• Clinical and Experimental Pediatrics
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• v.56 no.5
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• pp.211-217
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• 2013

Purpose: Sleep onset association disorder (SOAD) is a form of behavioral insomnia observed in children that is caused by inappropriate sleep training. SOAD typically disturbs the sleep of not only infants and children but also their parents. We investigated levels of depression and marital intimacy among parents of infants with typical SOAD, to understand the influence of SOAD on family dynamics, as well as examine ways for improving depression and marital intimacy through behavioral training. Methods: Depression and marital intimacy were assessed using the Beck Depression Inventory (BDI) and Waring Intimacy Questionnaire (WIQ). These measures were administered to 65 parents of infants (n=50) diagnosed with SOAD. We conducted sleep education and behavioral training for the parents and compared levels of depression and marital intimacy after 2-6 weeks of training. Results: The 65 parents consisted of 50 mothers and 15 fathers. Depressive symptoms were higher among mothers than fathers (P=0.007). Marital intimacy was negatively correlated with depressive symptoms. Twenty-six parents were assessed again after sleep training. We found that mothers' depressive symptoms and marital intimacy improved post training. Conclusion: SOAD can be detrimental to both infants and parents, especially for parents who sleep with their infants. For instance, disruption of sleep patterns in such parents can reduce marital intimacy. However, behavioral modification is an effective treatment for infants with frequent nighttime waking, as well as for diminishing the depressive symptoms of sleep-deprived parents.

• Clinical and Experimental Pediatrics
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• v.53 no.10
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• pp.863-871
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• 2010

The prevalence of pediatric obstructive sleep apnea syndrome (OSAS) is approximately 3% in children. Adenotonsillar hypertrophy is the most common cause of OSAS in children, and obesity, hypotonic neuromuscular diseases, and craniofacial anomalies are other major risk factors. Snoring is the most common presenting complaint in children with OSAS, but the clinical presentation varies according to age. Agitated sleep with frequent postural changes, excessive sweating, or abnormal sleep positions such as hyperextension of neck or abnormal prone position may suggest a sleep-disordered breathing. Night terror, sleepwalking, and enuresis are frequently associated, during slow-wave sleep, with sleep-disordered breathing. Excessive daytime sleepiness becomes apparent in older children, whereas hyperactivity or inattention is usually predominant in younger children. Morning headache and poor appetite may also be present. As the cortical arousal threshold is higher in children, arousals are not easily developed and their sleep architectures are usually more conserved than those of adults. Untreated OSAS in children may result in various problems such as cognitive deficits, attention deficit/hyperactivity disorder, poor academic achievement, and emotional instability. Mild pulmonary hypertension is not uncommon. Rarely, cardiovascular complications such as cor pulmonale, heart failure, and systemic hypertension may develop in untreated cases. Failure to thrive and delayed development are serious problems in younger children with OSAS. Diagnosis of pediatric OSAS should be based on snoring, relevant history of sleep disruption, findings of any narrow or collapsible portions of upper airway, and confirmed by polysomnography. Early diagnosis of pediatric OSAS is critical to prevent complications with appropriate interventions.

• Sleep Medicine and Psychophysiology
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• v.15 no.2
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• pp.71-76
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• 2008

Introduction: In this study, we compared sleep structure, EEG characteristic of pediatric obstructive sleep apnea (OSA) and normal controls which were matched in sex and age. Methods: Fifteen children (male：female=4：11) who complained snoring and were suspected to have sleep apnea and their age and sex matched normal controls (male：female=5：10) have been done nocturnal polysomnography (NPSG). Sleep parameters, sleep apnea variables and relative spectral components of EEG from NPSG have been compared between both groups. Results: Pediatric OSA group were distinguished from normal controls in terms of apnea index, respiratory disturbance index and nadir of oxyhemoglobulin desaturation. Pediatric OSA group showed increased percent of sleep stage 1, decreased rapid eye movement sleep percent and increased delta power in O1 EEG channel. However other sleep parameters and spectral powers were not different between two groups. Conclusion: In pediatric OSA group, sleep structure parameter disruption may be not prominent as the previous studies for adult OSA group because of including mild OSA data in diagnostic criteria. In addition, EEG changes might not be distinct due to low arousal index compared to adult OSA patients. We can observe general characteristics and particularity of pediatric OSA through this study.

