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Dong Wook KIM ; Kyunghwa LEE ; Seong Jin CHO ; In Hee CHO ; Seung Hee KOH ; Yu Jin LEE ; Jong Hoon KIM ; Seog Ju KIM

Sleep Medicine and Psychophysiology.2009;16(1):28-35.

INTRODUCTION: Human attachment is known to be closely associated with psychophysiological phenomenon. However, there have not been enough researches on the relationship of the attachment with sleep, especially with insomnia. The objective of the present study was to investigate the relationship between adult attachment styles and insomnia in community-dwelling population. METHODS: One hundred seventy seven community-dwelling adults (74 males and 103 females ;mean age 41.23+/-8.44) participated in the current study. To assess the attachment styles (secure, dismissing, preoccupied and fearful), self-reporting Relationship Style Questionnaires (RSQ) were completed by the participants. Presence, type, frequency and duration of insomnia in the last month were also investigated. RESULTS: Compared to subjects without insomnia, subjects with insomnia had higher fearful attachment scores (t =2.87, p=0.005). Higher fearful attachment score were found in all subtypes of insomnia (sleep-onset insomnia, t =2.33, p=0.021;maintenance insomnia, t=2.92, p=0.004;terminal insomnia, t=2.89, p=0.004). Subjects with frequent (>or =3 per week) insomnia had higher fearful attachment scores than subjects with infrequent (or =6 months) had higher preoccupied attachment scores relative to subjects with transient insomnia (<6 months), (t=2.57, p=0.012). CONCLUSION: In the current study, attachment styles were different depending on the characteristics of insomnia. The fearful attachment was associated with the presence of insomnia, while the preoccupied attachment was associated with the chronicity of insomnia. These findings suggest that there may be some relationship between the adult attachment styles and the clinical features of insomnia.
Adult ; Female ; Humans ; Male ; Surveys and Questionnaires ; Sleep Initiation and Maintenance Disorders

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Respiratory Sleep Physiology.

Jin Woo KIM ; Sang Haak LEE

Sleep Medicine and Psychophysiology.2009;16(1):22-27.

Regulation of respiration differs significantly between wakefulness and sleep. Respiration during wakefulness is influenced by not only automatic control but also voluntary and behavioral control. Sleep is associated with definite changes in respiratory function. With the onset of sleep, voluntary control of ventilation that overrides automatic control during wakefulness becomes terminated. Also ventilatory response to various stimuli including hypoxemia and hypercapnia is decreased. With these reasons respiration during sleep becomes fragile and unstable so that marked hypoxemia can be happened in patients with lung disease especially during REM sleep. Obstructive sleep apnea may also be developed if upper airway resistance is increased in addition to these blunted ventilatory responses.
Airway Resistance ; Anoxia ; Humans ; Hypercapnia ; Lung Diseases ; Respiration ; Sleep Apnea, Obstructive ; Sleep, REM ; Ventilation ; Wakefulness

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Sleep Onset Period from the EEG Point of View.

Hyun Kwon LEE ; Doo Heum PARK

Sleep Medicine and Psychophysiology.2009;16(1):16-21.

In accordance with the development of EEG and polysomnography in the field of sleep research, the sleep onset period (SOP) between wakefulness and sleep has been considered an important part for understanding the physiology of sleep. SOP in the transition from wakefulness to sleep is a gradual process integrating various viewpoints such as behavior, EEG, physiology and subjective report. Particularly, based on understanding of EEG changes during sleep, SOP has been regarded as a pattern of topographical change in specific frequency and specific state in EEG. Studies on quantitative EEG (qEEG) and event-related potential (ERP) have suggested that SOP shows the changes of functional coordination at the specific cortical areas in qEEG and the changes of regular patterns in response to environmental stimulation in ERP. The development of sleep EEG and topographic mapping of EEG is expected to integrate various viewpoints of SOP and clarify the neurophysiologic mechanism of SOP further.
Electroencephalography ; Evoked Potentials ; Polysomnography ; Wakefulness

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Cancer-Related Sleep Disorders.

Wan Seok SEO

Sleep Medicine and Psychophysiology.2009;16(1):10-15.

Sleep problems and disorders are common in patients with cancer. Sleep of the cancer patients is affected by various factors, including thermoregulatory changes associated with chemotherapy and radiotherapy, cancer related symptoms, such as pain, fatigue, and emotional difficulties. As one of the most common symptoms in cancer patients, fatigue is positively correlated with sleep difficulties. Cytokine is also frequently associated with chemotherapy and radiotherapy. It provokes excessive daytime sleepiness and hypersomnia. Medications for controlling pain, depression, and anxiety can affect sleep of the cancer patients. Medications as well as behavior therapy are reported to be effective for controlling sleep problems, and the physicians need to be accustomed to use the modalities appropriately. This paper reviews causative factors, evaluation, and management of sleep problems and disorders, experienced by cancer patients.
Anxiety ; Behavior Therapy ; Depression ; Disorders of Excessive Somnolence ; Fatigue ; Humans ; Sleep Wake Disorders

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Human Physiological Models of Insomnia.

