Background : Obesity is present in the majority of adult patients with obstructive sleep apnea(OSA) and is considered to be a major risk factor for its development. A reduction in body weight has been associated with substantial improvement in the severity of apnea. However, a variety of treatment strategies for obesity have yielded limited sucess. This study was done to determine resting energy expenditure(REE) in patients with obstructive sleep apnea and the correlation between the severity of sleep apnea and REE, and to investigate whether leptin influences REE and correlated with the severity of sleep apnea in 39 patients with OSA and 45 controls matched for obesity. Method : Overnight polysomnography was performed on all subjects using standard techniques. Measurements of REE were made using a Sensormedic Vmax 229 and a canopy system. Serum leptin concentration was measured by human leptin RIA kit of LINCO Research INC. Results : REE was greater in patients with OSA compared with controls, but there was no difference between the two groups on REE%. And also there was no significant correlation between anthropometric data, polysomnographic data and REE%. Serum leptin was linearly related to body mass index(BMI), apnea index, apnea hypopnea index and lowest arterial oxygen saturation($SaO_2$) but not related to REE%. Conclusion : This study suggests the followings. Firstly patients patients with sleep apnea have a pattern of obesity characterized by energy homeostasis at an elevated body weight set-point. In order to achieve a lower body weight in these patients, it may be necessary to increase energy expenditure by increasing physical activity. Secondly leptin level was not correlated with REE, suggesting that leptin may predominantly regulate body fat by altering eating behavior rather than calorigenesis. Lastly leptin level was significantly correlated with the severity of sleep apnea. These elevated level of leptin in patients of sleep apnea may be related to the obesity, however it needs further studies to determine the relationship between the severity of sleep apnea and serum leptin.
Objects : This study was carried out to investigate characteristics of patients who need hypnotics on the night before elective surgery as well as contributing variables for the necessity of hypnotics. Methods : After reviewing the clinical charts of patients who were scheduled to receive surgery by general anesthesia the following day, researchers had semi structural interviews with patients. In addition, Spielberger's State-Trait Anxiety Inventory(SSTAI), Beck Depression Inventory(BDI), Zung's Self-Rating Pain and Distress Scale(ZPDS), and Presleep and Postsleep Questionnaires were administered to patients. A total of 167 patients, who gave reliable information, were divided into two groups based on subjective judgement regarding the necessity for hypnotics on the night before surgery; 29 eligibles for hypnotics and 138 non-eligibles for hypnotics. Demographic and clinical characteristics of patients, some possible factors affecting sleep, psychological characteristics of patients and daytime status and nighttime sleep before surgery were compared between the two groups. In addition, discriminant function analysis was done to find the variables which would best discriminate among patients who differ in terms of necessity for hypnotics on the night before surgery. Results : There was no difference in demographic and clinical characteristics between the two groups; however, the satisfaction level with ward environment was significantly lower in the eligible group for hypnotics than the non-eligible group. Psychologically, the eligible group for hypnotics, compared to the non-eligible group, showed significantly more severe depression, pain, and distress; whereas anxiety level was not different between the two groups. For nighttime sleep before surgery, the eligible group for hypnotics, compared to the non-eligible group, expected poorer sleep before retiring and in fact, reported poorer sleep the following morning. In discriminant function analysis, 'expectation for sleep' and 'pain and distress' were the most potent contributors to discriminate the necessity of hypnotics. Conclusion : For the improvement of the patient's sleep on the night before elective surgery, giving hypnotics and/or analgesics should be determined by patient's opinion about the necessity of the drugs rather than by the therapist's own judgement or any other objective indices.
Objectives: To assess the effect and safety of transcranial direct-current stimulation (tDCS) in primary chronic insomnia. Methods: A one-month, double-blind, randomized, sham-controlled trial was performed. A total of 7 patients with primary chronic insomnia received tDCS using anodal (n=3), cathodal (n=2), or sham stimulation (n=2). They were followed up at 1 week and 1 month after treatment. The primary outcome measures included improvement in total sleep time (TST), sleep latency (SL), and sleep efficiency (SE) at 1 month follow-up. Results: TST and SE were improved with tDCS at 1 month follow-up in all patients (100%) of the anodal group, one (50%) of the cathodal group, and one (50%) of the sham group. tDCS improved SL at 1 month follow-up in two patients (67%) of the anodal group, one (50%) of the cathodal group, and none (0%) of the sham group. With respect to adverse events, transient itching sensation occurred in one patient of the anodal group. None of the other groups reported adverse events. Conclusions: Our results suggest that tDCS may be effective and safe for treatment of primary chronic insomnia. A larger controlled study needs to be further investigated.
