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The Association between Suicidal Ideation, Anxiety, and Sleep Quality Among College Students in a City.

Shin Hyeong KIM ; Chul Soo PARK ; Bong Jo KIM ; Cheol Soon LEE ; Boseok CHA ; Dongyun LEE ; Ji Yeong SEO ; Jae Won CHOI ; In Young AHN ; So Jin LEE

Sleep Medicine and Psychophysiology.2017;24(1):55-61. doi:10.14401/KASMED.2017.24.1.55

OBJECTIVES: Suicide is one of the leading causes of death among young adults. We investigated whether anxiety level and sleep quality were related to suicide ideation among university students. METHODS: Questionnaires were distributed to 1094 students at a local college. The scale for suicide Ideation, the Hospital Anxiety-Depression scale, the Pittsburgh Sleep Quality Index, and Morningness-eveningness questionnaires were used. Multiple linear regression analysis was conducted to examine the relationship between these variables and suicide ideation. RESULTS: Among the 292 students who answered the suicide ideation questionnaire, 31 students had a high suicide ideation score and 261 patients had a low suicide ideation score. Demographic variables that showed significant differences between the two groups were gender, exercise, chronotype, sleep quality, depression and anxiety. The results of multiple linear regression analysis showed that suicidal ideation increased as the level of sleep quality decreased. There was no significant relationship between depression and suicidal ideation. Another multiple linear regression analysis was performed to evaluate the relationship between sleep quality sleep related factors. This suggested the quality of sleep decreased as weekend oversleep increased. CONCLUSION: The results of this study showed that when anxiety was higher and the quality of sleep was lower, the more suicide ideation increased. Therefore, improving sleep quality and reducing anxiety are important strategies for reducing suicidal ideation.
Anxiety* ; Cause of Death ; Depression ; Humans ; Linear Models ; Suicidal Ideation* ; Suicide ; Young Adult

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Clinical Characteristics and Heart Rate Variability of Foreign Domestic Violence Victims in Korea.

Kyu Lee KIM ; Jin Sook CHOI ; Yong Lee JANG ; Hae Woo LEE ; Hyun Bo SIM

Sleep Medicine and Psychophysiology.2017;24(1):46-54. doi:10.14401/KASMED.2017.24.1.46

OBJECTIVES: Domestic violence is related to many psychiatric diseases, such as depression, anxiety disorder, and PTSD. Heart rate variability (HRV) is an index of autonomic control of the heart and is related to cardiovascular and emotional disorders. Although there have been some studies on the effects of domestic violence on women's mental health, relatively little information is available on HRV in this population. The aim of this study is to investigate demographic data, psychological features, and HRV in female victims of domestic violence and difference between Korean and foreign female victims. METHODS: A total of 210 female victims of domestic violence (166 Korean women and 44 foreign women) were recruited for this study. Psychological symptoms were measured using the Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Impact of Event Scale-Revised (IES-R). HRV measures were assessed by time-domain and frequency-domain analyses. RESULTS: The mean score of HAM-A was 13.81, that of HAM-D was 12.92, and that of IES-R was 33.61 ; there were no significant differences between Korean and foreign women in these measures. In HRV time domain analyses, approximate entropy (ApEn) was significantly increased in foreign women compared to the Korean women. The square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) was significantly decreased in foreign women compared to Korean women. There were no significant differences in the other HRV variables between Korean and foreign women. CONCLUSION: Female victims of domestic violence in Korea are associated with depression, anxiety, and PTSD symptoms. The physiologic factors of a female victim's nationality could be related to higher ApEn and lower RMSSD in foreign female victims. These findings have important implications for future study to study the relationships among ethnic and environmental factors and HRV variables.
Anxiety ; Anxiety Disorders ; Depression ; Domestic Violence* ; Emigrants and Immigrants ; Entropy ; Ethnic Groups ; Female ; Heart Rate* ; Heart* ; Humans ; Korea* ; Mental Health ; Stress Disorders, Post-Traumatic

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Prediction of Sleep Disturbances in Korean Rural Elderly through Longitudinal Follow Up.

