렘수면행동장애의 진단

김지언 대한수면연구학회 2009 Journal of sleep medicine Vol.6 No.1

REM sleep behavior disorder (RBD) is characterized by abnormal behaviors emerging during REM sleep that cause injury or sleep disturbance. RBD is also associated with electromyographic abnormalities during REM sleep. The EMG demonstrates an excess of muscle tone or phasic EMG twitching activity during REM sleep. Sleep related injurious, potentially injurious, or disruptive behaviors by history and characteristic polysomnographic findings are essential for diagnosis of RBD. In this article, previous and current diagnostic criteria of RBD will be reviewed.

수면다원검사 중 비디오 분석을 통한 렘수면행동장애를 가진 환자들의 꿈꾸면서 하는 행동들의 분석

박정준,김형지,조재욱,김지현 대한수면연구학회 2015 Journal of sleep medicine Vol.12 No.2

Objectives: The aim of this study is to analyze dream-enacting behaviors (DEB) using video REM sleep behavior disorder severity scale (RBDSS) during night polysomnography (PSG) and compare them between in patients with idiopathic RBD (iRBD) and patients with symptomatic RBD (sRBD). Methods: 21 consecutive patients with either iRBD or sRBD were recruited (15 female and 10 male, mean age 63.6±13.86 years). Video analysis of DEB in all the REM sleep during their night PSGs was retrospectively performed using RBDSS. According to the clinical history depicting behaviors were also categorized by RBDSS-C to compare with the video RBDSS. Comparison of difference of RBDSS in between patients with iRBD and in those with sRBD was done. The frequency of DEB during the night PSG was measured as RBD density. Results: iRBD patients had higher RBD density than sRBD despite the same disease duration. iRBD patients also tended to have higher RBDSS than sRBD, compatible with higher prevalence of injury history. Night-night variability was observed in the patients comparing RBDSS and RBDSS-C. Conclusions: RBDSS is an easy tool to analyze severity of DEB in patients with RBD. Analysis of clinical feature of DEB may give a clue to differentiation of RBD patients as well as the alarm for the treatment of RBD to prevent potential injury.

한국 렘수면행동장애 환자의 렘수면무긴장소실의 정량적 분석:도수적 방법과 컴퓨터 지원 방법과의 비교

이지훈,신원철,정유진,차현극,최혜연 대한수면연구학회 2014 Journal of sleep medicine Vol.11 No.2

Objectives : The Polysomnographic(PSG) hallmark of REM sleep behavior disorder (RBD) is loss of muscle atonia during REM sleep; REM sleep without atonia (RSWA). However, the international classification of sleep disorders (ICSD) – 3 criteria did not suggest optimized diagnostic value of RSWA and how to score muscle activity during REM sleep. Many previous studies have been tried to figure out the objective quantitative cut- off values of RSWA. We investigated RSWA in Korean RBD patients compared with normal control, to figure out it’s cut-off value in diagnosis of RBD, using both manual and computer-assisted scoring methods (REM atonia index, RAI). Methods: We retrospectively analyzed PSG and clinical data of 40 patients, 10 age-matched controls by ICSD-3 criteria. The quantitative analysis of chin electromyography (EMG) density during REM sleep was done by both manual and computerized method. The RSWA and RAI were compared within two groups to figure out cut-off values for distinguishing two groups. Result: In computerized method, the mean RAI of RBD patient was 0.66 [±0.20, standard deviation (SD)], and 0.93 [±0.38, SD, p<0.001) in control group. Also, in manual method, RSWA were also significantly increased within RBD patient compared with normal controls. (tonic activity : 9.1±10.3 vs 0.1±0.2, phasic activity : 7.5±6.4 vs 1.6±1.2, p<0.002) Conclusion : We quantitatively figured out the characteristics of RSWA in Korean RBD patients and suggest that we may diagnose RBD who have RSWA more than 4.1% of total REM sleep duration and RAI lower than 0.84.

과다수면증으로 오인된 양성수면인식장애

장철원,지기환 대한수면연구학회 2015 Journal of sleep medicine Vol.12 No.2

A condition of underestimation of sleep is classified as paradoxical insomnia or sleep state misperception. However, overestimation of sleep, so called positive sleep status misperception has not been clearly described. Here we report a middle-aged woman with positive sleep status misperception who presented excessive sleepiness mimicking hypersomnia.

