p=.005 ; r=-.460, p=.001 ; r=-.397, p=.014). Therefore, self-efficacy improved following the Self-Help Program including the stretching exercise. It was also found that physical symptoms (pain, number of tender points, level physical disability) and psychological symptoms (depression, fatigue, sleep disturbance, anxiety) were reduced. Moreover, It was found that the higher the self-efficacy, the the higher the degree of achievement of goals set for the stretching exercises. In addition, the level of exercise-performance influenced the level of physical disability, one of the symptoms of fibromyalgia. Accordingly, the conclusions from this study are that exercise-performance and the reduction of symptoms is achieved through promotion of self-efficacy. Therefore, it is proposed that are the Self-Help Program including stretching exercises is an appropriate nursing intervention for the reduction of symptoms of fibromyalgia.

• Journal of muscle and joint health
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• v.4 no.2
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• pp.163-176
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• 1997

Chronic fatigue syndrome Is a syndrome of unknown etiology and pathophysiology characterized by severe, chronic, debilitating fatigue as main symptom and numerous additional symptoms such as joint and muscle pain, headache, sleep disturbance. According to recent researches, it was suggested that chronic fatigue syndrome was developed by disturbance of interaction between neuropsychiatric system and immune system due to environmental factors and stress. Many patients experience gradual improvement but complete recovery from disorderd state is rare. There was no research elucidating the exact pathogenetic mechanism of chronic fatigue syndrome, so there was no established treatment. Several controlled studies about treatment was reported, but its results was not effective in all patients with chronic fatigue syndrome. For chronic fatigue syndrome, a comprehensive approach to physical, psychological, and social aspects is needed.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.6034-6039
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• 2012

In this paper, this may appear to exacerbate it met slopes of the mobile robot moves to overcome this by driving can occur if the mobile robot system has its own sleep problems driving progress in until you hit the target and solvedriving straight driving safer model for adaptive fuzzy control method of mobile robot based control algorithm is proposed. First, we propose a model based adaptive fuzzy controller, if possible, the dynamics model of the mobile robot, including model-based controller is designed to determine if you can check the condition of the mobile robot climbing and driving the mobile robot to overcome the slope and the to overcome driving control. Enough considering the ground friction forces and ensure the stability of the mobile robot system and the disturbance compensation, etc. In this case, the controller design will be possible. In addition, the nonlinear model, the dynamic characteristics of the mobile robot control method of adaptive fuzzy control techniques in the design that you want to fully reflect Non-holonomic system of mobile robots and solve sleep problems, and will be useful enough, it was verified through computer simulations.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.193-199
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• 2017

Objectives : Insomnia may be one of the risk factor for suicidal ideation, but little is known about the mechanism by which sleep disturbances confer risk for suicide. The aim of this study was to investigate examine whether insomnia severity would be associated with resilience and suicidal ideation, and whether resilience would mediate the relationship between insomnia and suicidal ideation. Methods : A total of 432 community-dwelling adults(227 male, 205 female,) completed the self-report questionnaire that covered basic socio-demographic data. To assess the psychological variables, the following instruments were applied: Insomnia Severity Index(ISI), Korean Version of the Connor-Davidson Resilience Scale(K-CD-RISC), Beck Hopelessness Scale(BHOP) and Scale for Suicidal Ideation(SSI-Beck). People with an ISI score of 8 or higher were defined as insomnia. Results : Greater insomnia symptom severity was significantly associated with higher level of suicidal ideation and lower level of resilience, adjusting for hopelessness, age, sex, presence of family members living together, and household income. Additional analysis revealed that disturbance of sleep initiation and disturbance of sleep maintenance were significantly associated with suicidal ideation. Mediation analyses revealed that resilience significantly accounted for the relationship between insomnia symptom severity and suicidal ideation. Conclusions : These findings suggest that the evaluation and control of insomnia and resilience may be needed to reduce the risk of suicide.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.27-35
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• 1999

