• Sleep Medicine and Psychophysiology
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• v.29 no.2
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• pp.40-44
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• 2022

Bipolar disorders are a group of mood disorders characterised by relapsing mood episodes throughout the course of illness. Patients with bipolar disorders commonly present with various sleep problems. Patients in a manic episode generally show decreased need of sleep and those in a depressed episode frequently complain about hypersomnia. Current literature even points to evidence that patients with bipolar disorder in euthymic state may still show signs of sleep disturbances when compared to the general population. Clinicians may also note intricate interactions between changes of circadian rhythm and evolution of mood episodes in patients with bipolar disorder. Also, commonly prescribed medications which plays a crucial role in treatment of bipolar disorders including mood stabilisers and antipsychotic medications often cause significant weight gain over time. Being a risk factor of sleep apnoea, weight gain can predispose the patient to develop sleep apnoea. In this narrative review, we summarised current evidence and literature regarding characteristics of circadian rhythm and comorbid sleep apnoea in patients with bipolar disorder. We also present literature regarding implications of circadian disturbance and comorbid sleep apnoea in managing patients with bipolar disorder.

• Journal of Korean Biological Nursing Science
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• v.16 no.4
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• pp.309-317
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• 2014

Purpose: The purpose of this study was to understand sleep circadian rhythm and sleep quality between normal-weight and obese group according to Body Mass Index to develop education and nursing intervention programs for the obese. Methods: This study involved 186 subjects who visited at S hospital obesity clinic, K province. They were divided into 2 groups: normal-weight group 91 and obese group 95. Data were collected from October 18th to November 12th in 2013. Data were analyzed with frequency, percentage, ${\chi}^2$-test, Mann-Whitney U test, ANCOVA, t-test and ANOVA with using SPSS version 20.0. Results: The results showed that morning type 1.1%, middle type 91.2% and evening type 7.7% of sleep circadian rhythm in normal-weight group and middle type 92.6% and evening type 7.4% of sleep circadian rhythm in obese group. There were statistically significant results on sleep quality with covariance sex and stress, sleep duration, habitual sleep efficiency and sleep disturbance between normal-weight and obese group. There were statistically significant results on sleep quality, sleep duration, habitual sleep efficiency and sleep disturbance in middle type of sleep circadian rhythm between normal-weight and obese group. Conclusion: Therefore, it is necessary to consider subject's sleep pattern to develop education and nursing intervention programs for the obese.

• Journal of Veterinary Clinics
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• v.27 no.4
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• pp.440-444
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• 2010

A 7-year-old neutered male Shih Tzu dog weighing 5.2 kg was presented because of severe neurological signs (paddling, unconsciousness, blindness, seizure). ECG revealed accelerated idioventricular rhythm (AIVR) with ~140 bpm ventricular rate. Based on magnetic resonance imaging (MRI) study and cerebrospinal fluid (CSF) analysis, the neurological condition was tentatively diagnosed as disseminated granulomatous meningoencephalomyelitis (GME). The neurological signs were managed with steroids, anticonvulsive drugs, diuretics and antibiotics with 20% mannitol infusion. The rhythm disturbance (AIVR) was managed with oral medication of mexiletine. Because the heart rhythms were unstable without anti-arrhythmic therapy in spite of improvement of clinical signs after emergency treatment for neurological problems, the anti-arrhythmic therapy was maintained till the neurological signs were abolished.

• Childhood Kidney Diseases
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• v.16 no.1
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• pp.1-8
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• 2012

Nocturnal polyuria is one of the main pathogenic mechanisms of enuresis. Disturbance of circadian rhythm of antidiuretic hormone (ADH or AVP), hypercalciuria, and/or solute diuresis are considered to cause nocturnal polyuria, which in turn causes enuresis in patients with relatively small bladder capacity and high threshold for awakening. Evaluation of these factors would guide the therapeutic approach for enuresis.

• Clinical and Experimental Pediatrics
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• v.53 no.6
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• pp.680-687
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• 2010

Patients with congenital heart diseases (CHD) are confronted with early- and late-onset complications, such as conduction disorders, arrhythmias, myocardial dysfunction, altered coronary flow, and ischemia, throughout their lifetime despite successful hemodynamic and/or anatomical correction. Rhythm disturbance is a well-known and increasingly frequent cause of morbidity and mortality in patients with CHD. Predisposing factors to rhythm disturbances include underlying cardiac defects, hemodynamic changes as part of the natural history, surgical repair and related scarring, and residual hemodynamic abnormalities. Acquired factors such as aging, hypertension, diabetes, obesity, and others may also contribute to arrhythmogenesis in CHD. The first step in evaluating arrhythmias in CHD is to understand the complex anatomy and to find predisposing factors and hemodynamic abnormalities. A practical stepwise approach can lead to diagnosis and prompt appropriate interventions. Electrophysiological assessment and management should be done with integrated care of the underlying heart defects and hemodynamic abnormalities. Catheter ablation and arrhythmia surgery have been increasingly applied, showing increasing success rates with technological advancement despite complicated arrhythmia circuits in complex anatomy and the difficulty of access. Correction of residual hemodynamic abnormalities may be critical in the treatment of arrhythmia in patients with CHD.

