• Tuberculosis and Respiratory Diseases
• /
• v.47 no.6
• /
• pp.824-835
• /
• 1999

Background: Sleep-related breathing disorders are commonly found in patients with chronic renal failure and particularly, sleep apnea may have an influence on the long-term mortality rates in these patients. Maintenance hemodialysis is the mainstay of medical measures for correcting the metabolic derangements of chronic renal failure but it is uncertain whether it may alleviate sleep disorders including sleep apnea. Methods: Forty seven patients on maintenance hemodialysis were surveyed with the sleep questionnaire about their clinical symptoms related to sleep disorders. Among them, 15 patients underwent the polysomnography and their blood levels of urea nitrogen, creatinine, electrolytes and the arterial blood gases in the nights before and following hemodialysis were measured. Results: Forty(85.1%) of the 47 patients complained of the symptoms associated with sleep-wake cycle disturbances, 55.3% experienced snoring and 27.7% reported witnessed apneas. The duration of REM sleep increased significantly in the nights after hemodialysis compared to the nights without hemodialysis(p<0.05) and the percentage of total sleep time comprising NREM sleep decreased significantly in the nights following hemodialysis compared to the nights before hemodialysis(p<0.05). The percentage of total sleep time consisting of the stage 1 and 2 NREM sleep showed the trend for a decrease in the nights after hemodialysis(p=0.051), while the percentage of total sleep time comprising the stage 3 and 4 NREM sleep did not change between nights. The obstructive sleep apnea was more predominant type than the central one in both nights and there were no differences in the apnea index and the apnea-hypopnea index between the nights. The decrease in the blood level of urea nitrogen, creatinine, potassium and phosphorus was observed after hemodialysis(p<0.05), but the differences of parameters measured during polysomnography between the nights did not correlate with the changes of biochemical factors obtained on the two nights. Arterial blood gas analysis showed that pH was significantly greater in the nights after hemodialysis than in the nights before hemodialysis(p<0.05), but there were no correlations between the parameters examined during polysomnography and the parameters of arterial blood gas analysis(p<0.05). Conclusion: These results suggest that chronic renal failure is an important systemic disorder which is strongly associated with sleep disorders. Maintenance hemodialysis, although it is a widely accepted measure to treat chronic renal failure, did not significantly modulate the sleep architecture and the severity of sleep apnea. Thus, taking the patients with chronic renal failure into account, it is advisable to try not only to find a substantial way for correcting metabolic derangements but also to consider the institution of more effective treatments for sleep disorders.

• Sleep Medicine and Psychophysiology
• /
• v.10 no.2
• /
• pp.100-107
• /
• 2003

Objectives: Periodic leg movements in sleep (PLMS) might be subdivided based upon whether or not they are associated with visible EEG microarousals (MA). MA is considered to be responsible for nonrestorative sleep and daytime fatigue. The American Sleep Disorders Association's (ASDA) scoring rules for MA based on visual analysis of the EEG changes suggest that MA should last more than 3 seconds. However, it has been suggested that visual analysis may not detect some changes in EEG activity. This study is aimed at measuring changes in EEG spectra during PLMS without MA in order to better understand the arousing response of PLMS. Methods: Ten drug-free patients (three men and seven women) diagnosed with PLMS by polysomnography were studied. Spectral analysis of the EEG was performed in each patient on 30 episodes of PLMS without MA, chosen randomly across the night in stage 2 non-REM sleep. We applied stricter criteria for MA compared to ASDA, by defining it as a return to alpha and theta frequency lasting at least 1 second. Results: The mean PLMS index was $16.7{\pm}10.0$. The mean PLMS duration was $1.3{\pm}0.7$ seconds. Comparison of 4-second EEG activity both before and after the onset of PLMS without MA using independent t-test showed that the movements were associated with significant increase of relative activity in the delta band (p=0.000) and significant decrease of activity in the alpha (p=0.01) and sigma (p=0.000) bands. No significant decrease in the theta (p=0.05), beta (p=0.129), or gamma (p=0.062) bands was found. Conclusion: PLMS without MA was found to be associated with EEG change characterized by increase in the delta frequency band. This finding seems to be compatible with the hypothesis of an integrative hierarchy of arousal responses of Sforza's. Considering that the subjects had lower PLMS index and shorter PLMS duration than those of the previous study, it is suggested that an even less severe form of PLMS without MA could induce neurophysiologic change, which may potentially be of clinical significance.