Kyung Mee PARK ; Woo Jung KIM ; Eun Chae CHOI ; Suk Kyoon AN ; Kee NAMKOONG ; Yoosik YOUM ; Hyeon Chang KIM ; Eun LEE

Sleep Medicine and Psychophysiology.2017;24(1):38-45. doi:10.14401/KASMED.2017.24.1.38

OBJECTIVES: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. METHODS: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. RESULTS: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. CONCLUSION: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.
Aged* ; Aging ; Anger ; Angina Pectoris ; Arthritis ; Asthma ; Cataract ; Cognition ; Cohort Studies ; Comorbidity ; Dementia ; Depression ; Education ; Epidemiologic Studies ; Follow-Up Studies* ; Glaucoma ; Hepatitis B ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy ; Korea ; Logistic Models ; Mass Screening ; Myocardial Infarction ; Osteoporosis ; Prevalence ; Prostate ; Sleep Initiation and Maintenance Disorders ; Stroke ; Tuberculosis, Pulmonary ; Urinary Incontinence

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Correlational Analysis of Supine Position Time and Sleep-related Variables in Obstructive Sleep Apnea Syndrome.

Si Young KIM ; Doo Heum PARK ; Jaehak YU ; Seung Ho RYU ; Ji Hyeon HA

Sleep Medicine and Psychophysiology.2017;24(1):32-37. doi:10.14401/KASMED.2017.24.1.32

OBJECTIVES: A supine sleep position increases sleep apneas compared to non-supine positions in obstructive sleep apnea syndrome (OSAS). However, supine position time (SPT) is not highly associated with apnea-hypopnea index (AHI) in OSAS. We evaluated the correlation among sleep-related variables and SPT in OSAS. METHODS: A total of 365 men with OSAS were enrolled in this study. We analyzed how SPT was correlated with demographic data, sleep structure-related variables, OSAS-related variables and heart rate variability (HRV). Multiple linear regression analysis was conducted to investigate the factors that affected SPT. RESULTS: SPT had the most significant correlation with total sleep time (TST ; r = 0.443, p < 0.001), followed by sleep efficiency (SE ; r = 0.300, p < 0.001). Snoring time (r = 0.238, p < 0.001), time at < 90% SpO2 (r = 0.188, p < 0.001), apnea-hypopnea index (AHI ; r = 0.180, p = 0.001) and oxygen desaturation index (ODI ; r = 0.149, p = 0.004) were significantly correlated with SPT. Multiple regression analysis revealed that TST (t = 7.781, p < 0.001), snoring time (t = 3.794, p < 0.001), AHI (t = 3.768, p < 0.001) and NN50 count (t = 1.993, p = 0.047) were associated with SPT. CONCLUSION: SPT was more highly associated with sleep structure-related parameters than OSAS-related variables. SPT was correlated with TST, SE, AHI, snoring time and NN50 count. This suggests that SPT is likely to be determined by sleep structure, HRV and the severity of OSAS.
Heart Rate ; Humans ; Linear Models ; Male ; Oxygen ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Snoring ; Supine Position*

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The Changes in Polysomnographic Sleep Variables by Periodic Limb Movements During Sleep.

Jongbae CHOI ; Jae Won CHOI ; Yu Jin LEE ; Jae Woo KOO ; Do Un JEONG

Sleep Medicine and Psychophysiology.2017;24(1):24-31. doi:10.14401/KASMED.2017.24.1.24