Background: Fibromyalgia is a common syndrome of musculoskeletal pain and fatigue. Lacking distinctive histological or laboratory abnormality in diagnosis, it has often been considered a form of "psychogenic rheumatism". Fibromyalgia causes much distress to the affected patients and often frustrates physicians, who are unable to start rational therapy on any logical disease pathology. Methods: Growth hormone is essential for muscular homeostasis. In the present study, the notion that the stage-4 sleep anomaly typically seen in the fibromyalgia syndrome may disrupt growth hormone secretion was tested. Because growth hormone has a very short half-life, serum levels of somatomedin C were measured; somatomedin C is the major mediator of growth hormone's anabolic actions and is a prerequisite for normal muscle homeostasis. Serum levels of somatomedin C using acid-extraction procedure and two-site immunoradiome-tric assay (IRMA) and number of tender points were measured in 27 female patients with fibromyalgia from 40 to 60 years old and 27 healthy controls. Results: There were no differences in the concentration of somatomedin C between fibromyalgia patients and controls ($mean{\pm}SD$: $178.3{\pm}75.5$ ng/ml versus $166.3{\pm}76.6$ ng/ml; p=0.55). And there were no correlations between number of tender point and serum somatomedin C level by linear regression analysis. Conclusions: These findings did not support that there is a distinctive disruption of the growth hormone-somatomedin C neuroendocrine axis in a fibromyalgia syndrome. But we can not discard the hypothesis that disturbed sleep predispose to muscle pain.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.112-119
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• 2012

Objectives : Delirium is a disorder defined as a sudden disturbance in thinking, speaking, acting and sleep pattern due to altered level of consciousness and cognitive function. The objective of this study is to analyze characteristics and therapeutic methods of the delirious patients during the recent 5 years, and provide basic data for further studies and investigation regarding delirium in the occurrence and treatment. Methods : We retrospectively reviewed medical records of 475 patients who were consulted for delirium in Kyunghee University Medical Center from January 2007 to December 2011. Results : During the 5 years, among the 475 patients who were diagnosed as delirium, men were more common(61.7%). The most commonly consulted reason and cause were sleep disturbance(80.8%) and post-operational delirium(30.9%), respectively. The medication prescription percentage was 76.6% and was significantly increased year after year. Ratio of using antipsychotics were 76.4% among prescribed medication and the most frequently prescribed antipsychotic drug was quetiapine(46.8%). Other specialists commonly misdiagnosed delirium when the patient was previously diagnosed as dementia(6.8%). Conclusions : In our study, post-operational delirium was the most commonly referred reason and the percentage of medication prescription tended to increase. Patients with history of dementia were more easily misdiagnosed as diseases other than delirium. Our study suggests that we should evaluate symptoms, causes, reasons of consultation, management tendency of delirium. We should also closely observe changes in sleep patterns and establish the prevention strategies for post-operational delirium and therapeutic bases for pharmacotherapy.

• Women's Health Nursing
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• v.11 no.2
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• pp.163-168
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• 2005

Purpose: This study was to identify the relationship between fatigue and sleep disturbance in adult women so as to provide basic data for developing a women's health promotion program and nursing intervention. Method: A convenience sample of 184 women who visited a Well-baby clinic at P city Maternal child center during October in 2004 was obtained. Data was collected by self-administered questionnaires. Results: The Subjects' mean age was 36.87 years and 70% were employed and had more education than high school. The mean level of fatigue was 56.65, mean sleeping hours were 6.54, and time until falling asleep was 17.58 minutes. Scores of fatigue differed by subject's age, level of education, and menstruation status. In addition, sleeping hours differed by age, occupation status, and income level. There were significant low levels of correlation between fatigue and sleeping hours (r=-.16) and getting up too early (r=-.15). Conclusion: This study concludes that fatigue and sleeping patterns have a significant relationship.

• Sleep Medicine and Psychophysiology
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• v.17 no.1
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• pp.28-33
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• 2010

Objectives: Working at other times than the regular day shift has been reported to be a stressor associated with health consequences and mental disorders as well as disturbance of sleep. In current study, we aimed at investigating the relationship between work schedule, sleep quality and depression among police officers. Methods: Eleven hundreds and forty five police officers (male: 1040, female: 105) completed questionnaires of basic socio-demographic data, Pittsburgh Sleep Quality Index (PSQI), Korean Scale of Occupational Stress (KOSS), Impact of Event Scale - Revised (IES-R) and Center for Epidemiologic Study-Depression (CES-D). Results: After controlling for age, sex and educational level, score of CES-D was correlated positively with the score of KOSS, PSQI and IES-R on partial correlation analysis (r=-0.077; p=0.009, r=0.262; p<0.000 and r=0.421, p<0.000, respectively). Logistic regression analysis revealed that female sex, age, the score of KOSS and IES-R and schedule of rotating shift work predicted higher score than 16 score of CES-D significantly in total subjects (p=0.023, p=0.015, p=0.000, p=0.000 and p=0.022, respectively). Conclusion: Current result suggested that not only female sex, age, higher occupational stress and impact of event scale but also rotating shift work schedule might be related to depression among police officers.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.39-44
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• 2005

