• Title/Summary/Keyword: Sleep: sleep disturbance

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Diagnosis of Obstructive Sleep Apnea Syndrome Using Overnight Oximetry Measurement (혈중산소포화도검사를 이용한 폐쇄성 수면무호흡증의 흡증의 진단)

  • Youn, Tak;Park, Doo-Heum;Choi, Kwang-Ho;Kim, Yong-Sik;Woo, Jong-Inn;Kwon, Jun-Soo;Ha, Kyoo-Seob;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.9 no.1
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    • pp.34-40
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    • 2002
  • Objectives: The gold standard for diagnosing obstructive sleep apnea syndrome (OSAS) is nocturnal polysomnography (NPSG). This is rather expensive and somewhat inconvenient, however, and consequently simpler and cheaper alternatives to NPSG have been proposed. Oximetry is appealing because of its widespread availability and ease of application. In this study, we have evaluated whether oximetry alone can be used to diagnose or screen OSAS. The diagnostic performance of an analysis algorithm using arterial oxygen saturation ($SaO_2$) base on 'dip index', mean of $SaO_2$, and CT90 (the percentage of time spent at $SaO_2$<90%) was compared with that of NPSG. Methods: Fifty-six patients referred for NPSG to the Division of Sleep Studies at Seoul National University Hospital, were randomly selected. For each patient, NPSG with oximetry was carried out. We obtained three variables from the oximetry data such as the dip index most linearly correlated with respiratory disturbance index (RDI) from NPSG, mean $SaO_2$, and CT90 with diagnosis from NPSG. In each case, sensitivity, specificity and positive and negative predictive values of oximetry data were calculated. Results: Thirty-nine patients out of fifty-six patients were diagnosed as OSAS with NPSG. Mean RDI was 17.5, mean $SaO_2$ was 94.9%, and mean CT90 was 5.1%. The dip index [4%-4sec] was most linearly correlated with RDI (r=0.861). With dip index [4%-4sec]${\geq}2$ as diagnostic criteria, we obtained sensitivity of 0.95, specificity of 0.71, positive predictive value of 0.88, and negative predictive value of 0.86. Using mean $SaO_2{\leq}97%$, we obtained sensitivity of 0.95, specificity of 0.41, positive predictive value of 0.79, and negative predictive value of 0.78. Using $CT90{\geq}5%$, we obtained sensitivity of 0.28, specificity of 1.00, positive predictive value of 1.00, and negative predictive value of 0.38. Conclusions: The dip index [4%-4sec] and mean $SaO_2{\leq}97%$ obtained from nocturnal oximetry data are helpful in diagnosis of OSAS. CT90${\leq}$5% can be also used in excluding OSAS.

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The Changes of Pulmonary Function and Systemic Blood Pressure in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증후군 환자에서 혈압 및 폐기능의 변화에 관한 연구)

  • Moon, Hwa-Sik;Lee, Sook-Young;Choi, Young-Mee;Kim, Chi-Hong;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.206-217
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    • 1995
  • Background: In patients with obstructive sleep apnea syndrome(OSAS), there are several factors increasing upper airway resistance and there is a predisposition to compromised respiratory function during waking and sleep related to constitutional factors including a tendency to obesity. Several recent studies have suggested a possible relationship between sleep apnea(SA) and systemic hypertension. But the possible pathophysiologic link between SA and hypertension is still unclear. In this study, we have examined the relationship among age, body mass index(BMI), pulmonary function parameters and polysomnographic data in patients with OSAS. And also we tried to know the difference among these parameters between hypertensive OSAS and normotensive OSAS patients. Methods: Patients underwent a full night of polysomnography and measured pulmonary function during waking. OSAS was diagnosed if patients had more than 5 apneas per hour(apnea index, AI). A careful history of previously known or present hypertension was obtained from each patient, and patients with systolic blood pressure $\geq$ 160mmHg and/or diastolic blood pressure $\geq$ 95mmHg were classified as hypertensives. Results: The noctural nadir of arterial oxygen saturation($SaO_2$ nadir) was negatively related to AI and respiratory disturbance index(RDI), and the degree of noctural oxygen desaturation(DOD) was positively related to AI and RDI. BMI contributed to AI, RDI, $SaO_2$ nadir and DOD values. And also BMI contributed to $FEV_1,\;FEV_1/FVC$ and DLco values. There was a correlation between airway resistance(Raw) and AI, and there was a inverse correlation between DLco and DOD. But there was no difference among these parameters between hypertensive OSAS and normotensive OSAS patients. Conclusion: The obesity contributed to the compromised respiratory function and the severity of OSAS. AI and RDI were important factors in the severity of hypoxia during sleep. The measurement of pulmonary function parameters including Raw and DLco may be helpful in the prediction and assessment of OSAS patients. But we could not find clear difference between hypertensive and normotensive OSAS patients.

