The symptoms of restless legs syndrome (RLS) usually involve legs and can extend to other body parts. However, isolated body parts other than leg have rarely been involved. A 32-year-old woman had abnormal sensations of both forearms and face during night, which caused a difficulty falling in sleep. The symptoms were relieved by shaking and rubbing. She experienced a clear benefit from pramipexole, but a recurrence of restlessness was followed in both arms subsequent to pramipexole withdrawal. Finally, she had been prescribed a dose of 0.375 mg, which was well tolerated for 6 years. We report a case of nocturnal restless arms and face without leg involvement, which was like RLS in terms of clinical criteria except lesion site.
Accidental Falls ; Adult ; Arm* ; Dopamine Agonists* ; Dopamine* ; Female ; Forearm ; Human Body ; Humans ; Leg ; Psychomotor Agitation ; Recurrence ; Restless Legs Syndrome* ; Sensation

OBJECTIVES: The current study aimed to explore the relationship between subjective sleep, emotions, social support and excessive daytime sleepiness (EDS), and extract the strongest predictor of EDS in female undergraduate students. METHODS: Our subjects consisted of 168 female undergraduate students (mean age 21.64±1.66). All participants completed Epworth Sleepiness Scale (ESS), Insomnia Severity Index, Hospital Anxiety and Depression Scale, Social Support Scale, and the Munich Chronotype Questionnaire. RESULTS: There were significant associations between insomnia, anxiety, depression with EDS, but not with subjective total sleep time of workdays and freedays. Also, 23.8% (n=40) of subjects endorsed clinical levels of EDS (ESS>10). Insomnia, anxiety, and depression were higher, and social support was lower in the EDS group compared to the normal group. Finally, we explored factors that influenced EDS, resulting in anxiety and social support being the strongest predictors of EDS. Social support was the strongest predictor of EDS compared to other predictors (β=-0.276, p<0.001). CONCLUSIONS: Results suggest that social support may be important to consider in female undergraduate students who experience EDS.
Anxiety ; Depression ; Female* ; Humans ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: To investigate sleep-wake patterns and chronotype in rapidly rotating shift nurses (SRN). METHODS: We translated and back-translated the Korean Munich ChronoType for Shift-Workers (K-MCTQ(shift)) with original authors' permission. In this study, 353 full-time, SRN (age 28.7±3.95 years 341 females, mean shift–working duration=5 years 9 months) at one university hospital completed the K-MCTQ(shift) and the Morningness-Eveningness Questionnaire (MEQ). Time in bed, sleep duration, and mid-sleep time (sleep onset time+1/2 sleep duration) were evaluated on work days and free days. Social jet lag was computed for each shift. Chronotype was assessed based on the mid-sleep time on free days corrected for sleep debt accumulated over the workweek (MSF(SC)). RESULTS: Sleep duration on workdays were 5.2 hours (day shift, D), 7.7 hours (evening shift, E), and 5.7 hours (night shift, N), respectively. Alarm clock usage on workdays was the highest in day-shifts (92.4%). The chronotype of 166 SRN who did not use alarm on free days was 6:09 h. Social jet lag was the longest in day-shifts (3.3 hours), and the shortest in evening-shifts (0.3 hour). Mid-sleep after the evening-shift (MSW(E), MSF(E), MSF(E)(SC)) showed significant correlations with MEQ scores. CONCLUSIONS: The Korean MCTQ(shift) provides actual sleep-wake patterns per shift schedule and chronotype in shift workers. We suggest that the sleep-corrected version of mid-sleep on free days after evening shifts (MSF(E)(SC)) is suitable for assessing chronotype in shift workers.
Appointments and Schedules ; Female ; Humans

OBJECTIVES: The positive effects of nap on cognitive function and memory have been researched intensively among children and adults. However, the relationship between afternoon nap and executive function among sleep deprived late adolescents has not been studied as much. METHODS: Ten sleep deprived, otherwise healthy Korean high school students were recruited, and asked to fill out Pittsburgh Sleep Quality Index questionnaire. They were put to nap for 5 min on three days during the first week, then for 10, 20, and 30 min in the same protocol during the consecutive weeks. After a 1-h class, both the students themselves and their corresponding teachers evaluated the participation level of the participants. They were then divided into two groups, and were instructed to play iPad game ‘Free Flow’. One group took a nap while the other group was prohibited from taking a nap. Both groups were instructed to play the game again. This was repeated once every afternoon for three days. RESULTS: The experiment showed that 20-min nap was superior in subjective evaluations to the other nap duration, and the mean game score differences before and after were significantly higher in the nap taking group after the 20-min nap when analyzed using non-parametric statistical method (p-value 0.04). CONCLUSIONS: Therefore, 20-min nap is likely to boost planning domain of executive function on sleep deprived late adolescents.
Adolescent* ; Adult ; Child ; Cognition ; Executive Function* ; Humans ; Memory ; Methods ; Sleep Deprivation