• Tuberculosis and Respiratory Diseases
• /
• v.40 no.5
• /
• pp.501-508
• /
• 1993

Background: Sleep apnea syndrome is a common disorder which is estimated to affect about 1~4% of adult male population. And if untreated, sleep apnea can cause significant sequelae, such as hypertension, nocturnal cardiac arrhythmia, daytime hypersomnolence, and cognitive impairment. Various kinds of treatment for obstructive sleep apnea (OSA) have been developed. Among them nasal CPAP, first introduced by Sullivan et al in 1981, has received widespread interest and acclaim as a treatment of OSA, and is currently recommended as first-line treatment for OSA. We evaluated the effect of nasal CPAP in OSA and the side effects of nasal CPAP hindering patients from using nasal CPAP. Methods: We performed sleep studies in 20 OSA patients at 2 consecutive nights; baseline night at first day and CPAP night at second day. We compared apnea index, lowest oxygen concentration during apnea, maximal apnea time, and total apnea duration per total sleep time before and after CPAP. We also evaluated the side effects of CPAP with inquiry to the patients. Results: 1) Apnea index was significantly decreased after CPAP in 17 out of 20 OSA patients (85%) and increased in 3 patients (15%). 2) Average apnea index was significantly decreased after CPAP ($34.1{\pm}18.9/h{\rightarrow}15.4{\pm}10.3/h$, p<0.01). 3) Total apnea duration per total sleep time was also significantly decreased after CPAP ($28.5{\pm}16.0%{\rightarrow}11.9{\pm}9.3%$, p<0.05). 4) The lowest oxygen satuation and maximal apnea time were not significantly changed after CPAP. 5) The most frequent side effect of nasal CPAP was mask discomfort (80%), and the next was drying of nasal passages (65%). Conclusion: Nasal CPAP is an effective treatment for OSA. Futher studies should be concentrated on long term follow up of nasal CPAP for its therapeutic effects and the study of methods to enhance patients' compliance.

• Journal of Korean Public Health Nursing
• /
• v.14 no.2
• /
• pp.342-354
• /
• 2000

This study was conducted to identify the characteristics of activities of daily living(ADU) and its influencing factors in patients with chronic arthritis. The data were obtained from 104 patients with chronic arthritis in one university hospital from May to August. 2000. For analysing data. SAS program was used for t-test. ANOVA, Schefte test. Pearson correlation. and stepwise multiple regression. The results were as follows: 1. The variables which influenced self-efficacy were duration of disease. number of painful joint, quality of sleep and alcohol drinking. 2. The variables which influenced fatigue were diagnosis and number of painful joint. 3. The variables which influenced ADL were age. duration of disease. diagnosis. number of painful joint. number of exercise and alcohol drinking. 4. ADL was positive correlation with self-efficacy and negative correlation with fatigue. And self-efficacy was negative correlation with fatigue. 5. The predictors to explain ADL were self-efficacy. number of painful joint. lupus. duration of disease and religion. These predictors explained $66.01\%$ of the activites of daily living. According to these findings. the most significant influencing factor of ADL was self-efficacy. therefore the development of nursing intervention for enhancing self-efficacy would be needed. Also. it is suggested that an exercise program should be recommended as one of useful and appropriate nursing intervention for reducing fatigue and increasing ADL.

• Journal of Convergence for Information Technology
• /
• v.10 no.7
• /
• pp.116-121
• /
• 2020

This study was undertaken to investigate the influence and related mechanisms that have yet to be clearly demonstrated of Lithospermum erythrorhizon derived-naphthoquinone (shikonin) on the anxiety, insomnia, depression in rats. We hypothesized that naphthoquinone, the primary ingredient of Lithospermum erythrorhizon, plays a role in the modulation of insomnia evoked by stress, depression evoked by forced swimming or anxiety evoked by elevated plus maze. Male ICR (Institute of Cancer Research) mice were used and the immobility or swimming time, the duration of sleep, the duration and entry frequency into open arms were measured and recorded. The administration of naphthoquinone (10, 30 and 100 mg/kg) potentiated barbiturate-induced sleep suggesting the activation of GABAA receptor. It also potentiated the time spent in open arms of the maze and decreased the immobility time in forced swimming. In conclusion, naphthoquinone has anxiolytic, hypnotic and anti-depressant properties and is a potential therapeutic for anxiety, insomnia and depression.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
• /
• 2006.05a
• /
• pp.99-103
• /
• 2006