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Genetic polymorphisms of monoamine oxidase(MAO) B and serotonin transporter receptor(5-HTTR) influence variability in neurobehavioral symptoms by n-hexane exposur (n-Hexane 노출에 의한 신경행동학적 증상에 monoamine oxidase(B)와 serotonin transporter receptor 유전자다양성의 영향)

  • Kim, Ki-Woong
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.21 no.2
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    • pp.116-122
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    • 2011
  • Human occupational exposure to n-hexane has been associated with neurobehavioral symptoms such as depression, irritablity, acute irritation symptom, concentration disturbance and fatigue. Effects of monoamine oxidase (MAO) B and serotonin transporter receptor (5-HTTR) polymorphisms on the neurobehavioral symptoms were investigated in 70 male workers from TV and computer monitor manufacturing plants exposed to n-hexane. Neurobehavioral symptoms were assessed through a self-reported questionnaire and ambient level of n-hexane was measured by NIOSH method. Blood and urine were collected from each workers to determine the MAO(B), 5-HTTR and urinary 2,5-hexanedione(2,5-HD). The mean concentration of volatile n-hexane was $18.8{\pm}28.8ppm$ and that of urinary 2,5-HD was $1.07{\pm}1.47mg/g$ creatinine. Statistically significant associations with sexual disturbance were age and smoking. The frequencies of MAO(B) AA, AG and GG were 18.6%, 45.7% and 35.7%, respectively, and the frequencies of 5-HTTR ll, ls and ss genotype were 82.9%, 15.7% and 1.4%, respectively. MAO (B) gene polymorphisms had susceptibility to the neurobehavioral symptoms such as fatigue, concentration disturbance, irritability and acute irritation symptom and 5-HTTR gene polymorphism had susceptibility to the sleep disturbance and acute irritation symptom. On multiple logistic regression analysis for the neurobehavioral symptoms, memory disturbance was significantly associated with smoking(OR=6.752, 95% CI=37.46) and drinking(OR=4.033, 95% CI=1.252-12.98), emotional lability was MAO(B) genotype(OR=0.412, 95% CI=0.170-0.996), fatigue (OR=1.011, 95% CI=1.000-1.021) and acute irritation(OR=0.990, 95% CI=0.981-1.000) were working duration and sexual disturbance were significantly associated with age(OR=1.208, 95% CI=1.042-1.399), ambient n-hexane(OR=1.077, 95% CI=1.005-1.154) and 2,5-HD(OR=0.186, 95% CI=0.041-0.841). This finding implies that the MAO (B) and 5-HTTR polymorphisms may affect susceptibility for specific neurobehavioral symptoms associated with n-hexane exposure in workers.

The Clinical study of Su-Gi therapy's Effects on Insomnia by observing of ISI and PSQI (불면환자에 대한 수기치료 효과의 임상 사례 보고)