Hyun Bo SIM ; Bum Hee YU

Sleep Medicine and Psychophysiology.2009;16(1):5-9.

Relatively little is known about the neurobiology of insomnia, despite its wide prevalence and broad medical impact. Although much is still to be learned about the pathophysiology of the disorder, identification, systematic assessment, and appropriate treatment are clearly beneficial to patients. Recent research, using quantitative EEG, polysomnography (PSG), multiple sleep latency test (MSLT) and neuroimaging techniques, suggests that some broad areas can be identified as possible pathophysiological models. Sleep-wake homeostat model hypothesizes a failure in homeostatic regulation of sleep, an attenuated increase in sleep drive with time awake, and/or defective sensing of sleep need. Circadian clock model hypothesizes a dysfunctional circadian clock, resulting in changes in the timing of sleep-wake propensity that are incompatible with normal sleep. Intrinsic sleep-wake state mechanism model suggests that abnormal function of insomnia comprises the systems responsible for expression of the sleep states themselves. Extrinsic over-ride mechanism (stress-response) model suggests that insomnia reflects the consequences of overactivity of one of the systems considered "extrinsic" to normal sleep-wake control. Many current therapies for insomnia are based on these physiological models. Several attempts have been made to create a physiological model that would explain this disorder and could be used as a foundation for treatment. However, it appeared that no model can fully explain and clarify all aspects of insomnia. Future research should be necessary to expand our knowledge on the biological dimensions of insomnia.
Circadian Clocks ; Electroencephalography ; Humans ; Neurobiology ; Neuroimaging ; Polysomnography ; Prevalence ; Sleep Initiation and Maintenance Disorders

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Compliance of Nasal Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea Syndrome.

Jong Bae CHOI ; Seung Hee LEE ; Do Un JEONG

Sleep Medicine and Psychophysiology.2006;13(1):27-32.

OBJECTIVES: Nasal continuous positive airway pressure (nCPAP) is the treatment of choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture, and decrease daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). However, little is known about the compliance of nCPAP treatment in Korea. Our objective was to look into the nCPAP compliance and examine the factors influencing it. METHODS: We reviewed the records of one hundred and twenty consecutive patients with OSAS referred for nocturnal polysomnography with nCPAP pressure titration during the period of January 1995 through April 1999 to the Seoul National University Hospital. We performed a telephone interview and obtained data from eighty-three patients. RESULTS: In sixty patients who had accepted nCPAP treatment, twenty-six patients (43.3%) were still using nCPAP device, while thirty-four patients (56.7%) stopped using it. Fifteen patients (25%) were using nCPAP device everyday. In thirty-four patients who discontinued nCPAP use, twenty-five patients (73.5%) did within the first three months, and thirty-one (91.2%) within the first year. Significant predictor of long-term nCPAP use was the presence of subjective daytime sleepiness before nCPAP application. CONCLUSIONS: Long-term compliance with nCPAP treatment appears to be associated with the presence of subjective daytime sleepiness before nCPAP application. Long-term compliance with nCPAP may be mostly predicted from the usage pattern within the first three months of use.
Compliance* ; Continuous Positive Airway Pressure* ; Humans ; Interviews as Topic ; Korea ; Polysomnography ; Seoul ; Sleep Apnea, Obstructive*

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Association of the Period3 Gene Polymorphism and Seasonal Variations in Mood and Behavior.

Heon Jeong LEE ; Seung Gul KANG ; Leen KIM

Sleep Medicine and Psychophysiology.2006;13(1):22-26.

Circadian rhythms have been observed to be disturbed in mood disorders, especially seasonal affective disorder (SAD). Clock related gene variants also have been suggested to be associated with seasonality (seasonal variations in mood and behavior). This study tested the potential association between a length polymorphism of Period3 gene and seasonal variations in mood and behavior. 297 Korean college students were genotyped for the Period3 polymorphism and were for evaluated the seasonal variation by Seasonal Pattern Assessment Questionnaire (SPAQ). The genotype frequencies were 0.76 for 4R/4R, 0.22 for 4R/5R and 0.013 for 5R/5R. The global seasonality score was not different among Period3 gene variants (4R/4R, 4R/5R and 5R/5R) except for 'sleep length' subscore. The 5R/5R genotype showed the higher 'sleep length' subscore than others (p=0.024). The comparison between seasonals (syndromal plus subsyndromal SAD determined by SPAQ) and non-seasonals did not show any significant difference in frequencies of genotypes. These findings suggest that there is a possibility that the investigated Period3 polymorphism may play a partial role in the susceptibility of seasonal variations in a Korean population.
Circadian Rhythm ; Genotype ; Humans ; Mood Disorders ; Surveys and Questionnaires ; Seasonal Affective Disorder ; Seasons*

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Characteristics of Sleep Pattern among Korean College Students.