Objectives: To evaluate the effectiveness of Mindfulness & Loving Beingness (M&L) psychotherapy combined with traditional Korean medicine in treating acute sleep disorders in patients hospitalized following traffic accidents. Methods: We applied traditional Korean medicine treatments in conjunction with various mindfulness meditation techniques from M&L therapy, including Resource Mindfulness and Nourishment Brief Therapy. This study was conducted on three patients who reported acute sleep disorder symptoms on the first day of hospitalization following a traffic accident. The effectiveness of these interventions was assessed using the PTSD Checklist for DSM-5 (PCL-5-K), Insomnia Severity Index (ISI), EuroQol 5-Dimension (EQ-5D), Numerical Rating Scale (NRS), and Patient Global Impression of Change (PGIC). Results: ISI and PCL-5-K scores showed significant improvements after treatment, indicating reduced sleep disturbances and stress symptoms. Additionally, EQ-5D and PGIC scores were enhanced, reflecting an overall improvement in quality of life. Conclusions: This study suggests that integrating M&L therapy with traditional Korean medicine could significantly improve symptoms in patients with acute sleep disorders following traffic accidents.
The current 52-hour workweek in South Korea consists of 40 hours of regular work and 12 hours of overtime. Although the average working hours in South Korea is declining, it is still 199 hours longer than the Organisation for Economic Co-operation and Development average of 1,716 hours per year. In view to this, the South Korean government has now proposed to reform the workweek, mainly intending to increase the workweek to 69 hours when the workload is heavy. This reform, by increasing the labor intensity due to long working hours, goes against the global trend of reducing work hours for a safe and healthy working environment. Long working hours can lead to increased cerebrovascular and cardiovascular diseases, industrial accidents, mental health problems, and safety accidents due to lack of concentration. In conclusion, the Korean government's working hour reform plan can have a negative impact on workers' health, and therefore it should be thoroughly reviewed and modified.
This case report describes a patient with olivopontocerebellar atrophy accompanied by sleep disorder and gait disturbance whose condition was improved by treatment with Korean medicine. The 61-year-old woman, who was diagnosed with olivopontocerebellar atrophy (Multiple Systemic Atrophy-Cerebellum), was admitted to hospital twice and treated with Korean medicine (acupuncture and herbal medicine) and rehabilitation. The Korean medicine was Gwibiondam-tang-gami and Jaeumgeonbi-tang-gami. Clinical symptoms were assessed by the Modified Bathel index, functional independent measurement, Berg balance scale, and Unified Multiple System Atrophy rating scale. A brain MRI at the one-year follow up after onset showed similar progress but clinical symptoms were improved after treatment, and the evaluation index score increased. Multiple system atrophy, a type of degenerative neurological disease, has no targeted treatment. In this situation, although this report describes a single case, Korean medicine treatment could provide a meaningful improvement in the sleep disturbance and gait disorder symptoms of patients with olivopontocerebellar atrophy.
Objectives: The aim of this review was to investigate whether evidence of complementary and alternative medicine (CAM) was reflected in clinical practice guidelines (CPGs) for insomnia based on relevant clinical trials. Methods: We conducted a systematic search on domestic and international CPG databases and medical databases. In addition, we conducted manual searches of relevant articles. Three authors independently searched and selected relevant studies; any disagreement was resolved by discussion. We extracted and analyzed the following data: published language, country, development group, participants, interventions, presence or absence of recommendations for CAM, level of evidence, grade of recommendation for CAM, and methods of development. Results: We identified 8,241 records from domestic and international databases, and 22 CPGs were included. Eleven of the 22 CPGs mentioned CAM interventions including herbal medicine, relaxation, acupuncture moxibustion, Tai Chi, meditation, hypnosis, biofeedback, Tuina, and external herbal medicine. However, most of the CPGs indicated 'no recommendation' or 'weak recommendation' for CAM interventions. Only Valeriana dageletiana Nakai and relaxation were considered to have experimental evidence. Valeriana dageletiana Nakai was recommended for improvement of sleep latency, sleep maintenance, total sleeping time, and sleep cycle. Relaxation was recommended as effective intervention for relieving physical and psychological arousal. Conclusions: Despite systematic reviews and randomized controlled trials on CAM for insomnia, most of the CPGs for insomnia did not reflect the evidence obtained. Further CPGs for insomnia should be developed by considering the current advanced studies in the field of CAM.