• Journal of Oral Medicine and Pain
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• v.38 no.4
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• pp.313-318
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• 2013

The aim of this study was to the relationship between sleep disturbances and Burning mouth syndrome(BMS). BMS presents as a chronic burning sensation in the oral mucous membrane that is frequently associated with sleep disturbances. BMS is considered neuropathic pain condition with dysfunction of small diameter afferent sensory fiber. A review of the studies reveals, BMS suggested peripheral and cental nervous system changes. Sleep disruption or Rem sleep deprivation cause an inhibition of opioid protein synthesis and a reduced affinity of ${\mu}$ and ${\delta}$ opioid receptors. Let me say that sleep disturbances suggest a risk factor For BMS and support to evaluate as a part of BMS treatment. Further study will be required to ascertain the relationship between distruption of sleep continuity or Rem sleep deprivation and BMS and the evidence of altered neurochemical degeneration of BMS.

• The Journal of the Convergence on Culture Technology
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• v.10 no.5
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• pp.453-458
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• 2024

If you are unable to get comfortable sleep to maintain and recover your health, it will cause a lot of disruption to your daily life. Among the intraoral devices used to resolve snoring, obstructive sleep apnea, bruxism, teeth clenching, and mouth breathing, which interfere with a comfortable sleep, devices that stabilize the lower jaw by moving it forward are a treatment that replaces surgical therapy and positive airway pressure. It is showing effect. During use of the device, a force is generated that causes the lower jaw to return to its original position, so a device that fixes it with screws, rubber bands, etc. is used. To see the effect of the device, you must bite your upper and lower teeth. In order to eliminate the inconvenience of having to stay closed while sleeping, the device is manufactured only in the upper jaw and creates a vertical guideway in the lingual embarasure of the lower jaw in the shape of a key & key way structure, allowing twisting movements and allowing forward and lateral movements. It is about the development of a device that has a blocking function that allows the mouth to be opened while wearing the device and has a function that solves sleep apnea by inducing airway expansion during sleep.

• Safety and Health at Work
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• v.5 no.2
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• pp.73-79
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• 2014

Background: The aim of this study was to investigate the burden experienced by nursing personnel working irregular shifts in Greece and to conduct the first test of a Greek version of the Standard Shiftwork Index (SSI). Methods: A cross-sectional survey was carried out. The SSI was completed by 365 nurses and nursing assistants working shifts, including nights. Results: Female nursing personnel and those suffering from a chronic disease were most affected by working rotating shifts as they had elevated scores on the majority of the SSI scales, such as sleep, chronic fatigue, digestive and cardiovascular problems, general health questionnaire, cognitive and somatic anxiety, shift time satisfaction, engagement and disengagement strategies, languidity, flexibility, and neurotisicm. Nurses with longer working experience and those with family responsibilities also scored higher on some of the SSI scales, such as the sleep, shift time satisfaction, social and domestic disruption, disengagement strategies, morningness, and languidity scales. Conclusion: Shiftwork affects female nurses, those with chronic disease, older age, and domestic responsibilities more severely. Therefore management should take these factors into account when designing work schedules to alleviate the burden caused by shiftwork.

• Journal of the Korean society of biological therapies in psychiatry
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• v.24 no.3
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• pp.142-155
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• 2018

Insomnia in patients with hematopoietic stem cell transplantation(HSCT) has been underdiagnosed and undertreated. This study reviewed the frequency, characteristics, physical and psychological effects, and treatments of insomnia in HSCT patients to highlight clinical importance in this specialized population. Furthermore, the authors intended to suggest a model that would conceptualize insomnia in the context of HSCT. In the pre-transplant period, about half of patients with HSCT suffered from sleep disturbance. A substantial number of patients experienced distressing insomnia during the HSCT procedure and recovered to the level of the pre-transplant period. However, sleep disruption could be a chronic symptom in HSCT survivors and could negatively impact quality of control, cancer-related fatigue(CRF), immune function, and psychological distress. The 3P's model(Predisposing, Precipitating, Perpetuating) explains insomnia in cancer population and could be also relevant to HSCT patients with specific consideration of CRF, graft-versus-host diseases, specific properties of hematological disease, and protective isolated milieu. Effective treatment of insomnia in HSCT includes non-pharmacological(e.g., cognitive behavioral therapy, environmental modification) and pharmacological interventions. The decision of pharmacological treatment should be based on the issue of safety due to high risk of potential drug-drug interactions. Screening, treatment, and further research of insomnia in HSCT patients using validated subjective and/or objective measures are warranted.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.3
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• pp.182-191
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• 2011