OBJECTIVES: To investigate the effect of electrical automatic massage (EAM) at bedtime on sleep quality and fatigue. METHODS: We recruited consecutively 35 adults (23 male, 48.7±8.07 y) who complained of poor sleep (Pittsburgh Sleep Quality Index≥5) and fatigue (Chalder Fatigue Scale≥4). This is a cross over study including two consecutive sleep studies with or without EAM. The EAM session includes preset ‘sleep mode’, which last 30 minutes covering whole body. Participants were seated in the commercially available massage chair (REX-L®) under the calm and dim light condition immediately before polysomnography. Participants reported perceived sleep latency, sleep duration, and fatigue using visual analogue scale following morning. RESULTS: Polysomnography parameters and subjective reports were compared between sleep with EAM and sleep without EAM. Paired comparison on average revealed sleep structure improvement N1 (13.6→10.9%) and N2 sleep (59.3→57.2%) decreased, and N3 sleep increased (3.0→6.4%), as well as sleep latency (10.3→5.6 min). Improvement in arousal index (17.1→13.0/h) and apnea-hypopnea index (9.1→7.0/h) were also seen following sleep after EAM. Sleep efficiency and total sleep time were not changed by EAM. Participants subjective reports also indicated better sleep on EAM; more lengthened sleep (306→330 minutes) and more relieved fatigue significantly after EAM. CONCLUSIONS: This study demonstrated that muscle relaxation through EAM at bedtime may improve the sleep and alleviate fatigue. It suggests that EAM may be one of alternatives to promote sleep quality. Further studies in a clinical setting are warranted to support this finding.
Adult ; Arousal ; Fatigue* ; Humans ; Male ; Massage* ; Matched-Pair Analysis ; Muscle Relaxation ; Polysomnography ; Relaxation

Obstructive sleep apnea (OSA) is a common disorder characterized by obstructive apneas, hypopneas, and respiratory effort related arousals during sleep. Treatment of OSA is important because untreated patients have potential adverse clinical outcomes, such as excessive daytime sleepiness, metabolic dysfunction, cardiovascular disease, and mortality. Therefore, OSA should be considered as a chronic disease that requires long-term and multidisciplinary care. Positive airway pressure (PAP) therapy is the mainstay of treatment for OSA in adults. Alternative therapies include oral appliance, behavioral modification, and upper airway surgery. The treatment of OSA in adults is reviewed here with focus on PAP therapy.
Adult* ; Apnea ; Arousal ; Cardiovascular Diseases ; Chronic Disease ; Complementary Therapies ; Humans ; Mortality ; Sleep Apnea, Obstructive*

No abstract available.
Disorders of Excessive Somnolence* ; Pituitary Neoplasms*

Sleepwalking is a rare parasomnia in the elderly. We report two cases of the patients who presented complex motor behaviors during sleep triggered by hypoglycemia. A 76-year-old male patient with diabetes mellitus presented to the sleep clinic for recurrent sleepwalking with amnesia. Night polysomnogram showed REM sleep without atonia with sleep talking and distal arm movements. While taking clonazepam, he had a few more episodes of sleepwalking. The last episode finally revealed severe hypoglycemia when he was found very far from his house. The second patient, a 67-year-old male showed four episodes of nocturnal confusion and sleepwalking lasting 20 minutes during sleep. His blood glucose and HbA1c were low. After decrease of the dose of oral hypoglycemic agent, no more recurrent sleepwalking occurred. Our cases showed hypoglycemia can induce sleepwalking in the older adults, rather than decreased mentality. Metabolic workup should perform for evaluation of sleepwalking, especially in the elderly.
Adult ; Aged ; Amnesia ; Arm ; Blood Glucose ; Clonazepam ; Diabetes Mellitus ; Humans ; Hypoglycemia* ; Male ; Parasomnias ; Polysomnography ; Sleep, REM ; Sleep-Wake Transition Disorders ; Somnambulism*

A condition of underestimation of sleep is classified as paradoxical insomnia or sleep state misperception. However, overestimation of sleep, so called positive sleep state misperception has not been clearly described. Here we report a middle-aged woman with positive sleep state misperception who presented excessive sleepiness mimicking hypersomnia.
Disorders of Excessive Somnolence* ; Female ; Humans ; Sleep Disorders, Intrinsic* ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: Obstructive sleep apnea-hypopnea syndrome (OSAHS) and insomnia are two of the most common sleep disorders in the general population. Because OSAHS patients with insomnia may have difficulty in adapting to the sleep breathing medical equipment, it is necessary to pay special attention to the diagnosis and treatment of comorbid insomnia. This study is to investigate the emotion and personality in OSAHS patients with insomnia complaints by using Minnesota Multiphasic Personality Inventory-2 (MMPI-2). METHODS: We reviewed the results of the standardized questionnaires assessing sleep-related variables, MMPI, and polysomnographic findings of the patients diagnosed as OSAHS. RESULTS: 145 subjects were 49.05+/-11.83 years of age. The mean Respiratory Disturbance Index was 33.57+/-19.91 and the mean score of Insomnia Severity Index (ISI) was 11.52+/-6.49. The mean scores of the Beck Depression Inventory (BDI) and MMPI-2 were within normal ranges. We divided the patients into two groups based on the scores of the ISI, OSAHS with insomnia (n=109) and OSAHS without insomnia (n=36). OSAHS patients with insomnia symptoms had significantly higher scores of hypochondriasis, hysteria, psychasthenia, schizophrenia, paranoia and psychopathic deviate scales and BDI than those without insomnia. CONCLUSIONS: Our results suggest that insomnia complaints are very common in OSAHS patients and the psychological problems are more frequently found in OSAHS patients with insomnia symptom than those without it.
Depression ; Diagnosis ; Humans ; Hypochondriasis ; Hysteria ; Minnesota* ; MMPI* ; Paranoid Disorders ; Polysomnography ; Reference Values ; Respiration ; Schizophrenia ; Sleep Apnea, Obstructive* ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders* ; Weights and Measures