• Journal of Korean Biological Nursing Science
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• v.11 no.1
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• pp.23-31
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• 2009

Purpose: The purpose of the present study was to investigate the prevalence and related factors of sleep-wake disturbance (SWD) in Korean post-stroke patients. This study was the first to address post-stroke SWD in Korea using a structured questionnaire. Method: We investigated the prevalence of SWD and related factors including lesion location, stroke severity, presence of depression and fatigue. We assessed sleep-wake pattern including quality of sleep, sleep latency, wake episodes, wake time after sleep onset, daytime sleep episode and sleep time at daytime. Ninety stroke patients admitted to a university affiliated hospital in Seoul between the period September 2008 and January 2009 were included in the study. Result: Thirty five patients (38.9%) complained insomnia and 32 (35.6%) complained excessive daytime sleepiness (EDS). Quality of sleep (p=.000), sleep latency (p=.000) and total sleep time (p=.001) were significantly poorer in 16 patients with both insomnia and EDS than in the others. The related factors to insomnia were level of education (p=.030), depression (p=.007) and fatigue (p=.034), though related factors to EDS were stroke onset time (p=.049), stroke severity (p=.005), motor dysfunction (p=.035), dysphasia (p=.018), fatigue (p=.001) and lesion location (p=.019). Conclusion: Sleep-wake disturbance is a common problem in Korean stroke patients. Strategies to improve quality of sleep are urgently needed in the post-stroke patients.

• Sleep Medicine and Psychophysiology
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• v.23 no.1
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• pp.10-15
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• 2016

Since its development in the early 70s, actigraphy has been widely used in sleep research and clinical sleep medicine as an assessment tool of sleep and sleep-wake cycles. The validation and reliability of actigraphic measures have been reasonably examined in healthy normal individuals with good sleep patterns. Recent literature suggests that the use of actigraphy could be further extended to monitor insomnia and circadian sleep-wake disturbances, and detect sleep changes associated with drug treatments and non-pharmacologic interventions, although it is generally recommended to use complementary assessments such as sleep diaries and overnight polysomnography when possible. The development of actigraphy includes its improved hardware sensors for better detection of movements and advanced algorithms to score sleep and wake epochs. In this paper, we briefly review the quantitative analysis methods of actigraphy and its potential applications in sleep research.

• Animal cells and systems
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• v.6 no.3
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• pp.239-245
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• 2002

Plasma melatonin, thyroid-stimulating hormone (TSH) and body temperature were measured simultaneously and continuously before and after the sleep-wake cycle was shifted in 4 healthy males and changes in the circadian rhythm itself and in the phase relationship among these circadian rhythms were determined. Normal sleep-wake cycle (sleep hours: 2300-0700) was delayed by 10 h (sleep hours: 0900-1700) during the experiment. Even after this shift the typical melatonin rhythm was maintained: low during daytime and high during night. The melatonin rhythm was gradually delayed day by day. The TSH rhythm was also maintained fundamentally during 3 consecutive days of altered sleep-wake cycle. The phase was also delayed gradually but remarkably. The daily rhythm of body temperature was changed by the alteration of sleep-wake cycle. The body temperature began to decrease at the similar clock time as in the control but the decline during night awake period was less steep and the lowered body temperature persisted during sleep. The hormonal profiles during the days of shifted sleep/wake cycle suggest that plasma melatonin and TSH rhythms are basically regulated by an endogenous biological clock. The parallel phase shift of melatonin and TSH upon the change in sleep-wake cycle suggests that a common unitary pacemaker probably regulates these two rhythms. The reversal phase relationship between body temperature and melatonin suggests that melatonin may have a hypothermic effect on body temperature. The altered body temperature rhythm suggests that the awake status during night may inhibit the circadian decrease in body temperature and that sleep sustains the lowered body temperature. It is probable but uncertain that there ave causal relationships among sleep, melatonin, TSH, and body temperature.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.18-31
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• 1996

