• Sleep Medicine and Psychophysiology
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• v.16 no.2
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• pp.65-73
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• 2009

Objectives: The purpose of this study was to assess the clinical and polysomnographic characteristics of Korean patients with obstructive sleep apnea syndrome (OSAS), especially in relation to differences due to age and gender. Methods: All subjects were consecutive patients who were proven to have OSAS with nocturnal polysomnography. They were interviewed with a structured interview format including sociodemographic information, past medical history, medication, and sleep-related history. Simultaneously, they were also given Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) to answer in order to check subjective sleep quality and subjective sleepiness. Results: Mean age of the 308 subjects was $49.5{\pm}$13.3 years, with 77.6% of the subjects being males and 22.4% of the subjects being females. The aging effects on the sleep architecture in Korean OSAS corresponded with normal aging, but with the effect of OSAS itself superimposed, the extent of aging effects was more marked than that of normal aging. The severity of Korean patients of OSAS was not correlated with age. When divided into age subgroups, significant correlation was found between RDI and BMI in patients of each subgroup of those in the 4th to 7th decades. The oldest subgroup (>70 years) described their subjective sleep quality as poorer than any other age subgroups, despite of less subjective drowsiness. The severity of OSAS and the change of sleep architecture of male subjects turned out to be severer than those of female ones. The female/male ratio of the subjects tended to increase with aging. Conclusions: The aging effect on the sleep architecture in Korean OSAS seems to be a mixture of the changes by normal aging and sleep disorder per se. The severity of OSAS was not correlated with age, but highly correlated with BMI. The severity of OSAS and the change of sleep architecture of male patients were severer than those of female ones.

• Korean Journal of Occupational Health Nursing
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• v.7 no.2
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• pp.177-185
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• 1998

The purposes of this study were to investigate the effects of farming in greenhouses with respect to subjective fatigue symptoms among farmers and the degree of symptoms. The study compared 176 green-house farmers with 216 open field farmers using a subjective fatigue symptoms rating scale developed by the Industrial Research Institute of Fatigue, Japanese Association for industrial Hygiene. 1. With respect to complaint rates of the subjective fatigue symptoms, the results indicated that greenhouse farmers have, in order of severity, high degrees of low back pain, difficulty in collecting thoughts, and apt to forget. 2. With respect to cumulative scores of fatigue symptoms, the results indicated that both groups of farmers exhibited a lack of attentiveness and a high degree of dullness and sleepiness(category I), body projection of fatigue(category II), and difficulty in concentration(category III). 3. With respect to general characteristics, it was found that the degrees of subjective fatigue symptoms were found to be higher among females, people with lower educational levels, and the elderly, regardless of the group. 4. With respect to work related factors, farmers with more years of experiences were found to have higher degrees of subjective fatigue symptoms, except for open field farmers with less than nine years experience. Both groups of farmers were found to have high degrees of subjective fatigue symptoms when working less than eight hours a day and less than six months a year. 5. With respect to health habits, for people who get less than eight hours of sleep per day exhibited higher fatigue scores than people who get more than eight hours. People who do not smoke and drink also exhibited higher fatigue scores than people who smoke and drink. 6. The results of multiple regression showed that the risk factors related to the subjective fatigue symptoms of farmers in the greenhouse group were ages, levels of education, sex and for the comparison group, were sex. years of farming, and hours of sleep. The R-square were 12.5% in the greenhouse group and 12.1% in the comparison son group. The differences between the greenhouse and open field farmers in the degrees of fatigue symptoms were found not to be statistically significant even if the working conditions of the greenhouse farmers were poor. This may be attributed to non-work related factors, i.e., social, economical, and psychological factors among greenhouse farmers.

• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.76-82
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• 2006

Background : The objective of this study was to understand sleep-related problems, and to determine whether the sleep questionnaires is a clinically useful method in patients who need polysomnography. Methods : Subjects were patients who performed polysomnography and who asked to answer a sleep questionnaires at the Sleep Disorders Clinic of St. Paul's Hospital, Catholic University of Korea. Baseline characteristics, past medical illness, behaviors during sleep-wake cycle, snoring, sleep-disordered breathing and symptoms of daytime sleepiness were analyzed to compare with data of polysomnography. Results : The study population included 1081 patients(849 men, 232 female), and their mean age was $44.2{\pm}12.8years$. Among these patients, 38.9% had an apnea-hypopnea index(AHI)<5, 27.9% had $5{\leq}AHI<20$, 13.2% had $20{\leq}AHI<40$, and 20.0% had $40{\leq}AHI$. The main problems for visiting our clinic were snoring(91.7%), sleep apnea(74.5%), excessive daytime sleepiness(8.0%), insomnia(4.3%), bruxism(1.1%) and attention deficit(0.5%). The mean value of frequency of interruptions of sleep was 1.6 and the most common reason was urination(46.3%). Epworth Sleepiness Scale(ESS) had a weak correlation with AHI(r=0.209, p<0.01). When we performed analysis of sleep questionnaires, there were significant differences in the mean values of AHI according to the severity of symptoms including snoring, daytime sleepiness, taking a nap and arousal state after wake(p<0.05). Conclusion : On the basis of statistical analysis of sleep questionnaires, the severity of subjective symptoms such as ESS, snoring, daytime sleepiness and arousal state after wake correlated with the AHI significantly. Therefore the sleep questionnaires can be useful instruments for prediction of the severity of sleep disorder, especially sleep-disordered breathing.

• Proceedings of the Korean Society for Emotion and Sensibility Conference
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• 2002.05a
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• pp.139-143
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• 2002

운전자가 고속도로와 시내도로에서 3시간 동안 주행했을 때 주관적인 운전 피로감 및 졸림감, 신체적인 불편도를 주관적 평가지를 이용하여 측정하였다. 실험결과 운전 피로감은 모든 주행조건에서 운전시간이 경과됨에 따라 유의하게 증가하였고 졸림감은 고속도로 주행시 운전시간에 따라 유의하게 증가하였으며 시내 주행에서 고속도로 주행보다 더 많은 신체부위에서 불편도가 높았다. 따라서 운전 피로는 운전시간에 따라 증가하고 고속도로에서는 졸음, 시내주행에서는 신체적인 불편으로 인한 피로가 증가함을 알 수 있었다.

• 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.

• Journal of environmental and Sanitary engineering
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• v.22 no.2
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• pp.1-8
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• 2007

This research is based on self-filling survey which 656 dental hygienists who work in, seoul, the metropolitan area, jeon-buk area participated on July 2006 through August 2006. This survey was analyzed the relationship between the subjective symptoms(6 types) and outdoor air quality($O_3,\;NO_2,\;CO,\;SO_2,\;PM_{10}$) As follows analyzed results. The health condition of dental hygienists were "Feel Good" more than 50% in last month. The experience the symptoms level is higher then non-experience level in "Dry eye, itch, smarting", "Headaches", "Fatigue and sleepiness", "Red eye", "Hypersensitivity", "Dorsalgia, omarthralgia, cervicodynia". We anticipated that the more experience the subjective symptom the more likely it is that outdoor air quality will be high rate level. But we could not find the uniformity in metropolitan-area and seoul-area. In the case of jeonbuk area, the group's pollution density levels which experienced the subjective symptom were appeared high rate than inexperienced group except $SO_2$. It probably comes from sensibility for an air pollution in this area. Dental hygienists who work in jeonbuk area have an unusual sensibility for an air pollution because outdoor air quality of jeonbuk area was rule good rather than others area. especially $SO_2$ was revealed out even though low rate level in inexperienced group it is that the number of cars in jeonbuk area is increasing rapidly.