In this paper, we focus on the problem of designing an energy efficient MAC protocol for wireless sensor networks and analyze S(Sensor)-MAC and T(Time-out)-MAC. S-MAC is based on the concept of the 'listen/sleep mode cycle'. This applies message passing to reduce contention latency for sensor-network applications that require store-and-forward processing as data moves through the network. However unlike the S-MAC, where the duration of the cycle is fixed, T-MAC introduces an adaptive duty cycle in a novel way: by dynamical ending the active part of it. This reduces the amount of energy wasted on idle listening, in which nodes wait for potentially incoming messages while still maintaining a reasonable throughput. In this paper we discuss the design of these two Protocols. We analyze them from the aspect of latency, throughput, and power savings when using the OMNeT++ simulator in various environments.

• Journal of muscle and joint health
• /
• v.24 no.1
• /
• pp.56-65
• /
• 2017

Purpose: The purposes of this study were to identify degrees of low back pain, knowledge of and educational needs for low back pain of patients with chronic low back pain and to investigate their relationships. Methods: Data were collected from questionnaires distributed to 83 patients with chronic low back pain at a hospital. Results: The low back pain score was $4.70{\pm}2.22$ out of 10. The degree of low back pain was a statistically significant difference according to gender, smoking, radiating pain and frequency and duration, daily life disturbance degree, sleep disturbance and depression. The knowledge score was 8.29 out of 13. The knowledge was a statistically significant difference according to smoking and degree of sleep disturbance. The educational needs score was 39.83 out of 50. The educational needs was a statistically significant difference according to age, duration of disease, radiating pain, standing time, depression, pain treatment experience, and treatment institutions. As the low back pain increased, the educational needs increased (r=.254, p=.021). There were no correlations between low back pain and knowledge (r=-.040, p=.720) and knowledge and educational needs (r=.061, p=.581). Conclusion: It is important to focus on items with statistically significant differences in pain, knowledge, and educational needs, and to select low knowledge and high educational needs items to develop a systematic education plan.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.25 no.2
• /
• pp.20-37
• /
• 2012

Objectives : The primary purpose of present study is to evaluate the effect of a supplement of Bee Larva on tinnitus. the second is to comparatively evaluate safety of this supplement. Methods : Among those patients who visited Semyung Oriental Medical Center from January 11st, 2010 to February 20th, 2010, we screened 45 patients considered suitable for this study after some examinations and consent of the patients. they were devided into 2 groups. Group A took 5 tablets of this supplement everyday for 4 weeks, group B, placebo, in the same way. for 4 weeks, we checked changes in intensity, duration, extent of tinnitus on daily life and sleep and THI(Tinnitus Handicap Inventory) score. to evaluate safety of this supplement, adverse events, assessment of vital sign, hematologic examination were recorded. Result : Through 4 weeks of the clinical trial, we found that this supplement is effective on tinnitus and it improves intensity, duration and extent (its influence on daily life) of tinnitus, influence of tinnitus on sleep and THI score more effectively than the placebo drug. Also, in the assessment of the safety of the study the supplement of bee Larva and placebo drug, there were no adverse events and side effects over the average which need treatment for it. Moreover, there were not any abnormal findings in change of blood pressure and hematologic examination. Conclusion : According to this experiment, we confirmed that the supplement of bee Larva can be used effectively and safely on tinnitus.

