• Journal of muscle and joint health
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• v.8 no.1
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• The Journal of the Korean dental association
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• v.49 no.4
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• pp.219-226
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• 2011

Snoring and obstructive sleep apnea (OSA) are common sleep disordered breathing conditions. Habitual snoring is caused by a vibration of soft tissue of upper airway while breath in sleeping, and obstructive sleep apnea is caused by the repeated obstructions of airflow for a sleeping, specially airflow of pharynx. Researchers have shown that snoring is the most important symptom connected with the obstructive sleep apnea syndrome The treatment is directed toward improving the air flow by various surgical and nonsurgical methods. The current surgical procedures used are uvulopalatopharyngoplasty(UPPP), orthognathic surgery, nasal cavity surgery. Among the nonsurgical methods there are nasal continuous positive air pressure(CPAP), pharmacologic therapy. weight loss in obese patient, oral appliance(sleep splint). Sleep splint brings the mandible forward in order to increase upper airway volume and prevents total upper airway collapse during sleep. However, the precise mechanism of action is not yet completely understood, especially aerodynamic factor. The aim of this study evaluated the effect of conservative treatment of snoring and OSAS by sleep splint through measured aerodynamic change by an aerophone II. We measured a airflow, sound pressure level, duration, mean power from overall airflow by aerophone II mask. The results indicated that on a positive correlation between a decrease in maximum airflow rate and a decrease in maximum sound pressure level, on a negative correlation between a decrease in maximum airflow rate and a increase in duration.

• Biomolecules & Therapeutics
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• v.24 no.2
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• pp.115-122
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• 2016

Sleep, which is an essential part of human life, is modulated by neurotransmitter systems, including gamma-aminobutyric acid (GABA) and dopamine signaling. However, the mechanisms that initiate and maintain sleep remain obscure. In this study, we investigated the relationship between melatonin (MT) and dopamine D2-like receptor signaling in pentobarbital-induced sleep and the intracellular mechanisms of sleep maintenance in the cerebral cortex. In mice, pentobarbital-induced sleep was augmented by intraperitoneal administration of 30 mg/kg MT. To investigate the relationship between MT and D2-like receptors, we administered quinpirole, a D2-like receptor agonist, to MT- and pentobarbital-treated mice. Quinpirole (1 mg/kg, i.p.) increased the duration of MT-augmented sleep in mice. In addition, locomotor activity analysis showed that neither MT nor quinpirole produced sedative effects when administered alone. In order to understand the mechanisms underlying quinpirole-augmented sleep, we measured protein levels of mitogen-activated protein kinases (MAPKs) and cortical protein kinases related to MT signaling. Treatment with quinpirole or MT activated extracellular-signal-regulated kinase 1 and 2 (ERK1/2), p38 MAPK, and protein kinase C (PKC) in the cerebral cortex, while protein kinase A (PKA) activation was not altered significantly. Taken together, our results show that quinpirole increases the duration of MT-augmented sleep through ERK1/2, p38 MAPK, and PKC signaling. These findings suggest that modulation of D2-like receptors might enhance the effect of MT on sleep.

• Journal of the Korean Society of School Health
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• v.28 no.1
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• pp.1-9
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• 2015

Purpose: The purpose of this study is to examine the effect of sleep duration on suicidal ideation in Korean adolescents. Methods: This study used the data drawn from Korea Youth Risk Behavior Web-Based Survey in 2013. A total data of 63,301 adolescents were included in the analysis. Included variables were general characteristics, health status variables, hours of sleep, and suicidal ideation. For sample description weighted percentage and means were used. Rao-Scott ${\chi}^2$ test and simple and multiple logistic regression with dummy variables were conducted with use of SAS 9.2. Results: Among general characteristics and health status variables, gender, grade, school level, school achievement, family's economic status, living with parents, subjective health, happiness, stress, and feeling of despair were found to be significantly related to suicidal ideation. Rates of having suicidal ideation were 22.4% in the case of students with less than 5 hours of sleep and 12.9% in students with 8 or more hours of sleep. After controlling general characteristics and subjectively perceived variables, hours of sleep was still significantly related to suicidal ideation. That is, compared to adolescents with 8 hours or more of sleep, those with less than 5 hours of sleep showed significantly higher risk for having suicidal ideation (adjusted odds ratio: 1.20, p<.001). Conclusion: These findings suggest that short sleep has negative effects on psychological health in adolescents. Particularly, less than 5 hours of sleep has harmful effect on adolescents' increased risk for having suicidal ideation.

• Clinical and Experimental Pediatrics
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• v.50 no.8
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• pp.711-717
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• 2007

Sleep is a vital, highly organized process regulated by complex systems of neuronal networks and neurotransmitters. Normal sleep comprises non-rapid eye movement (NREM) and REM periods that alternate through the night. Sleep usually begins in NREM and progresses through deeper NREM stages (2, 3, and 4 stages), but newborns enter REM sleep (active sleep) first before NREM (quiet sleep). A period of NREM and REM sleep cycle is approximately 90 minutes, but newborn have a shorter sleep cycle (50 minutes). As children mature, sleep changes as an adult pattern: shorter sleep duration, longer sleep cycles and less daytime sleep. REM sleep is approximately 50% of total sleep in newborn and dramatically decreases over the first 2 years into adulthood (20% to 25%). An initial predominant of slow wave sleep (stage 3 and 4) that peaks in early childhood, drops off abruptly after adolescence by 40% from preteen years, and then declines over the life span. The hypothalamus is recognized as a key area of brain involved in regulation of sleep and wakefulness. The basic function of sleep largely remains elusive, but it is clear that sleep plays an important role in the regulation of CNS and body physiologic processes. Understanding of the architecture of sleep and basic mechanisms that regulate sleep and wake cycle are essential to evaluate normal or abnormal development of sleep pattern changes with age. Reduction or disruption of sleep can have a significant impact on daytime functioning and development, including learning, growth, behavior, and emotional regulation.