• Journal of the Korean Society of School Health
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• v.16 no.1
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• pp.9-21
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• 2003

The present study was designed to evaluate the factors influential on stress and subjective fatigue symptoms based on school life environments and daily life styles among high school students. The self-administered questionnaires were delivered to 2,381 high school students of both sexes in Taejon Metropolitan city during the period from Mar. 1st to Jun. 30th, 2000. The analysis of study results revealed the following findings: 1. According to the magnitude of stress, the normal subjects were 3.1%, the groups with potential stress were 64.7%, and the groups at high risk for stress were 32.2%. Higher level of stress existed in the female than the male students, and in the third grader than the 1st and 2nd graders. According to the classification of typical constitutional symptoms of fatigue, category III (group with bodily projection of fatigue) was the most frequent and it was followed by category II (group with difficulty in concentration) and category I (group with dullness and sleepiness) in a decreasing order of frequency, which showed that the predominant pattern of fatigue arose from the body parts. 2. With regard to the school life characteristics and stress scores, the higher scores of stress were shown in the groups with the lower grades, with worse friend's relation and with the lower satisfaction with the school life. The scores for the subjective fatigue symptoms were higher in the male, in the low graders, in the better friend's relation, and in the satisfactory group than the respective counterparts. 3. Concerning home life characteristics, the higher scores of stress were associated with the students characterized by the recognized poor economic conditions, lower interests of parents, lack of satisfaction with the home life, the poor subjective health status. On the other hand, the scores for the subjective fatigue symptoms were higher in the student groups with good economic conditions, higher interests of parents, presence of satisfaction with the home life, and good subjective health status. 4. Concerning daily life styles, the higher scores of stress were in the students who had inappropriate sleep hours, skipped breakfasts, daily consumption of intermeal snacks, lack of exercise, daily smoking, normal indices of obesity, and lower indices of health habit. Conversely, the scores of subjective fatigue symptoms were higher in the groups who had daily breakfasts, no intermeal snacks, daily exercise, no smoking than their counterparts. 5. The factors exerting influence upon the stress included the satisfaction with school life, friend's relation, satisfaction with the home life, exercise, school grades, interests of parents, school year, sex, scores of health habit, degree of obesity, economic conditions of home. Those influencing on the degree os stress included stress, intermeal snacks, smoking, friend's relation and satisfaction with the home life.

• Sleep Medicine and Psychophysiology
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• v.9 no.2
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• pp.122-126
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• 2002

Objectives: The purpose of this study is to investigate the effects of the 37-hour sleep deprivation on visual discrimination using the Cybernetic Flicker Fusion Analyzer (FLIMK) and to see the correlation between this finding and various subjective scale scores. Methods: Twenty six subjects (20 men 6 women, $24.50{\pm}1.45$ years of age) participated in this study. Subjects remained awake for 37 hours under continuous surveillance. In the morning and evening of two study days, the FLIMK and the self-reporting scale of sleepiness, fatigue, anxiety and mood states were instituted. Results: In FLIMK, the flicker fusion threshold was significantly decreased after sleep deprivation (F=7.66, p=0.01). The number of trials (responses) before reaching fusion frequency threshold was significantly increased after sleep deprivation (F=13.16, p=0.001). The reduction of fusion frequency was correlated with the increase of sleepiness and fatigue (p<0.05), and the number of the trials was correlated with the scores of negative mood, anxiety, and fatigue (p<0.05). Conclusions: These results suggest that 37 hour total sleep deprivation cause the decrement in visual discrimination. The decrease of the fusion frequency after sleep deprivation was correlated with sleepiness and fatigue. Further study is needed to enlighten the biological mechanism of the decrement in visual function after sleep deprivation.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.277-287
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• 1996