OBJECTIVES: Periodic limb movement disorder (PLMD) has been debated with regard to its clinical significance and diagnostic criteria. The current diagnostic criterion for PLMD in adults has been changed from periodic limb movement index (PLMI) > 5/ hour to PLMI > 15/hour by the International Classification of Sleep Disorders (ICSD). In this study, we aimed to investigate the changes in polysomnographic sleep variables according to PLMI and to determine the relevance of the diagnostic criterion for PLMD. METHODS: Out of 4195 subjects who underwent standard polysomnography, we selected 666 subjects (370 males and 296 females, aged 47.1 ± 14.8) who were older than 17 years and were not diagnosed with primary insomnia, sleep apnea, narcolepsy, or REM sleep behavior disorder. Subjects were divided into three groups according to PLMI severity: group 1 (PLMI ≤ 5), group 2 (5 < PLMI ≤ 15), and group 3 (PLMI > 15). Demographic and polysomnographic sleep variables and Epworth sleepiness scale (ESS) were compared among the three groups. RESULTS: There were significant differences among the three groups in age and gender. Sleep efficiency (SE) and stage 3 sleep percentage in group 1 were significantly higher than those in groups 2 and 3. The wake after sleep onset (WASO) score in group 1 was significantly lower than those in groups 2 and 3. However, there were no significant differences in SE, stage 3 sleep percentage, or WASO between groups 2 and 3. Sleep latency (SL) in group 1 was significantly lower than that in group 3, but there was no difference in SL between group 2 and group 3. ESS score in group 1 was significantly higher than that in group 3, but there was no difference between group 2 and group 3. Partial correlation analysis adjusted by age showed that PLMI was significantly related to SE and WASO. CONCLUSION: This study suggests that PLMI influences polysomnographic sleep variables. In addition, we found the individuals who did not have PLMD but had PLMI > 5 were not different in polysomnographic sleep variables from the individuals who had PLMD according to the current criterion. These results raise questions about the relevance of the current diagnostic criterion of PLMD.
Adult ; Classification ; Extremities* ; Female ; Humans ; Male ; Narcolepsy ; Nocturnal Myoclonus Syndrome ; Polysomnography ; REM Sleep Behavior Disorder ; Sleep Apnea Syndromes ; Sleep Initiation and Maintenance Disorders ; Sleep Wake Disorders

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Obstructive Sleep Apnea in Interstitial Lung Disease.

Shin Bum KIM ; Sang Haak LEE ; Hyeon Hui KANG

Sleep Medicine and Psychophysiology.2017;24(1):19-23. doi:10.14401/KASMED.2017.24.1.19

Obstructive sleep apnea is a common disorder in which respiratory flow decreases or disappears despite respiratory effort due to occlusion of the upper respiratory tract during sleep. Oxidative stress and systemic inflammatory reaction induced by the obstruction cause complications such as hypertension, coronary artery disease, and diabetes and increase cancer incidence. Furthermore, in patients with interstitial lung disease, obstructive sleep apnea has a very high prevalence and is thought to have a close pathophysiological and clinical correlation. In other words, obstructive sleep apnea could be the cause or a complication of interstitial lung disease ; when these two afflictions coexist, the prognosis of the patient is worse. In patients with interstitial lung disease with obstructive sleep apnea, CPAP treatment significantly improved sleep and quality of life, as well as improved morbidity and mortality in a recent study. Therefore, early diagnosis and treatment of obstructive sleep apnea in patients with interstitial lung disease are very important, and additional studies designed to include patients with idiopathic pulmonary fibrosis as well as patients with advanced interstitial lung disease should be performed.
Coronary Artery Disease ; Early Diagnosis ; Humans ; Hypertension ; Idiopathic Pulmonary Fibrosis ; Incidence ; Lung Diseases, Interstitial* ; Mortality ; Oxidative Stress ; Prevalence ; Prognosis ; Quality of Life ; Respiratory System ; Sleep Apnea, Obstructive* ; Sleep Wake Disorders

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Sleep and Type 2 Diabetes.

Jin Seong LEE ; Sung Gon KIM

Sleep Medicine and Psychophysiology.2017;24(1):12-18. doi:10.14401/KASMED.2017.24.1.12

Adequate amount and quality of sleep are important for metabolic control in patients with type 2 diabetes. Too short or too long sleep time disrupts glycemic control in both prediabetes and type 2 diabetic patients. Circadian misalignment such as shift work is also associated with an increased risk of developing type 2 diabetes. Clinicians should pay attention to the sleep problems and circadian patterns of patients. However, the pathophysiologic mechanism of the association between sleep and diabetes is likely to be complex and bidirectional. The underlying mechanism remains poorly understood, and further research is warranted.
Circadian Rhythm ; Humans ; Prediabetic State

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Sleep Disorder and Alcohol.