Objectives: The aim of this study was to investigate the sleep patterns of South Korean elementary school children and whether the differences in sleep patterns were related to behavior, emotional problems, attention and academic performance. Method: This study included a community sample of 268 boys and girls from fourth-, fifth- and sixth-grade classes in a South Korean metropolitan city from November to December 2010. The primary caregivers completed a questionnaire that included information on demographic characteristics, as well as the Child's Sleep Habit Questionnaire (CSHQ), the Korean version of Child Behavior Checklist (K-CBCL), the Korean version of the Learning Disability Evaluation Scale (K-LDES), the Korean version of ADHD Rating Scale (K-ARS) and the Disruptive Behavior Disorder Scale (DBDS). We conducted analyses on the CSHQ individual items, between the subscales, on the total scores and on the K-CBCL, the K-LEDS, the K-ARS and the DBDS. Results: Based on the findings from the CHSQ, the subjects had significantly higher scores for bedtime resistance ($9.18{\pm}2.17$), delayed sleep onset ($1.32{\pm}0.62$), the sleep duration ($4.19{\pm}1.52$) and daytime sleepiness ($14.10{\pm}3.55$) than the scores from the previous reports on children from western countries. The total CHSQ score showed positive correlations to all subscales of the K-CBCL : withdrawn (r=0.24, p<.005), somatic complaint (r=0.24, p<.005) and anxious/depressive (r=0.38, p<.005). Bedtime resistance was associated with oppositional defiant disorder (r=0.15, p<.05) and a positive correlation was demonstrated between sleep anxiety and the oppositional defiant disorder score (r=0.13, p<.05), night waking and the conduct disorder score (r=0.16, p<.05). Delayed sleep onset was related with low performance on the K-LDES with respect to thinking (r=-0.17, p<.05) and mathematical calculation (r=-0.17, p<.05). Conclusion: The results of this study reconfirm Korean children's problematic sleep patterns. Taken together the results provide that the reduced sleep duration and disruption of sleep pattern can have a significant impact on emotion, behavior, performance of learning in children. Further studies concerning more diverse psychosocial factors affecting sleep pattern will be helpful to understanding of the sleep health in Korean children.

• 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 Adult Nursing
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• v.15 no.4
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• pp.617-627
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• 2003

Purpose: The purpose of this study is to investigate fatigue and its related factors in cancer patients receiving radiotherapy. Method: The subjects of this study consisted of 98 patients receiving radiotherapy. Subjects were recruited from C University Hospital radiation oncology unit located in Gwangju from March to May, 2001. Questionnaire and medical records were used for data collection. The obtained data was analyzed using SAS program that included descriptive statistics, t-test, ANOVA, Post-hoc test(Fisher's LSD) and Pearson's correlation coefficients. Result: The fatigue perceived by the subjects was middle level ($5.59{\pm}1.59$) and 72.4% of them reported greater than 5 points. The subjects in no religion, low income, and spouse caregiver groups experienced the higher fatigue than another groups, respectively. The subjects in nasopharyngeal cancer, head & neck radiation site, and analgesics medication groups did, experience fatigue as well. The fatigue not only positively correlated with symptom distress, disruption of usual activity, sleep dissatisfaction, and mood state, but also negatively with less family support. Conclusion: Cancer patients receiving radiotherapy experience the middle level of fatigue and it correlates with the multi-dimensional factors. However, further research is needed to identify the changes in fatigue over the radiotherapy period through longitudinal design and to develop nursing intervention for fatigue decrease.