Background: The prevalence of sleep disorders increases as pregnancy progresses, which affects the health of pregnant women, fetal health, and the outcomes of pregnancy. The aim of this study is to evaluate the quality of sleep and life in pregnant women in Korea. Methods: This study is a prospective cross-sectional, case-control study of pregnant women and age-matched controls. From July to September 2019, all participants completed Korean-language versions of the sleep questionnaires including Pittsburgh sleep quality index (K-PSQI), Insomnia severity index, Epworth sleepiness scale, Back’s depression inventory-2(K-BDI), STOP (Snoring, Tiredness, Observed apneas, and high blood Pressure), and short-form 36 (K-SF-36). Results: A total of 422 participants consisted of 385 pregnant women and 137 controls. Second and third trimester were 200 and 185, respectively. K-PSQI scores were higher in pregnant women compared with the controls (7.87±3.49 and 8.50±3.55 vs. 5.79±2.76, p<0.001). Total score of K-SF-36 was lowest in third trimester (62.07±17.72) and highest in the control group(79.41±13.36). There was no statistical difference between groups in K-BDI. Conclusions This study demonstrated worsening of sleep quality as well as life quality during pregnancy. More attention to sleep of pregnant women is needed.

Insomnia is a common sleep disorder, and various strategies have been explored for its treatment. One of the methods involves the administration of carbon dioxide (CO2) at bedtime, as the CO2 increment exerts a sedative effect on the central nervous system. We aimed to assess the effect of CO2 on sleep quality in patients with insomnia using the coefficient of variation of the envelope (CVE) analysis, a novel analytical method. Methods: In this randomized, double-blind, sham-controlled crossover trial, 24 adults with sleeping difficulties underwent level 1 polysomnography. Two interventions involved exposure to either 2% low-concentration CO2 gas or room air. CVE analysis was performed to assess the stability of the delta band. Morphological variations in delta waves can be quantitatively monitored using the envelope analysis, which assesses the effect of manipulations on sleep that may otherwise elude detection. Results: Exposure to CO2 improved the total sleep time (TST) (p=0.010) and total arousal index (TAI) (p=0.011). The CVE analysis showed a distinct distribution between the experimental and sham-controlled groups. Moreover, correlations between the TST and CVE (r=0.41) and those between the TAI and CVE (r=0.40) were observed. Conclusions: This study is the first to evaluate the effects of CO2 exposure on sleep stability in patients with insomnia. The CVE analysis implies the possibility of sleep stabilization by CO2 administration and suggests a link between enhanced sleep maintenance and sleep stability.

Insomnia is a common sleep disorder, and various strategies have been explored for its treatment. One of the methods involves the administration of carbon dioxide (CO2) at bedtime, as the CO2 increment exerts a sedative effect on the central nervous system. We aimed to assess the effect of CO2 on sleep quality in patients with insomnia using the coefficient of variation of the envelope (CVE) analysis, a novel analytical method. Methods: In this randomized, double-blind, sham-controlled crossover trial, 24 adults with sleeping difficulties underwent level 1 polysomnography. Two interventions involved exposure to either 2% low-concentration CO2 gas or room air. CVE analysis was performed to assess the stability of the delta band. Morphological variations in delta waves can be quantitatively monitored using the envelope analysis, which assesses the effect of manipulations on sleep that may otherwise elude detection. Results: Exposure to CO2 improved the total sleep time (TST) (p=0.010) and total arousal index (TAI) (p=0.011). The CVE analysis showed a distinct distribution between the experimental and sham-controlled groups. Moreover, correlations between the TST and CVE (r=0.41) and those between the TAI and CVE (r=0.40) were observed. Conclusions: This study is the first to evaluate the effects of CO2 exposure on sleep stability in patients with insomnia. The CVE analysis implies the possibility of sleep stabilization by CO2 administration and suggests a link between enhanced sleep maintenance and sleep stability.

Insomnia is a common sleep disorder, and various strategies have been explored for its treatment. One of the methods involves the administration of carbon dioxide (CO2) at bedtime, as the CO2 increment exerts a sedative effect on the central nervous system. We aimed to assess the effect of CO2 on sleep quality in patients with insomnia using the coefficient of variation of the envelope (CVE) analysis, a novel analytical method. Methods: In this randomized, double-blind, sham-controlled crossover trial, 24 adults with sleeping difficulties underwent level 1 polysomnography. Two interventions involved exposure to either 2% low-concentration CO2 gas or room air. CVE analysis was performed to assess the stability of the delta band. Morphological variations in delta waves can be quantitatively monitored using the envelope analysis, which assesses the effect of manipulations on sleep that may otherwise elude detection. Results: Exposure to CO2 improved the total sleep time (TST) (p=0.010) and total arousal index (TAI) (p=0.011). The CVE analysis showed a distinct distribution between the experimental and sham-controlled groups. Moreover, correlations between the TST and CVE (r=0.41) and those between the TAI and CVE (r=0.40) were observed. Conclusions: This study is the first to evaluate the effects of CO2 exposure on sleep stability in patients with insomnia. The CVE analysis implies the possibility of sleep stabilization by CO2 administration and suggests a link between enhanced sleep maintenance and sleep stability.