Seog Ju KIM ; In Kyoon LYOO ; Chang Yeon WON ; Do Un JEONG

Sleep Medicine and Psychophysiology.2006;13(1):15-21.

INTRODUNTION: The objective of the present study was to investigate bedtime, rise time and time-in-bed of Korean college students, separately on weekday and on weekend and to compare them. In addition, this study also aimed to evaluate the influence of gender, age and grade on the above sleep parmeters in Korean college students. METHODS: Information regarding bedtime and rise time, separately on weekday and on weekend, of Korean college students were obtained by self-administered questionnaire. Questionnaires of 1,825 students (1,416 females and 409 males, age 18-30 ; mean age 21.1+/-2.2) were used for statistical analyses. RESULTS: Korean college students retired to bed 50 minutes later (00 : 49 on weekday ; 01 : 40 on weekend ; t=39.67, p<0.001), rose 1 hour 58 minutes later (07 : 52 on weekday ; 09 : 50 on weekend ; t=39.46, p<0.001), and slept 1 hour 8 minutes longer (t=13.33, p<0.001) on weekend. Compared to male students, female students had earlier rise time (t=8.96, p<0.01 ; t=3.89, p<0.01) and earlier bedtime both on weekday and weekend (t=7.10, p<0.01; t=6.04, p<0.01), and shorter time-in-bed on weekday (t=1.99, p<0.01). In addition, rise time delay and time-in-bed increase on weekend were more prominent in female students than in male students (t=3.41, p<0.01 ; t=3.68, p<0.01). Grade was correlated with bedtime and rise time on weekday (beta=0.1022, p<0.01 ; beta=0.1009, p<0.01), bedtime and time-in-bed on weekend (beta=0.1096, p<0.01 ; beta=-0.0990, p<0.01), and differences between weekday and weekend of the rise time and the time-in-bed (beta=-0.0906, p<0.01 ; beta=-0.1115, p=0.02). CONCLUSIONS: In this study, Korean college students had earlier bedtime/rise time and shorter time-in-bed on weekday than on weekend. These findings suggest that weekday sleep-wake schedule of Korean college students may be advanced relative to their biological sleep-wake cycle and that this discrepancy may be associated with weekday sleep deprivation. In addition, differences of sleep patterns between weekday and weekend were more prominent in female students and students with lower grade. Therefore, discrepancy between weekday sleep-wake schedule and biological sleep-wake cycle, as well as weekday sleep deprivation, might be more serious in female or lower-grade students.
Appointments and Schedules ; Female ; Humans ; Male ; Surveys and Questionnaires ; Sleep Deprivation

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Yu Jin LEE ; Do Un JEONG

Sleep Medicine and Psychophysiology.2006;13(1):11-14.

Sleep-related behaviors observed in parasomnias can result in serious injuries of patients and/or spouses. Parasomnia is defined as undesirable physical or behavioral phenomenon occurring during sleep. If these disorders are accurately diagnosed, effective treatments are available. Often, these disorders can be even cured. Environmental management for patient and/or spouse safety and good sleep hygiene are the most recommended for individuals behaving abnormally during sleep. The aim of this article is to review the clinical features, diagnosis and treatment of several sleep-related behavior disorders.
Diagnosis ; Humans ; Hygiene ; Mental Disorders ; Parasomnias ; Spouses

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Alcohol and Sleep.

Doo Heum PARK ; Jaehak YU ; Seung Ho RYU

Sleep Medicine and Psychophysiology.2006;13(1):5-10.

Alcohol has extensive effects on sleep and daytime sleepiness. Alcohol has a sleep inducing effect and the effect of increased non-REM sleep and suppressed REM sleep during the first half portion of night sleep, but alcohol induces the effect of decreased non-REM sleep and increased light sleep and frequent awakenings and REM rebound during the second half portion of night sleep. Alcohol provokes chronobiological change such as the changes of amplitude or the phase shifts of hormones or core body temperature. The sleep disruption resulting from alcohol drinking may lead to daytime fatigue and sleepiness. The elderly are at particular in the increased risk of alcohol-related sleep disorders because they achieve higher levels of alcohol in the blood and brain than do younger adults after consuming an equivalent dose. Bedtime alcohol consumption among older adults may lead to unsteadiness if walking is attempted during the night, with increased risk of falls and injuries. Continued alcohol use for sleep induction often induces aggravation of insomnia, alcoholism or sleep related breathing disorders such as obstructive sleep apnea. Alcohol should not be used as substitution of sleep pill because of the dependence and tolerance for sleep inducing effect, and the sleep disruption produced by alcohol withdrawal.
Adult ; Aged ; Alcohol Drinking ; Alcoholism ; Body Temperature ; Brain ; Fatigue ; Humans ; Respiration ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sleep, REM ; Walking

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