The Journal of Korean Institute of Communications and Information Sciences
/
v.33
no.7B
/
pp.518-527
/
2008
Tag collection is one of the major functions in Radio Frequency Identification (RFID) systems. IS0/IEC 18000-7 defines the tag collection algorithm using the anti-collision algorithm, based on the framed slotted ALOHA for active RFID systems. However, it has inefficiency problems that reduce tag collection performance by deciding non-optimum slot size or using point-to-point commands to put collected tags to sleep. In this paper, we propose two mechanisms to overcome the inefficiency problems and improve tag collection performance: 1) a new slot size decision mechanism to allow the reader to choose the optimum slot size flexibly and 2) a broadcast-based sleep mechanism to put collected tags to sleep effectively. We also implemented an active RFID system, composed of an active RFID reader and multiple tags, and the reader is designed to maximize tag collection performance when the proposed mechanisms are applied. In experiments, we evaluated the tag collection performance using one reader and 50 tags in the real-world environment. The experimental results show that when two mechanisms are applied and the initial number of slots is chosen appropriately, the performance of the proposed tag collection algorithm is greatly enhanced, compared with that of the standard.
Sleepiness is associated with many different conditions and, as a neglected topic, it can be the cause of serious psychological and social disadvantages. In the aspect of learning, additional problems may arise from poor progress in school caused by the effect of sleepiness on concentration, memory, and other cognitive functions. Narcolepsy is by no means the most common cause of excessive sleepiness. Nonetheless, it is not a rarity, especially in young people. The non-specific nature of early features of narcolepsy, combined with very limited awareness that the condition can start in various ways, leads to many misinterpretations. Misinterpretation of narcolepsy symptoms is not confined to the medical profession. Teachers may well be critical of a student with narcolepsy because of their perception of narcolepsy symptoms as laziness, poor motivation, or difficult behavior and dull learning ability. Inappropriate reactions by parents, teachers, and peers, based on misinterpretation of narcolepsy symptoms or the patient's reactions to them, make a difficult situation worse. Especially in Korea, where schooling is focused on college entrance examinations, the problem is very serious and intensified by inappropriate or delayed diagnosis and treatment. Therefore, psychiatrists should be aware that narcolepsy in young adolescents is not rare and that they need to be familiar with its clinical features in both its classic and less obvious forms. Narcolepsy should be suspected if a adolescent's excessive sleepiness can not be explained in other ways. Therefore, we report on two patients who portray the tendency of dull learning ability and are mistaken as idle students. We diagnosed narcolepsy through polysomnography and multiple sleep latency testing. We treated the students with methylphenidate and pemolin. The students showed improvement in learning ability and were able to adapt better to school.
Journal of The Korean Society of Integrative Medicine
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v.9
no.3
/
pp.19-35
/
2021
Purpose : Recently, there has been a growing social interest in aging well. Consequently, wellness tourism has begun to attract attention. However, no studies on whether wellness tourism has any objective health benefits have been carried out yet. In this study, we assess the health benefits as well as the degree of improvement in health of a wellness tourism program. Methods : The study involved 30 adults over the age of 19 who live in the Gyeongsangnam-do region. Participants were evaluated on health indicator before and after participating in wellness tourism program. Participants took heart rate variability (HRV) test, and LFT, RFT, CBC, FBS HbA1C, and CRP test were conducted before and after the tour. Additionally, a survey was conducted before and after the program, and participant satisfaction was evaluated. Statistical differences in the tests conducted before and after the program were analyzed using a design t-test, a Wilcoxon signed-rank test, and McNemar's test. Results : The study showed that participants were very satisfied with and had significant health improvements after the wellness tourism program. The program was also found to be beneficial in improving participants' emotions as follows: BDI (p<.001), fatigue recovery (p=.006), stress relief (p=.003), improved quality of life (p<.05), and improved sleep quality (p<.001). Conclusion : Wellness tourism programs are specifically beneficial for improving participants' emotions (depression, anxiety), fatigue, stress levels, quality of life, and sleep. Therefore, they are beneficial to the overall health. Further research in the future by way of a follow-up study on the long-term effects on health after short-term interventions will provide more validation data.
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