• Nutrition Research and Practice
• /
• v.13 no.3
• /
• pp.222-229
• /
• 2019

BACKGROUND/OBJECTIVES: Aging is an imperative problem for many countries in this century, and presents several challenges for the maintenance of good nutritional status. This study aims to assess the impact of socio-demographic factors, lifestyle and health status on the nutritional status among the elderly in Taiwan. SUBJECTS/METHODS: A cross-sectional study was carried out in Taiwan. Data were obtained from the Mei Jau Health Management Institution, which is a private health evaluation provider with multiple health screening centers in Taiwan and Asia. This study included 7947 adults aged 65 years or above. The data were extracted between 2001 to 2010. Nutritional status was assessed using anthropometric data, biochemical data and dietary intake information. RESULTS: Among the 7947 participants with mean age of 70.1 (SD = 4.5) years, 20.2%, 6.6%, 10.5% and 52.5% experienced underweight, protein malnutrition, anemia and inadequate dietary intake in the past month, respectively. Age was negatively correlated with body weight (r = -0.19, P = 0.02), body mass index (r = -0.41, P < 0.001), albumin level (r = -0.93, P < 0.001) and hemoglobin level (r = -0.30, P = 0.008). Age above 70 years, gender, unmarried status, retirement, lack of education, low family income, smoking, alcohol drinking, sleep duration of 6-8 hours, vegetarian diet, multiple medications, comorbidity and dysphagia were positively associated with malnutrition in older adults. CONCLUSIONS: Underweight and inadequate dietary intake are prevalent among the elderly in Taiwan. Vegetarian diet, multiple medications, comorbidity, dysphagia and lifestyle factors such as smoking, alcohol drinking and sleep duration of 6-8 hours are risk factors for undernutrition in older adults.

• Sleep Medicine and Psychophysiology
• /
• v.4 no.2
• /
• pp.164-171
• /
• 1997

Introduction : Periodic limb movement disorder (PLMD) is shown to common in patients with OSA and may become evident or worsened when treated with nasal continuous positive airway pressure (CPAP). Whether this is due to im proved sleep continuity. adverse nocturnal body positioning, uncovered by CPAP, or due to the CPAP stimulus is still debat-ed. We hypothesized that the increase in PLM activity following CPAP is associated with more supine-sleeping tendencies when being treated with CPAP. In the present work, we compared differences in the PLMD index (PLMI) and sleeping position of patients with sleep disordered breathing before and after CPAP treatment. Method : We studied 16 patients (mean age 46 yr, 9M, 7F) with OSA (11 patients) or UARS (5 patients) who either had PLMD on initial polysomnogram (baseline PSG) or on nasal CPAP trial (CPAP PSG). All periodic leg movements were scored on anterior tibialis EMG during sleep according to standard criteria (net duration; 0.5-5.0 seconds, intervals; 4-90 seconds. 4 consecutive movements). Paired t-tests compared PLMD index (PLMI), PLMD-related arousal index (PLMD-ArI), respiratory disturbance index (RDI), and supine sleeping position spent with baseline PSG and CPAP PSG. Results : Ten patients (63%) on baseline PSG and fifteen patients (94%) on CPAP PSG had documented PLMD ($PLMI{\ge}5$) respectively with significant increase on CPAP PSG(p<0.05). Ten patients showed the emergence (6/10 patients) or substantial worsening (4/10 patients) of PLMD during CPAP trial. Mean CPAP pressure was $7.6{\pm}1.8\;cmH_2O$. PLMI tended to increase from baseline PSG to CPAP PSG, and significantly increase when excluding 2 outlier (baseline PSG, $19.0{\pm}25.8/hr$ vs CPAP PSG, $29.9{\pm}12.5/hr$, p<0.1). PLMD-ArI showed no significant change, but a significant decrease was detected when excluding 2 outlier (p<0.1). There was no significant sleeping positional difference (supine vs non-supine) on baseline PSG, but significantly more supine position (supine vs non-supine, p<0.05) on CPAP PSG. There was no significant difference in PLMI during supine-sleeping and nonsupine-sleeping position on both of baseline PSG and CPAP PSG. There was also no significant difference in PLMI during supine-sleeping position between baseline PSG and CPAP PSG. With nasal CPAP, there was a highly significant reduction in the RDI (baseline PSG, $14.1{\pm}21.3/hr$ vs CPAP PSG, $2.7{\pm}3.9/hr$, p<0.05). Conclusion : This preliminary data confirms previous findings that CPAP is a very effective treatment for OSA, and that PLMD is developed or worsened with treatment by CPAP. This data also indicates that supine-sleeping position is more common when being treated with CPAP. However, there was no clear evidence that supine position is the causal factor of increased PLMD with CPAP. It is, however, suggested that the relative movement limitation induced by CPAP treatment could be a contributory factor of PLMD.