• Journal of dental hygiene science
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• v.17 no.4
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• pp.298-305
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• 2017

This study aimed to investigate the relationship between sleep duration and periodontitis in adult Korean women. This cross-sectional study was based on the 2014 Korea National Health and Nutrition Examination Survey (KNHNES). We selected the data from 3,292 women (over 19 years of age) out of 7,550 participants for analysis, after excluding data from men. Complex logistic regression analysis was performed to determine the effect of sleep duration on the risk of periodontitis; the crude and adjusted odds ratios (ORs) were calculated. The risk of periodontitis was higher in participants who had a sleep duration of 7 hours or more, than in those with less than 7 hours (crude OR) by 1.37 times (95% confidence interval [CI], 1.13~1.65). The adjusted OR of the participants after adjusting for the sample characteristics of the participants (age, education level, income level, diabetes, hypertension, obesity) was 1.04 times (95% CI, 0.82~1.32), but the risk for periodontitis was slightly higher, though not statistically significant. This study confirmed the relationship between sleep duration and the risk of periodontitis in Korean women. Therefore, it is necessary to develop and implement a comprehensive health promotion program that can improve the proper sleeping habits of adult women in Korea and to combine oral hygiene management programs to prevent periodontal disease.

• KIPS Transactions on Computer and Communication Systems
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• v.7 no.7
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• pp.175-182
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• 2018

The purpose of this study is to analyze the effect of sleep environment on individual sleep and to calculate optimal sleep environment. The input and output data sets are selected and the optimized sleep environment information is calculated using the neuro-fuzzy technique. Provides optimal sleep environment considering sleep duration. The arousal ratio calculated by the proposed method is 12%, which is at least 5% lower than the previous studies.

• The Journal of Korean Medicine
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• v.41 no.3
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• pp.22-31
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• 2020

Objectives: The purpose of this study was to investigate the association between sleep status and weight loss among adult women with obesity administered with Gamitaeeumjowee-tang. Methods: We retrospectively reviewed the medical records of 137 patients who were were administered with Gamitaeeumjowee-tang for 3 months for the purpose of weight loss. We divided subjects according to sleep duration and sleep quality. We conducted an independent t-test to compare the differences of weight loss between two groups. Also, a regression analysis was applied to determine which factors affected weight loss. Results: There was no significant difference in weight loss between patients who sleep more than 7 hours regularly and patients who sleep less than 7 hours. There was no significant difference between good sleepers and poor sleepers. Initial body mass index and the number of visits to the clinic were the significant factors in weight loss in 2-4 weeks. Initial weight loss was the significant factor in weight loss in 10-12 weeks. There was no significant correlation of sleep duration and sleep quality in weight loss in 2-4 weeks and 10-12 weeks. Conclusions: This study suggests that weight loss may not be affected by sleep status during Gamitaeeumjowee-tang intervention. ostachys japonicus, THP-1, acute myeloid leukemia, apoptosis, autophagy.

• Journal of Sasang Constitutional Medicine
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• v.33 no.1
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• pp.102-108
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• 2021

Objectives The purpose of this study was to identify differences in sleep by Sasang constitutional type using Pittsburgh Sleep Quality Index(PSQI). Methods The subjects of this study were 3,578 people who had information on Sasang constitutional type and PSQI among the data established at the Korean Medicine Data Center. We compared each item score in PSQI (subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication, daytime dysfunction) and PSQI global scores by Sasang constitutional type using analysis of variance. Logistic regression was conducted to calculate the odds ratio of poor sleep by Sasang constitutional type. Results & Conclusions The SE type showed statistically significantly higher scores than the TE type and SY type in subjective sleep quality, sleep latency, habitual sleep efficiency, sleep disturbance, and PSQI global score, indicating poor sleep compared to other constitutional types. The odds ratio for poor sleep also shows that even after adjusting sex, age, height, and weight, the SE type was significantly higher than other constitutional types, indicating that the SE type could be a risk factor for poor sleep.

• Korean Journal of Biological Psychiatry
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• v.28 no.2
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• pp.58-69
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• 2021

Objectives The aim of this study was to examine the association between the sleep pattern, chronotype (midpoint of sleep on free days) and the depressive symptoms in adults aged 19 years and over in Korea. This study also investigated the mediating effect of perceived usual stress (PUS) and self-rated health (SRH) on the association between chronotype and depressive symptoms. Methods Among the subjects of the 7th Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018, 16142 adults aged 19 or over responded to the survey and finally 8604 were analyzed according to the exclusion conditions. Logistic regression analysis was conducted to see the risk of depressive symptoms, suicidal ideation over sleep pattern, chronotype. Finally, mediation analysis was performed in order to clarify how PUS and SRH are associated to chronoytpe and depression. Results After controlling for potential covariates, weekly sleep duration < 5 hours, ≥ 10 hours was associated with depressive symptoms. And late bed time sleeping after am 1:00 and later midpoints of sleep was associated with a higher level of depressive symptoms. Additionally, the PUS and SRH between chronotype and depressive symptoms showed a serial multiple mediation effect. Conclusions Short or long sleep duration, late bed time and later midpoints of sleep on free days are associated with depressive symptoms. Furthermore, the mechanism between chronotype and depressive symptoms needs to be further clarified by identifying the serial multiple mediation effects of PUS and SRH.