Objective : It has been proposed that cognition and related aspects of mental functioning are decreased in depression as well as in alcoholism. The objective of the study was to compare behavioral side effects of paroxetine and amitriptyline in depressed patients accompanied by alcoholism. The focused comparisons were drug effects concerning psychomotor performance, cognitive function, sleep and daytime sleepiness during the first 2 weeks of treatment. Methods : After an alcohol detoxification period(3 weeks) and a washout period(1 week), a total of 20 male inpatients with alcohol use disorder (DSM-IV), who also had a major depressive episode(DSM-IV), were treated double-blind with paroxetine 20mg/day(n=10) or amitriptyline 25mg/day(n=10) for 2 weeks. All patients were required to have a scare of at least 18 respectively on bath the Hamilton Rating Scale far Depression(HAM-D) and Beck Depression Inventory(BDI) at pre-drug baseline. Patients randomized to paroxetine received active medication in the morning and placebo in the evening whereas those randomized to amitriptyline received active medication in the evening and placebo in the morning. All patients performed the various tasks in a test battery at baseline and at days 3, 7 and 14. The test battery included : critical flicker fusion threshold for sensory information processing capacity : choice reaction time for gross psychomotor performance : tracking accuracy and latency of response to peripheral stimulus as a measure of line sensorimotor co-ordination and divided attention : digit symbol substitution as a measure of sustained attention and concentration. To rate perceived sleep and daytime sleepiness, 10cm line Visual analogue scales were employed at baseline and at days 3, 7 and 14. The subjective rating scales were adapted far this study from Leeds sleep Evaluation Questionnaire and Epworth Sleepiness Scale. In addition a comprehensive side effect assessment, using the UKU side effect rating scale, was carried out at baseline and at days 7 and 14. The efficacy of treatment was evaluated using HAM-D, BDI and clinical global impression far severity and improvement at days 7 and 14. Results : The pattern of results indicated thai paroxetine improved performance an mast of the lest variables and also improved sleep with no effect on daytime sleepiness aver the study period. In contrast, amitriptyline produced disruption of performance on same tests and improved sleep with increased daytime sleepiness in particular at day 3. On the UKU side effect rating scale, mare side effects were registered an amitriptyline. The therapeutic efficacy was observed in favor of paroxetine early in day 7. Conclusion : These results demonstrated thai paroxetine in much better than amitriptyline for the treatment of depressed patients accompained by alcoholism at least in terms of behavioral safety and tolerability, furthermore the results may assist in explaining the therapeutic outcome of paroxetine. For example, and earlier onset of antidepressant action of paroxetine may be caused by early improved cognitive function or by contributing to good compliance with treatment.

• Journal of the Korean Society of School Health
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• v.10 no.2
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• pp.169-178
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• 1997

In order to investigate the complaint rates of subjective fatigue symptoms and study the relationship between them and body type, health awareness in middle school students, we carried out a survey of 1,209 students (654 boy students and 555 girl students) at a middle school in Taejon City by a self-recorded questionnaire. The survey was conducted in June, 1997. The results obtained were as follows: 1. Among complaints of fatigue, "feel like lying down" was the highest, followed by "feel anxious about things", "feel drowsy", "yawning a lot", "eye strain" and "whole body feels tired" in descending order. 2. In the average weighted score of fatigue complaint, dullness and sleepiness (I) was the highest, followed by a difficulty in concentration (II) and bodily projection of fatigue (III) in descending order. Fatigue seems to create mental stress rather than physical burdens. 3. In the classification of body type based on the $R\ddot{o}hrer$ index, the obesity type (145 and above) was 11.0%, standard type (110~144) was 64.7% and leptosomic type (l09 and below) was 24.3%. Comparison between both sexes revealed that the rate of obesity and leptosomic types were significantly higher in boy students than in girl students. 4. In terms body type awareness, the statistics are the following: those who consider themselves to be standard type, 44.3%, slightly obese 24.5%, leptosomic, 23.5% and obese 7.8%. However, the level of obesity awareness was significantly higher in girl students than in boy students. 5. As for health awareness, 36.5% considered themselves healthy, 5.4% generally healthy and 10.1% a little unhealthy, but the level of unhealthy awareness was higher in girl students than in boy students. 6. In the relationship between body type and health awareness, most students thought that they were obese in spite of their standard body type. Also, many students who were obese and leptosomic tended to consider themselves to be a little unhealthy. 7. The more the students were obese or felt unhealthy, the more the average weighted score of fatigue complaints was high.