Objectives: Much attention has been paid to sleep apnea syndrome (SAS) in the elderly because of its high prevalence. It is expected that SAS in the elderly has both similarities and differences compared to SAS in the young or middle-aged populations. The aim of this study was to elucidate the characteristics and consequences of SAS in the elderly. Methods: In this study we included 210 young or middle-aged adults between 23 and 59 years (20 women and 190 men) and 65 older adults between 60 and 83 years of age (16 women and 49 men). Respiratory disturbance indices (RDIs) of the study subjects were more than 5 in an overnight polysomnography. They completed the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Informations about body mass index (BMI), neck, waist, and hip measurements, and blood pressure were obtained. Results: No difference was observed between older adults with SAS (older SAS) and adults aged under 60 with SAS (SAS aged under 60) in RDI, apnea index, % time of oxygen saturation less than 90%, and PSQI. Obstructive apnea index and oxygen desaturation index (ODI) were lower in older SAS. Compared to SAS aged under 60, lowest oxygen saturation and central apnea index were higher in older SAS, but they were statistically not significant. BMI and neck circumference were significantly lower in older SAS compared to SAS aged under 60. Diastolic blood pressure was lower in older SAS compared to SAS aged under 60 with no difference in systolic blood pressure. Older SAS showed lower scores in ESS than SAS aged under 60. Significant correlation was observed between RDI and BMI in SAS aged under 60, but not in the case of older SAS. The relationships between RDI and neck circumference, systolic and diastolic pressure, and ESS were similar. Conclusions: The elderly with SAS were not over-weight and there was no relationship between body weight and the severity of SAS. Also, the behavioral and cardiovascular effects of SAS were not marked in the elderly, which might be partly explained by decreased ODI and relatively higher lowest oxygen saturation in older SAS. The normal aging process, aside from increased body weight, might contribute to the development of SAS in the elderly with modest complications.

• Sleep Medicine and Psychophysiology
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• v.9 no.1
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• pp.24-33
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• 2002

Objectives: Nasal continuous positive airway pressure (CPAP) corrected elevated blood pressure (BP) in some studies of obstructive sleep apnea syndrome (OSAS) but not in others. Such inconsistent results in previous studies might be due to differences in factors influencing the effects of CPAP on BP. The factors referred to include BP monitoring techniques, the characteristics of subjects, and method of CPAP application. Therefore, we evaluated the effects of one night CPAP application on BP and heart rate (HR) reactivity using non-invasive beat-to-beat BP measurement in normotensive and hypertensive subjects with OSAS. Methods: Finger arterial BP and oxygen saturation monitoring with nocturnal polysomnography were performed on 10 OSAS patients (mean age $52.2{\pm}12.4\;years$; 9 males, 1 female; respiratory disturbance index (RDI)>5) for one baseline night and another CPAP night. Beat-to-beat measurement of BP and HR was done with finger arterial BP monitor ($Finapres^{(R)}$) and mean arterial oxygen saturation ($SaO_2$) was also measured at 2-second intervals for both nights. We compared the mean values of cardiovascular and respiratory variables between baseline and CPAP nights using Wilcoxon signed ranks test. Delta ($\Delta$) BP, defined as the subtracted value of CPAP night BP from baseline night BP, was correlated with age, body mass index (BMI), baseline night values of BP, BP variability, HR, HR variability, mean $SaO_2$ and respiratory disturbance index (RDI), and CPAP night values of TWT% (total wake time%) and CPAP pressure, using Spearman's correlation. Results: 1) Although increase of mean $SaO_2$ (p<.01) and decrease of RDI (p<.01) were observed on the CPAP night, there were no significant differences in other variables between two nights. 2) However, delta BP tended to increase or decease depending on BP values of the baseline night and age. Delta systolic BP and baseline systolic BP showed a significant positive correlation (p<.01), but delta diastolic BP and baseline diastolic BP did not show a significant correlation except for a positive correlation in wake stage (p<.01). Delta diastolic BP and age showed a significant negative correlation (p<.05) during all stages except for REM stage, but delta systolic BP and age did not. 3) Delta systolic and diastolic BPs did not significantly correlate with other factors, such as BMI, baseline night values of BP variability, HR, HR variability, mean SaO2 and RDI, and CPAP night values of TWT% and CPAP pressure, except for a positive correlation of delta diastolic pressure and TWT% of CPAP night (p<.01). Conclusions: We observed that systolic BP and diastolic BP tended to decrease, increase or remain still in accordance with the systolic BP level of baseline night and aging. We suggest that BP reactivity by CPAP be dealt with as a complex phenomenon rather than a simple undifferentiated BP decrease.