Jet-lag can be defined as the cumulative physiological and psychological effects of rapid air travel across multiple time zones. Many reports have suggested that age-related changes in sleep reflect fundamental changes in the circadian system and in significant declines in slow wave sleep. Jet lag is a dramatic situation in which the changes of the phase of circadian process and homeostatic process of sleep occur. Thus the authors evaluatead the changes of sleep-wake cycle from jet lag by age. Thirty-eight healthy travellers were studied for 3 days before and 7 days after jet-flights across seven to ten time zone. They were aged 19-70, They trareled eastbound, Seoul to North America (USA, Canada). Sleep onset time, wake-up time, sleep latency, awakening frequency on night sleep, awakening duration on night sleep, sleepiness at wake-up and nap length were evaluated. Our results suggest that by the 7 to 10 time zone shift, the old age group was significantly influenced in sleep-wake cycles. The date on which subjective physical condition was recovered was $6.23{\pm}83$ day after arrivals for old age group, while for young and middle age group, $4.46{\pm}1.50$ day and $4.83{\pm}1.52$ day, respectively. In old age group, sleep onset time was later than baselines and could not recover untill 7th day. But in other groups, the recovery was within 5th day. Nap dura fion was longer in old age group through jet lag than younger age group. In other parameters, there was no definite difference among three age groups. Our results suggested that the old age was significantly influenced by the disharmony between internal body clock and sleep-wake cycle needed at the travel site. Thus we proved that recovery ability from jet lag was age-dependent as well as travelling direction-dependent. To demonstrate more definite evidence, EEG monitoring and staging of sleep were funthun encouraged.

• Sleep Medicine and Psychophysiology
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• v.9 no.2
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• pp.81-85
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• 2002

There are several factors which are more likely to have sleep disorders in fertile women with menstruation than adult men. Menstrual cycle plays an important role in them. We describe herein the overview about the association of menstrual cycle and sleep disorders by viewing the interactions of menstrual cycle and circadian rhythm. We review how menstrual cycle affects sleep-wake cycle by reviewing menstrual cycle and estrous cycle to understand these interactions. Menstrual cycle and estrous cycle are mainly affected by hormonal cycle and light-dark cycle, respectively and they are generally determined in monthly rhythm and annual rhythm, respectively. The determination of estrous cycle is also affected by cyclic changes of hormones besides light-dark cycle. Although sleep-wake cycle almost alternates according to estrous cycle in non-primate mammals, it is hardly affected by menstrual cycle in primate mammals as compared with estrous cycle. But menstrual cycle affects sleep-wake cycle via desynchronization of sleep-wake cycle and temperature rhythm. The decrease of amplitude and phasic change during luteal phase in the daily fluctuation of body core temperature can partially contribute to the induction of sleep disorders in fertile women. In addition to this, premenstrual syndrome which nearly happens during luteal phase commonly have sleep problems. Therefore, we suggest that menstrual cycle and PMS can partially contribute the increase of sleep disorders in fertile women.

• Sleep Medicine and Psychophysiology
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• v.2 no.2
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• pp.146-155
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• 1995

Jet lag can be defined as the cumulative physiological and psychological effects of rapid air travel across multiple time zone. The consequences of jet lag include fatigue, general malaise, sleep disturbances, and reductions of cognitive and psychomotor performance, all of which have been documented in experimental biological and air crew personnel studies. Thus authors tried to study the jet lag of natural travellers by modified self reporting sleep log. Total 61 healthy travellers was studied for 3 days before and 7 days after jet-flights across seven to ten time zone. The eastbound travelling group was 38 persons, aged 19 -70 and westbound travelling group was 23 persons, aged 13 - 69. Sleep onset time, wake-up time, sleep latency, awakening frequency on night sleep, awakening duration on night sleep, sleepiness at wake-up and nap length were evaluated. Our results suggested that the 7 to 10 time zone shift gave significant influence to traveller's sleep-wake cycles. The date which subjective physical condition was recovered on was $5.16{\pm}1.50$ day after arrivals for eastbound, while for westbound, $4.91{\pm}1.62$ day. In eastbound travelling, sleep onset time became later than baselines and could not recover until 7th day. But in westbound, it became earlier than baseline and could recover until 6th day. The mean score of 24-hour sleepiness was greater in eastboumd than westbound. Therefore the eastbound travelling caused more sleep-wake cycle disturbance and daytime dysfunction than westbound travelling. In other parameters, there was no definite difference between east and westbound. From our results, it was suggested that the symptom severity of jet lag was dependent on the travelling direction. To demonstrate more definite evidence, large sized data collections and comparision by age difference were needed.

• Sleep Medicine and Psychophysiology
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• v.16 no.1
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• pp.5-9
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• 2009

Relatively little is known about the neurobiology of insomnia, despite its wide prevalence and broad medical impact. Although much is still to be learned about the pathophysiology of the disorder, identification, systematic assessment, and appropriate treatment are clearly beneficial to patients. Recent research, using quantitative EEG, polysomnography (PSG), multiple sleep latency test (MSLT) and neuroimaging techniques, suggests that some broad areas can be identified as possible pathophysiological models. Sleep-wake homeostat model hypothesizes a failure in homeostatic regulation of sleep, an attenuated increase in sleep drive with time awake, and/or defective sensing of sleep need. Circadian clock model hypothesizes a dysfunctional circadian clock, resulting in changes in the timing of sleep-wake propensity that are incompatible with normal sleep. Intrinsic sleep-wake state mechanism model suggests that abnormal function of insomnia comprises the systems responsible for expression of the sleep states themselves. Extrinsic over-ride mechanism (stress-response) model suggests that insomnia reflects the consequences of overactivity of one of the systems considered "extrinsic" to normal sleep-wake control. Many current therapies for insomnia are based on these physiological models. Several attempts have been made to create a physiological model that would explain this disorder and could be used as a foundation for treatment. However, it appeared that no model can fully explain and clarify all aspects of insomnia. Future research should be necessary to expand our knowledge on the biological dimensions of insomnia.

