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Background@#and Purpose Excess or insufficient sleep, irregular sleep-wake patterns, and an extreme early or late chronotypes adversely impact physical and mental health. Changes in sleep characteristics should therefore be tracked, and factors that contribute to poor sleep should be identified. We investigated the changes in sleep patterns among South Korean adults during 2009–2018. @*Methods@#Using data of a representative sample of South Korean adults from the 2009 (n= 2,658, 48.5% males; age=44.5±15.0 years old [mean±standard deviation], age range=19–86 years) and 2018 (n=2,389, 49.1% males; age=47.9±16.3 years, age range=19–92 years) Korean Headache-Sleep Study, we explored changes in sleep timing, sleep duration, chronotype, and social jetlag (SJL). Logistic regression analysis was used to examine the association between average sleep duration and depression. @*Results@#From 2009 to 2018, bedtimes were advanced by 10 and 25 min on workdays and free days, respectively. Meanwhile, wake-up times were advanced by 13 min and delayed by 12 min on workdays and free days, respectively. The average sleep duration significantly decreased from 7.45 h to 7.13 h. The prevalence of short sleep duration (<7 h) increased, whereas that of long sleep duration (≥8 h) decreased. A circadian preference toward eveningness and SJL increased. The prevalence of depression increased from 4.6% to 8.4%, and there were significant reverse J-shaped and U-shaped associations between average sleep duration and depression in 2009 and 2018, respectively. @*Conclusions@#Changes in sleep patterns and the association between sleep duration and depressive mood were determined from a representative sample of the South Korean adult population. Interventions to modify sleep behaviors might improve public health.
ABSTRACT
Objectives@#Clinicians often depend on the results of the the multiple sleep latency test (MSLT) for diagnosing narcolepsy, but the diagnosis can be confusing when there is a co-existence of obstructive sleep apnea (OSA). This study is aimed to address the diagnostic tendency and the strategies of treatment for narcolepsy and other hypersomnia in the grey zone. @*Methods@#We performed a web-based survey of Korean neurologists who were interested in narcolepsy and had experience with sleep studies. @*Results@#The results of this survey present their concerns according to the severity of comorbid OSA in analyzing the results of the MSLT. @*Conclusions@#This study also might help by providing the opinions of experienced Korean neurologists for the assessment and management of excessive daytime sleepiness.
ABSTRACT
We present the case of a 78-year-old female who experienced acute mental deterioration after vomiting. She showed severe hypercapnia without definite lung disease and hypoxic injury on brain image. After the acute period, she still had excessive daytime sleepiness, and the hypercapnia aggravated during the night. Polysomnography revealed severe obstructive sleep apnea, a sleep-related breathing disorder with a high apneahypopnea index of 60.2/h (mainly a hypopnea index of 59.0/h). She was diagnosed with combined obesity hypoventilation syndrome (OHS) and sleep-related breathing disorder, as the cause of daytime hypercapnia and excessive daytime sleepiness. Three months of successful bi-level positive airway pressure (BiPAP) therapy dramatically improved her daytime sleepiness and cognition. This case suggests that patients with OHS can be susceptible to hypoxic brain damage, and emphasizes the importance of the recognition and diagnosis of OHS and appropriate treatment with BiPAP therapy.
ABSTRACT
Obstructive sleep apnea (OSA) is known to be associated with various health concerns, including sleepiness, fatigue, cognitive dysfunction, diminished quality of life, hypertension, cardiovascular diseases, and stroke. OSA-induced sleepiness at the wheel reduces vigilance and driving performance, which significantly increase the risk of motor vehicle accidents. Sleepiness-induced motor vehicle accidents are characterized by high morbidity and mortality. OSA is a well-established significant risk factor for drowsy driving-related motor vehicle accidents, which can be prevented through appropriate treatment. However, currently no clinical guidelines or regulations are available for evaluation or management of the risk of motor vehicle accidents in patients with OSA in Korea. In this review, we discuss the risk of motor vehicle accidents in patients with OSA, the effects of positive airway pressure therapy as a preventive measure to reduce this risk, and the published recommendations for OSA in other countries with regard to fitness to drive. We propose recommendations for screening, evaluation, and treatment of OSA with regard to the risk of motor vehicle accidents, which would serve as useful practical guidelines for sleep specialists in clinical practice. Further research is warranted to establish optimal strategies for effective improvements in OSA-related traffic safety.
ABSTRACT
Narcolepsy is a chronic sleep disorder characterized by irresistible sleep attacks, hypersomnolence, cataplexy (sudden loss of muscle tone provoked by emotion), and sleep paralysis. Individuals with narcolepsy are at a high risk of experiencing sleepiness while driving leading to road traffic accidents. To prevent such accidents, some countries have regulations for commercial and noncommercial drivers with narcolepsy. Evaluating sleepiness is essential. Therefore, several subjective reports and objective tests were used to predict the possibility of car crashes or near-misses. Brain stimulants are effective in treating narcolepsy and can reduce daytime sleepiness in these patients. However, no guideline has been established for the driving safety of patients with narcolepsy in Korea. The Korean Sleep Research Society has prepared this proposal for preventing motor vehicle accidents caused by drowsy driving in patients with narcolepsy.