기면증에서의 수면다원검사와 수면잠복기반복검사

김지언 대한수면연구학회 2008 Journal of sleep medicine Vol.5 No.2

The multiple sleep latency test (MSLT) has played a major role in the diagnosis of narcolepsy. The MSLT is indicated as part of the evaluation of patients with suspected narcolepsy and may be useful in the evaluation of patients with suspected idiopathic hypersomnia. The MSLT cannot be used in isolation to confirm or exclude narcolepsy, is indicated only in selected patients with excessive daytime sleepiness, and is most valuable when interpreted in conjunction with clinical findings.

불면증상이 동반된 폐쇄성 수면 무호흡 환자의 정서적, 성격적 특성 : 미네소타 다면적 인성검사 분석

이지훈,신원철,나부석,이학영,최혜연,김상범,성민지,조한아,차현극 대한수면연구학회 2015 Journal of sleep medicine Vol.12 No.2

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. J Sleep Med 2015;12(2):59-63

렘수면행동장애 진단을 위한 렘수면무긴장소실의 정량적 분석: 후향적 환자-대조군 연구

김지영,이가현,성상민,김태웅,정대수 대한수면연구학회 2020 Journal of sleep medicine Vol.17 No.1

Objectives: Rapid eye movement (REM) sleep without atonia (RSWA) fulfils one of the criteria for diagnosing REM sleep behavior disorder (RBD) according to the International Classification of Sleep Disorders, Third Edition. However, RSWA quantification is an unresolved issue, which is associated with the future direction of revising the diagnostic criteria. The purpose of this study was to evaluate the quantification of RSWA in patients with RBD and identify an optimal cut-off value of quantitative RSWA for RBD diagnosis. Methods: Medical records and polysomnographic results were analyzed retrospectively to diagnose sleep disorders from June 2017 to May 2018 at Pusan National University Hospital. Nineteen subjects with idiopathic RBD were included in the present study. Propensity score matching was used to control age, gender, and anti-depressant factors, which influenced RSWA. RSWA was scored according to the American Academy of Sleep Medicine scoring manual. Cohen’s kappa coefficient was measured to test inter-rater reliability between two polysomnography raters. Results: Cohen’s kappa coefficients were 0.755 (p<0.001) and 0.689 (p<0.001) for tonic and phasic activities, respectively. RSWA was significantly increased in subjects with RBD compared with controls [median and interquartile range: 16.5 (8.8–24.6) vs. 6.3 (4.1–7.2) p=0.001]. The optimal cut-off value was 8.0% for the proportion of RSWA (sensitivity 78.5%, specificity 85.7%, area under the receiver-operating characteristic curve 0.837). Conclusions: Subjects with RBD had significantly increased RSWA compared to controls. The proportion of RSWA during REM sleep can be applied to discriminate subjects with RBD from controls.

기면병 환자의 졸음운전 관련 교통사고 예방을 위한 제안

조재욱,선우준상,임수환,김대영,구대림,임희진,김혜윤,김경민,양광익,대한수면연구학회 대한수면연구학회 2021 Journal of sleep medicine Vol.18 No.3

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.

렘수면 행동 장애와 퇴행성 신경계 질환

천상명 대한수면연구학회 2009 Journal of sleep medicine Vol.6 No.1

REM sleep behavior disorder (RBD) is characterized by dream-enacting violent behavior during REM sleep, which usually start at the age of older than 50. Patients with idiopathic RBD (IRBD) show various features similar to parkinsonian disorders and many of patients are known to be developing symptoms of neurodegenerative disorders in the course of disease. These close associations suggest that clinicians need to know the potential risk of developing parkinsonism and pay more attention to various features beyond sleep complaint when they manage the IRBD patient.

Deep Learning Based Symbol Detection in Engineering Drawings

Joon-Young Kim(김준영),Taekyong Lee(이태경) 대한기계학회 2020 대한기계학회 춘추학술대회 Vol.2020 No.12