Sung Bae CHO ; Sang Haak LEE

Sleep Medicine and Psychophysiology.2017;24(1):5-11. doi:10.14401/KASMED.2017.24.1.5

The use of alcohol is associated with the development and worsening of sleep disorder. Alcohol is generally known to have a sedative effect, but it has an arousal or sedative effect depending on the timing and drinking dose and directly affects REM sleep physiology. Alcohol acts on the central nervous system (CNS) to interfere with the sleep-wake cycle and to affect sleep-related hormone secretion. In addition, the ingestion of alcohol pre-sleep is associated with deterioration and development of sleep related breathing disorders (SBD). The increase in resistance of the upper respiratory tract and the decrease in sensitivity of the CNS respiratory center and the respiratory muscles are major mechanisms of alcohol-induced SBD, and result in snoring or apnea in healthy men or aggravating apnea in patients with OSA. Sleep-related restless leg syndrome and circadian rhythm disorders are common in alcohol use disorder patients. This review provides an assessment of scientific studies that investigated on the impact of alcohol ingestion on nocturnal sleep physiology and sleep disorders.
Alcohols ; Apnea ; Arousal ; Central Nervous System ; Chronobiology Disorders ; Drinking ; Eating ; Humans ; Hypnotics and Sedatives ; Male ; Physiology ; Respiration ; Respiratory Center ; Respiratory Muscles ; Respiratory System ; Restless Legs Syndrome ; Sleep Apnea Syndromes ; Sleep Wake Disorders* ; Sleep, REM ; Snoring

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Neuropsychological Tests in Psychiatric Outpatients.

Sung Hoon LEE ; Hee Jung PARK ; Hye Jung PARK ; Hee Sang LEE ; Chan Hyung KIM

Sleep Medicine and Psychophysiology.1997;4(1):120-128.

Clinical neuropsychological test were developed originally for the diagnosis of neurological and neuro-surgical diseased. Recently, these tests are being introduced to psychiatric patients. Authors had the experience to use these tests in pychiatric outpatient clinic. Results were as follows. There was a significantly increase in language and attentional function in residual schizophrenia compared to normal control. In chronic neurosis, as visuospatial function was reduced, language and attentional functions were enhanced. With these results, authors suggest that application of neuropsychological tests in psychiatric patients may be very helpful in classifying the subgroups of disease, in selecting the modality of treatment. and in expecting prognosis.
Ambulatory Care Facilities ; Diagnosis ; Humans ; Neuropsychological Tests* ; Neuropsychology ; Outpatients* ; Prognosis ; Schizophrenia

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The Psychophysiologic Response in Korea Patients with Generalized Anxiety Disorder.

Sang Keun CHUNG ; Ik Keun HWANG

Sleep Medicine and Psychophysiology.1997;4(1):107-119.

OBJECTIVES: The psychophysiologic response pattern between healthy subjects and patients with generalized anxiety disorder, and the relationship among anxiety rating scales and those patterns in patients were examined. METHODS: Twenty-three patients with generalized anxiety disorder(AD) and 23 healthy subjects were evaluated by Hamilton Rating Scale for Anxiety(HRSA)and State- Trait Anxiety Inventory before baseline stressful tasks, Subjective Units of Distress were evaluated just before baseline period, immediately after stressful tasks, at the end of the entire procedure, and psychophysiologic measures, i.e., skin temperature(ST), electromyographic activity(EMG), heart rate(HR), electrodermal response(EDR) during baseline & rest and during two psychologically stressful tasks (mental arithmentic, TM; talk about a stressful event, TT) were also evaluated. RESULTS: 1) AD group showed significantly higher EMG level during rest after stressful tasks and higher HR level during all period except TM compared to control group. 2) AD group showed lower change in the startle response(SR) of ST, in the SR & the recovery response(RR) of EMG during TM, and in the RR of EDR immediately after TM than control group. AD group showed that the RR of EDR was significantly lower than the SR during stressful tasks. 3) We found that there was significantly negative correlation between state anxiety and the RR of EDR after TT in AD group. We also found that there were significantly positive correlations between HRSA score and the SRs of EDR during stressful tasks, and between state anxiety and the SR of EDR during TT. CONCLUSION: Our results suggest that patients with generalized anxiety disorder show higher autonomic arousal than healthy subjects and decreased physiologic flexibility or reduced autonomic flexibility.
Anxiety Disorders* ; Anxiety* ; Arousal ; Heart ; Humans ; Korea* ; Life Change Events ; Pliability ; Skin ; Weights and Measures

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