  • Kim, Min Seok;Ahn, Hun Mo;Kim, Jun Cheol
    • Journal of Korean Medical Ki-Gong Academy
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    • v.15 no.1
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    • pp.61-70
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    • 2015
  • Objectives : The purpose of this study is to investigate the effects of Su-Gi therapy for Insomnia by using ISI scores and PSQI test. Methods : We investigated 4 patients on condition of Insomnia who was hospitalized in the M Korean medicine hospital in Gyeonggi Province from 8th June, 2015 to 21st October, 2015. The Su-Gi therapy was treated on patients once a day for 10 minutes. We figured out the outcome by using ISI scores and PSQI test. Results : There were no differences on average sleeping time and the time to falling a sleep. Meaningful outcomes in values of ISI scores and PSQI test was not deduced after Su-Gi therapy. There were some progress on disturbance of daytime due to insomnia, ISI scores and PSQI test. In the Correlation analysis of outcomes of before and after the Su-Gi therapy, there were some improvements on ISI scores and PSQI tests and some questionnaire but were not enough to reach meaningful outcomes. We concluded that the more treatment time is needed to improve the condition of patients on insomnia as we see in PSQI test, one month is minimum period time to draw the conclusion. Conclusions : Theses outcomes suggest a possibilities that improvements who are suffering from insomnia can be get well when the Su-Gi therapy is performed for sufficient moments.

Comprehensive Predictors of Fatigue for Cancer Patients (암환자의 피로와 관련된 포괄적 예측요인에 대한 분석)

  • Seo, Young-Min;Oh, Hyun-Soo;Soe, Wha-Sook;Kim, Hwa-Soon
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1224-1231
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    • 2006
  • Purpose: This study was conducted to identify comprehensive predictors of fatigue in cancer patients. Methods: One hundred ten cancer patients visiting in-patient or out-patient clinics of a university hospital located in Incheon participated in this study. Results: The hematologic indicators (WBC and Hemoglobin) were significant fo. explaining fatigue. The psychological factors of fatigue were statistically significant. Both anxiety and depression, included as psychological factors, were significant in explaining fatigue in cancer patients. The influence of physical factors on fatigue was also statistically significant. Among the variables included as physical factors, pain, nausea/vomiting/anorexia, and sleep disturbance were significant whereas, dyspnea was not significant. The influence of the daily activity factor on fatigue was statistically significant. Among the variables included as daily activity factors, regular exercise or not and the usual activity level were significant in explaining fatigue of cancer patients, while the level of rest was not statistically significant. Conclusions: From the study results fatigue of cancer patients appeared to be influenced by multidimensional factors, such as physiological, physical, psychological, and activity related factors.

A Case Study of Multiple System Atrophy Patient with Diplopia Using Korean Medical Treatment (복시를 호소하는 다계통위축증 환자 치험 1례)

  • Jung, Min-ho;Son, Jeong-hwa;Cho, Ki-ho;Mun, Sang-kwan;Kwon, Seung-won;Jung, Woo-sang
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.246-251
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    • 2017
  • In this study, a 54-year-old female woman diagnosed as Multiple System Atrophy (MSA) presented diplopia with other symptoms - gait disturbance, ataxia, sleep apnea, dysuria. She had been cared with Korean medical treatment - Herbal medicine, acupuncture, bee venom acupuncture, electroacupuncture, cupping, moxa. Notable improvement was observed in diplopia expressing time and Unified Multiple System Atrophy Rating Scale (UMSARS). For MSA patient with no typical treatment indispensable, Korean medical treatment may be effective.

A Survey Study of Nursing Diagnosis Use in Clinical Practice (간호진단의 임상적용 활성화를 위한 기초조사 연구)

  • 최영희;이향련;김혜숙;김소선;박광옥
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.930-945
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    • 1996
  • The purpose of this study was to identify the degree to which nursing diagnoses accepted by NANDA are used and to identify problems in application of nursing diagnoses in clinical practice. With the expanding potential for computerization of nursing diagnosis, the survey also included data on the present status of hospital computerization and willingness to use computerized nursing diagnoses. The data collection was done from July 1 to August 3, 1996 using structured questionnaires. The questionnaires were mailed to 1,126 head nurses working in 44 hospitals with on occupacy of over 500 beds located in Korea, of these, 883 were returned from 40 hospitals. Among the 883 questionnaires, 867 were used for the analysis. The results of the analysis are as follows 1. Among 109 nursing diagnoses, pain, constipation, diarrhea, hyperthermia, high risk for infection, sleep pattern disturbance, and anxiety, chronic pain, altered urinary elimination, and altered nutrition : less than body requirements were the ten most frequently used diagnoses. 2. The primary problem in the use of nursing diagnoses was lack of time and personnel. Others were lack of knowledge and motivation, absence of protocols and absence of the appropriate methods to apply nursing diagnoses. 3. Among the 40 hospitals, 27 hospitals used a computerized system and expressed willingness to utilize the computerized system of nursing diagnoses that is planned for the future.