No abstract available.
Choroid ; Meningoencephalitis

Painful legs and moving toes syndrome (PLMT) is a rare syndrome characterized by pain in the lower extremities and involuntary movements of single or multiple toes. A 29-year-old woman with lumbosacral intervertebral disc herniation complained of bilateral foot pain and involuntary toe movements for three months. This is the first case of PLMT in a young adult patient with a lumbosacral intervertebral disc herniation in Korea.

Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by complex motor behaviors and REM without atonia. RBD shows diverse clinical manifestations, ranging from typical violent dreamenacting behaviors to relatively subtle limb movements. Sleep disorders such as obstructive sleep apnea (OSA) and nocturnal seizure that mimic RBD symptoms are referred to as pseudo-RBD. We describe a patient who showed an atypical clinical presentation of pseudo-RBD associated with severe OSA. Polysomnography with a full 10–20 electroencephalography montage was useful for accurate diagnosis.

Objectives: The aim of this study was to evaluate dizziness in patients with sleep disorders, objectively identify vestibular function through the vestibulo-ocular reflex (VOR) using the video Head Impulse Test (vHIT), and evaluate the association between these findings. Methods: Among the patients who visited the sleep clinic from June to October 2021, 69 who underwent both polysomnography (PSG) and vHIT were included. Participants completed questionnaires including the Dizziness Handicap Inventory (DHI), Beck Anxiety Inventory, Korean-Beck Depression Inventory-II, Epworth Sleepiness Scale, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI). The subjects were classified into four groups: insomnia (n=4), rapid eye movement sleep behavior disorder (RBD) (n=13), obstructive sleep apnea syndrome (OSAS) (n=34), and RBD and OSAS (n=18). Moderate to severe OSAS (n=49) was compared with no OSAS and mild OSAS (n=20). Results: In comparison of the four groups according to sleep disorders, the OSAS patients showed the highest DHI scores and the lowest VOR gain, but statistical significance was not found. Although all VOR gains were within the normal range, the VOR gain of the left posterior semicircular canal was significantly lower in the moderate to severe OSA group than in the no OSA and mild OSA groups (1.02±0.18 vs. 0.94±0.10, p=0.019). DHI total scores showed no correlation with VOR gain but showed a positive correlation with ISI (r=0.422, p=0.001) and PSQI (r=0.287, p=0.022). Among PSG parameters, lowest oxygen saturation (SaO2) and percentage of time with SaO2 less than 90% were correlated with the emotional score of DHI (r=-0.245, p=0.043 and r=0.311, p=0.010, respectively). Conclusions Although our study could not objectively confirm vestibular dysfunction in patients with sleep disorders, we found that subjective sleep complaints were associated with dizziness and hypoxic conditions during sleep were associated with emotional aspects of dizziness. This suggests that the treatment of concomitant sleep disorders may improve dizziness.

Paroxysmal kinesigenic dyskinesia (PKD) is a diagnostic term for transient, involuntary abnormal movements triggered by sudden motions. The treatment for PKD differs from other paroxysmal dyskinesias, as it notably responds well to sodium channel blockers. We report a case of atypical PKD, coupled with paroxysmal exercise-induced dyskinesia (PED). Both PKD and PED in this patient showed a good response to oxcarbazepine. This case could be clinical evidence that paroxysmal dyskinesias could potentially be regarded as a spectrum disorder with overlapping features.

Background: and Purpose This study aimed to determine the long-term effects of vagus nerve stimulation (VNS) on sleep-disordered breathing (SDB), daytime sleepiness, and sleep quality in patients with drug-resistant epilepsy (DRE). It also investigated the relationships among these main effects, clinical characteristics, and VNS parameters. Methods: Twenty-four patients were recruited. Paired t-tests and multiple linear regression analyses were performed to determine how the demographic and clinical characteristics of the patients influenced the variables that changed significantly after VNS treatment. Results: After VNS, the patients showed significant increases in the apnea-hypopnea index (AHI), respiratory disturbance index (RDI), apnea index, hypopnea index, and oxygen desaturation index (ODI), as well as a significant decrease in the lowest arterial oxygen saturation (SaO 2 nadir) (p<0.05). The multiple linear regression analyses demonstrated that the predictor of larger increases in AHI and RDI was being older at baseline, and that the predictor of a larger increase in apnea index was a longer epilepsy duration. The strongest predictor of a larger increase in ODI was a higher frequency of aura episodes at baseline, followed by a longer epilepsy duration. The strongest predictor of a larger decrease in SaO2 nadir was a higher frequency of aura episodes at baseline, followed by a longer epilepsy duration. Conclusions This study has confirmed that VNS improves seizure control in patients with DRE, whereas it increases obstructive sleep apnea (OSA). Furthermore, the increase in OSA is affected by age and the duration of epilepsy. Therefore, careful observation and monitoring of SDB is recommended in patients who undergo VNS.