• Sleep Medicine and Psychophysiology
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• v.20 no.1
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• pp.10-14
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• 2013

Sleep disturbances are commonly encountered problems in cancer patients. Sleep has a role in maintenance of immunity, metabolism, and quality of life but little has been known about the prevalence, risk factors, and effects on prognosis of sleep disturbances in patients with cancer. Also little attention has been made on proper assessment and management of sleep disorders in these patients. Recently, there have been some reports that sleep disorders are related with development of many cancers such as breast, colorectal, prostate, and endometrial cancers. An intermittent hypoxia and a disruption of circadian rhythm are considered as one of the possible mechanisms of cancer developments. More aggressive evaluation and meticulous management of sleep disturbances in cancer patients are essential to improve quality of life as well as prognosis.

• Journal of Korean Academy of Nursing
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• v.40 no.1
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• pp.43-51
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• 2010

Purpose: The purpose of this study was to investigate sleep habits, sleep disturbance, and circadian types, and to identify factors influencing sleep disturbance in nursing students. Methods: Participants were 140 senior nursing students. The data were collected from May 19 to 27, 2008 using self-report questionnaires. Results: 1) Evening type delayed sleep-wake schedules were more frequent than for morning type, especially during weekend and evening shift duty. 2) In total sleep time, there were no significant statistical differences between morning type and evening type during weekdays, weekend, day or evening shift duty. 3) On weekdays and day shift duty, the mean score for sleep disturbance was significantly higher in the evening type compared to the morning type. 4) Sleep disturbance in weekday and day shift duty was influenced by circadian types, eating habits, and gender. Conclusion: The circadian types are a very important factor for determining the sleep quantity and quality in nursing students.

• Journal of Chest Surgery
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• v.23 no.1
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• pp.192-200
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• 1990

The results of conventional operative resection of diffuse subaortic stenosis[tunnel subaortic stenosis] have been less than satisfactory. We have performed modified Konno operation to enlarge the outflow tract of both ventricle with a patch in three patients with diffuse tunnel subaortic stenosis in the department of Thoracic and Cardiovascular Surgery, Seoul National University Children`s Hospital. Preoperative left ventricular aortic pressure gradients were 135 mmHg, 50 mmHg, 80 mmHg respectively in these patients. After right ventriculotomy, the septotomy was done and extended beyond the limit of the stenosis and fibrous and/or muscular tissue was removed from each edge of septal incision. After adequate widening of the tunnel subaortic stenosis with various patches, right ventricle was closed primarily or with prosthetic patches successfully. One patient who was diagnosed as complete atrioventricular septal defect had complete AV block preoperatively and was implanted permanent pacemaker, and others who were sinus rhythm preoperatively have no serious postoperative rhythm disturbance. One patient developed mild postoperative aortic insufficiency and one who had preoperative aortic insufficiency has still same grade of aortic insufficiency after operation. All had good postoperative hemodynamics without any postoperative residual pressure gradient.

• Journal of Veterinary Clinics
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• v.24 no.2
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• pp.218-224
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• 2007

Digital electrocardiogram (ECG) recorders are rapidly replacing to conventional paper ECG recorders. Digital ECG recorders have several advantages over conventional type ECG recorders, including better capability for data storage, better portability and better applicability in clinical settings. In this study, we presented 4 case studies related to cardiac rhythm disturbances, which were diagnosed and managed using a digital ECG recorder.

• Journal of Korean Biological Nursing Science
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• v.23 no.3
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• pp.227-236
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• 2021

Purpose: The purpose of this study was to investigate the sleep duration, social jetlag (SJL), and subjective sleep disturbance according to the individual chronotype in rotating shift nurses. Methods: A total of 344 rotating 3-shift nurses (mean age 28.67 years) were recruited at one university affiliated hospital. They completed the following questionnaires, which were used to assess their chronotype and sleep: the morningness-eveningness questionnaire (MEQ), self-reported sleep duration of work days (SDW_shift) and free days (SDF_shift) in each shift (day [D], evening [E], night [N]), and sleep disturbance (Insomnia severity index, ISI). SJL_shift was calculated as the difference in midsleep (MS=sleep onset+1/2 sleep duration) between work days (MSW) and free days (MSF). Results: Subjects were divided into 3 chronotype groups according to the MEQ; morning (MG, 4.4%) intermediate (IG, 57.8%), and evening groups (EG, 37.8%). SDW_D was shortest (4.68 hr) and SDF_E was longest (8.93 hr) in the EG. SJL_D was longest in the EG (3.77 hr), and SJL_N was longest in the MG (7.37 hr). The prevalence of sleep disturbance was 33.3% (MG), 29.6% (IG), and 40.0% (EG), respectively, without any statistical significance. Conclusion: In order to improve the sleep of shift workers, it is recommended that the evening chronotypes should reduce the day shifts and the morning chronotypes should reduce the night shifts. We also propose a study to determine whether these shift assignments can improve the sleep in shift nurses.