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The Craniofacial Pain and the Personality Characteristics in the Students who Failed the College-Entrance Examination (대입재수생의 두경부 동통 발생 양상과 인성 특성)

  • 구자윤;기우천;최재갑
    • Journal of Oral Medicine and Pain
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    • v.23 no.1
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    • pp.57-64
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    • 1998
  • Personality characteristics were studied by means of SCL-90-R test, Behavioral problem and pain site was studied Isleep disturbance, irregular eating habit, decreased physical activity, decreased social activity, increased emotional tension) by examination sheets. This study was conducted to examine the mature and extent of psychological difference between the students who failed the college-entrance examination and freshment and to determine whether psychological distress acts as a precipitate for craniocervical pain. 96students who failed the college-entrance examination (examination-failed student) and 86 freshmen were included in this study. The obtained results were as follows : Mean T-score of SCL-90-R primary scaled and global Indies in examination-failed students were significantly higher than the freshmen group. In comparison with examination-failed student group, the prevalence of neck and shoulder pain was significantly higher than the freshmen group. When the study and control group were compared in behavioral problem the study group had not more sound sleep than the control group. The study group had more irregular eating habit than control group. The study group had the lower physical activity than control group. The study group had poor social activity than control group. There was no significant difference in emotional tension.

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A Case Report of Intractable Hiccups after Laparoscopic Cholecystectomy (복강경 담낭절제술 후 발생한 난치성 딸꾹질 환자 증례)

  • Shin, Cho-Young;Jung, Hye-Mi;Hwang, Min-Young;Kim, Sol-Li;Yoon, Cheol-Ho
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.901-907
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    • 2010
  • Hiccups are defined as abrupt involuntary contractions of diaphragm and intercostal muscles with sudden closure of the glottis. Hiccups are one of the common transient symptoms but when hiccups last more than 48 hours, or have no response to treatment, they are defined as intractable hiccups. Intractable hiccups can induce multiple problems such as weight loss, dehydration and sleep disturbance. We report a 76-year-old male patient who suffered from intractable hiccups for 6 days after laparoscopic cholecystectomy. Hiccupping was so severe as to continue all day long and limit sleeping and eating. We succeeded in cure intractable hiccups with acupuncture and herbal formula; Gyulyeohwadam-tang.

Effect of Depression and Anxiety on Symptoms in Thyroid Cancer Patients Undergoing Radioactive Iodine($I^{131}$) Therapy (고용량 방사성요오드($I^{131}$)치료를 받는 갑상선암 환자의 우울, 불안이 증상에 미치는 영향)

  • Chun, Nami
    • Asian Oncology Nursing
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    • v.12 no.4
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    • pp.297-304
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    • 2012
  • Purpose: This study was to identify the symptom severity, interference and their psychological predictors in thyroid cancer patients hospitalized for radioactive iodine administration. Methods: One hundred seventy-seven thyroid cancer patients admitted to the isolation room for Iodine ($I^{131}$) therapy were recruited. Subjects were asked to complete the questionnaire on core symptoms, thyroid cancer symptoms, interference, depression and state anxiety in the evening after receiving radioactive iodine therapy. Data was analyzed using frequency, percentage, mean, Pearson's correlation, and multiple regression with SPSS vs. 19. Results: Lack of appetite, drowsiness, sleep disturbance, fatigue, and nausea were the 5 most core symptoms. More than 20% of patients experienced moderate to severe thyroid cancer symptoms including feeling cold, hoarseness, swallowing difficulty, and feeling hot. More than 30% of subjects experienced moderate to severe interferences in mood, general activity, and 22% in walking. Depression and state anxiety were identified as predictors of core symptoms, thyroid symptom severity and interference. Conclusion: Nursing interventions to reduce the symptom severity and interference need to be developed by considering thyroid cancer patients' depression and anxiety when hospitalized in the isolation room for radioactive iodine administration.