ABSTRACT
Driving is a complicated process that demands coordination between a range of neurocognitive functions, including attention, visuo-perception, and appropriate judgment, as well as sensory and motor responses. Therefore, several factors may reduce the driving performance of an individual, such as sleepiness, distraction, overspeeding, alcohol consumption, and sedative drugs, all of which increase the hazard of motor vehicle accidents. Among them, drowsy driving is a major cause of traffic accidents, leading to more serious injuries as compared to other causes of major traffic accidents. Although sleep disorders have been highly associated among drowsy drivers, they are often untreated and unrecognized as a disease. In particular, obstructive sleep apnea and narcolepsy are some sleep disorders that are highly related to traffic accidents. Insomnia, which can cause inadequate sleep duration and promote sedative effects from sleeping pills, may also cause traffic accidents. These conditions are especially applicable to commercial bus or truck drivers, nocturnal workers, and shift workers, who are highly vulnerable to drowsy driving. Therefore, assertive screening and management of sleep disorders are necessary in general private drivers and relevant occupational drivers.
ABSTRACT
The relationship between cluster headache (CH) and sleep has been demonstrated. A 60-year-old man who suffered from refractory CH that occurred exclusively at night, complained of sleep fragmentation. Polysomnography revealed severe obstructive apnea with deep desaturation and sleep fragmentation every 2 hours due to cyclic pain. Three months of successful continuous positive airway therapy dramatically improved both headache intensity and frequency, as well as sleep apnea. This case suggests the significance of comorbid OSA when managing patients with CH or primary headaches with nocturnal tendencies.
ABSTRACT
Driving is a complicated process that demands coordination between a range of neurocognitive functions, including attention, visuo-perception, and appropriate judgment, as well as sensory and motor responses. Therefore, several factors may reduce the driving performance of an individual, such as sleepiness, distraction, overspeeding, alcohol consumption, and sedative drugs, all of which increase the hazard of motor vehicle accidents. Among them, drowsy driving is a major cause of traffic accidents, leading to more serious injuries as compared to other causes of major traffic accidents. Although sleep disorders have been highly associated among drowsy drivers, they are often untreated and unrecognized as a disease. In particular, obstructive sleep apnea and narcolepsy are some sleep disorders that are highly related to traffic accidents. Insomnia, which can cause inadequate sleep duration and promote sedative effects from sleeping pills, may also cause traffic accidents. These conditions are especially applicable to commercial bus or truck drivers, nocturnal workers, and shift workers, who are highly vulnerable to drowsy driving. Therefore, assertive screening and management of sleep disorders are necessary in general private drivers and relevant occupational drivers.
ABSTRACT
The relationship between cluster headache (CH) and sleep has been demonstrated. A 60-year-old man who suffered from refractory CH that occurred exclusively at night, complained of sleep fragmentation. Polysomnography revealed severe obstructive apnea with deep desaturation and sleep fragmentation every 2 hours due to cyclic pain. Three months of successful continuous positive airway therapy dramatically improved both headache intensity and frequency, as well as sleep apnea. This case suggests the significance of comorbid OSA when managing patients with CH or primary headaches with nocturnal tendencies.
ABSTRACT
OBJECTIVES: To evaluate association between presence of time preference of headache attack and social jetlag and circadian preference in patients with migraine with or without aura. METHODS: A total of 50 patients of migraine with or without aura who visited for the first time at a single tertiary medical center were examined and interviewed about their sleep pattern on weekdays and weekends and whether they have time preference of headache attack during a day or not. Frequency of headache and measurement for disability of headache such as six-item Headache Impact Test and other sleep profiles such as sleep duration, sleep quality, daytime sleepiness, and insomnia severity were obtained by a booklet of questionnaire. RESULTS: In this pilot study, the time preference of migraine attack during a day was present in 42% among the participants. In the cross-sectional analysis, the group of presence of time preference of attack showed earlier circadian preference (1:36 am±282 min vs. 4:24 am±186 min, p=0.02) and lower social jetlag than the other group (0.4±0.8 hour vs. 1.4±2.2 hour, p=0.04). Other demographic characteristics and frequency and severity of headache was comparable between groups. CONCLUSIONS: Considering an individual circadian preference might be a strategy in integrated management of migraine.
Subject(s)
Humans , Cross-Sectional Studies , Epilepsy , Headache , Migraine Disorders , Pamphlets , Pilot Projects , Sleep Initiation and Maintenance DisordersABSTRACT
BACKGROUND: Fibromyalgia (FM) is a chronic diffuse pain syndrome of unknown etiology. FM is commonly associated with various neurological symptoms and signs including headache, non-restorative sleep, fatigue, and cognitive dysfunction. The purpose of this study is to investigate the clinical features of chronic daily headache patients with FM comorbidity. METHODS: Outpatients with chronic daily headache were recruited. FM was diagnosed on the basis of 2010 American College of Rheumatology criteria. We analyzed clinical features of the patients with FM and which general somatic symptoms were common in them. RESULTS: Of the 70 patients with chronic headache, 22 (about 31%) met the new ACR criteria of FM. Most of them were female, and their headache was likely to be tension type. Paresthesia, itching, and heartburn were significantly common in the headache patients with FM. CONCLUSIONS: Our study showed that a significant proportion of female patients with chronic tension type headache had chance to have FM. While taking history from patients with headache, neurologists should concern other somatic symptoms of FM as well as headache itself. Identification of FM in chronic headache patients may help more efficient treatment for the headache.