• Journal of the Korean Society of School Health
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• v.30 no.3
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• pp.317-324
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• 2017

Purpose: Breakfast is the most important meal to provide energy for the day. Breakfast is especially important to give enough nutritional support to children and adolescents for their physical growth and sexual development. Sleep-related factors like average sleep duration and wake up time would mostly be associated with regular breakfast. This study aimed to investigate the effect of sleep on regular breakfast consumption in Korean adolescents. Methods: The study used the data from the 12th Korea Youth Risk Behavior Web-based Survey (KYRBS-XII) conducted in 2016 by the Korea Centers for Disease Control and Prevention. The data of 62,820 subjects (middle/high school students) were included in the final analysis. The study examined the factors related to regular breakfast, focusing on weekday average sleep duration and wake up time of middle school students and high school students, respectively. Results: Regular breakfast consumption was shown to have a statistically significant association with high economic status, nutritional education, weekday average sleep duration, wake up time, and subjective sleep satisfaction in the multivariate logistic regression. Regardless of the school level, regular breakfast consumption was significantly associated with early wake up time. As to the effect of weekday average sleep duration on regular breakfast consumption, it showed some different results depending on the school level. Conclusion: Regular breakfast consumption of Korean adolescents was related to weekday average sleep duration and wake up time. Having breakfast regularly was affected by both adequate weekday average sleep duration and early wake up time.

• Journal of mucopolysaccharidosis and rare diseases
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• v.1 no.2
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• pp.35-39
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• 2015

Sleep problems occur frequently among patients with Prader-Willi syndrome (PWS). The most common problem is excessive daytime sleepiness (EDS) that are closely related to of sleep-related breathing disorder (SRBD) such as obstructive sleep apnea (OSA) and congenital hypoventilation syndrome. Obesity, craniofacial dysmorphism and muscular hypotonia of patients with PWS may increase the risk of SRBD. Sleep apneas can interrupt the continuity of sleep, and these disruptions result in a decrease in both the quality and quantity of sleep. In addition to SRBD, other sleep disorders have been reported, such as hypersomnia, a primary abnormality of the rapid eye movement (REM) sleep and narcolepsy traits at sleep onset REM sleep. Patients with PWS have intrinsic abnormalities of sleep-wake cycles due to hypothalamic dysfunction. The treatment of EDS and other sleep disorders in PWS are similar to standard treatments. Correction of sleep hygiene such as sufficient amount of sleep, maintenance of regular sleep-wake rhythm, and planned naps are important. After comprehensive evaluation of sleep disturbances, CPAP or surgery should be recommended for treatment of SRBD. Remaining EDS or narcolepsy-like syndrome are controlled by stimulant medication. Bright light therapy might be beneficial for disturbed circadian sleep-wake rhythm caused by hypothalamic dysfunction.

• Journal of Ginseng Research
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• v.32 no.3
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• pp.220-225
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• 2008

The present investigation was performed to evaluate the homeostatic regulation of sleep architecture by the ethanol extract of Korea red ginseng (KRG), since the available data were often controversial. In addition, it was also interested in whether the sleep-wake stages were differently affected by low and high doses of KRG. Each adult Wistar male rat was implanted with a transmitter for recording EEG and activity via telemetry. After one week of surgery, polygraphic signs of undisturbed sleep-wake activities were recorded for 12 h (between 9:00 am and 9:00 pm) after KRG administration. KRG (10 and 100 mg/kg) increased non-rapid eye movement (NREM) sleep as well as total sleep. The total percentages of wakefulness were decreased comparably. KRG (10 mg/kg) decreased the power density of the ${\delta}-wave$ (0.75-4.5 Hz) and increased ${\alpha}-wave$ (8.0-13.0 Hz) in the NREM and rapid eye movement (REM) sleep. KRG also decreased ${\delta}-wave$ power density in wake time. However, KRG (100 mg/kg) increased ${\delta}-wave$ and decreased ${\theta}-wave$ (5.0-9.0 Hz) power density in wake time, while showed little effect on the power density in NREM and REM sleep. In conclusion, low and high doses of KRG increase spontaneous sleep and NREM sleep and differently regulate the EEG spectra in REM and NREM sleep.