주간과다졸림 및 불면증을 호소하는 환자의 임상적, 수면다원검사적 특징 = Clinical and Polysomnographic Characteristics of Patients Complaining of Excessive Daytime Sleepiness and/or Insomnia

다국어 초록 (Multilingual Abstract)

Objectives: This study aimed to investigate group differences in demographic, clinical, and polysomnographic characteristics based on the presence or absence of excessive daytime sleepiness (EDS) and insomnia symptoms.Methods: In this retrospective study, patients were divided into five groups based on their Epworth Sleepiness Scale and Insomnia Severity Index scores. The participants’ demographics, sleep-related symptoms, questionnaires, and polysomnography findings were used in the analysis.Results: The study found that patients in the group with EDS were younger, were mostly males, and had higher body mass index (BMI) than other groups. They also reported obstructive sleep apnea symptoms. The patients in the group with both EDS and insomnia were younger and had a higher BMI than other groups. They reported higher levels of fatigue and depression, as well as insomnia, rapid eye movement sleep behavior disorder and restless legs syndrome symptoms. The patients in the group with only insomnia had a higher proportion of females, were older, and had a lower BMI than other groups. Most characteristics of the patients in the threshold insomnia group were similar to those of the patients in the EDS-insomnia group. The normal group had a higher proportion of males and a higher prevalence of obstructive sleep apnea; however, they reported lower sleep-related symptoms. Furthermore, the polysomnography showed differences among the five groups in total sleep time, sleep latency, sleep efficiency, total arousal index, and spontaneous arousal. Total apnea-hypopnea index was significantly lower in the insomnia group than that in other groups.Conclusions: This study demonstrated the clinical and polysomnographic characteristics of the five groups through self-reported questionnaires. The findings provided evidence to help assess patients’ sleep problems and the possibility of sleep disorders.

참고문헌 (Reference)

1 임선영 ; 이은정 ; 정성원 ; 김희철 ; 정철호 ; 전태연 ; 이민수 ; 김재민 ; 조현주 ; 김정범, "한국판 벡 우울 척도 2판의 타당화 연구" 대한불안의학회 7 (7): 48-53, 2011

2 김명규, "주간 과다졸음의 진단과 평가" 대한수면연구학회 1 (1): 1-7, 2004

3 소민아, "수면클리닉을 방문한 환자들의 불면증에 대한 인식조사" 대한수면의학회 26 (26): 23-32, 2019

4 이세영 ; 강재명 ; 조윤수 ; 윤현진 ; 김지언 ; 신승헌 ; 박기형 ; 김선태 ; 강승걸, "수면무호흡증과 단순 코골이 환자의 증상과 질환 인식도 비교" 대한수면의학회 23 (23): 16-24, 2016

5 이정현 ; 정현석 ; 임수미 ; 조한별 ; 마지영 ; 고은 ; 임주연 ; 이선혜 ; 배수진 ; 이유진 ; 류인균 ; 정도언, "대학교 재학생에서 Fatigue Severity Scale의 신뢰도 및 타당도 연구" 대한생물정신의학회 20 (20): 6-11, 2013

6 Bastien CH, "Validation of the insomnia severity index as an outcome measure for insomnia research" 2 : 297-307, 2001

7 조용원 ; Mei Ling Song ; Charles M. Morin, "Validation of a Korean Version of the Insomnia Severity Index" 대한신경과학회 10 (10): 210-215, 2014

8 Javaheri S, "Update on persistent excessive daytime sleepiness in OSA" 158 : 776-786, 2020

9 Sohn SI, "The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index" 16 : 803-812, 2012

10 Cho YW, "The reliability and validity of the Korean version of the Epworth sleepiness scale" 15 : 377-384, 2011

11 Krupp LB, "The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus" 46 : 1121-1123, 1989

12 Buysse DJ, "The Pittsburgh Sleep Quality Index : a new instrument for psychiatric practice and research" 28 : 193-213, 1989

13 Wulterkens BM, "Sleep structure in patients with COMISA compared to OSA and insomnia" 2023

14 Roth T, "Sleep problems, comorbid mental disorders, and role functioning in the national comorbidity survey replication" 60 : 1364-1371, 2006

15 Karna B, "Sleep disorder" StatPearls Publishing 2022

16 Zhang B, "Sex differences in insomnia : a meta-analysis" 29 : 85-93, 2006

17 Kim KW, "Prevalence and clinical characteristics of insomnia and its subtypes in the Korean elderly" 68 : 68-75, 2017

18 Hoffstein V, "Predictive value of clinical features in diagnosing obstructive sleep apnea" 16 : 118-122, 1993

19 Crönlein T, "Polysomnography reveals unexpectedly high rates of organic sleep disorders in patients with prediagnosed primary insomnia" 16 : 1097-1103, 2012

20 American Academy of Sleep Medicine, "International classification of sleep disorders. 3rd ed"

21 Kao CC, "Insomnia : prevalence and its impact on excessive daytime sleepiness and psychological well-being in the adult Taiwanese population" 17 : 1073-1080, 2008

22 Buysse DJ, "Insomnia" 309 : 706-716, 2013

23 Tami TA, "Identification of obstructive sleep apnea in patients who snore" 108 (108): 508-513, 1998

24 Barateau L, "Hypersomnolence, hypersomnia, and mood disorders" 19 : 13-, 2017

25 Zhou J, "Excessive daytime sleepiness predicts neurodegeneration in idiopathic REM sleep behavior disorder" 40 : zsx041-, 2017

26 Seneviratne U, "Excessive daytime sleepiness in obstructive sleep apnea : prevalence, severity, and predictors" 5 : 339-343, 2004

27 Gandhi KD, "Excessive daytime sleepiness : a clinical review" 96 : 1288-1301, 2021

28 Pagel JF, "Excessive daytime sleepiness" 79 : 391-396, 2009

29 Morphy H, "Epidemiology of insomnia : a longitudinal study in a UK population" 30 : 274-280, 2007

30 Ohayon MM, "Epidemiology of excessive daytime sleepiness" 1 : 9-16, 2006

31 조용원 ; 신원철 ; 윤창호 ; 홍승봉 ; 김주한 ; Christopher J. Earley, "Epidemiology of Insomnia in Korean Adults: Prevalence and Associated Factors" 대한신경과학회 5 (5): 20-23, 2009

32 Ohayon MM, "Epidemiological and clinical relevance of insomnia diagnosis algorithms according to the DSM-IV and the international classification of sleep disorders(ICSD)" 10 : 952-960, 2009

33 Sadeghniiat-Haghighi K, "Comparison of two assessment tools that measure insomnia : the insomnia severity index and polysomnography" 36 : 54-57, 2014

34 Luyster FS, "Comorbid insomnia and obstructive sleep apnea : challenges for clinical practice and research" 6 : 196-204, 2010

35 Lang CJ, "Co-morbid OSA and insomnia increases depression prevalence and severity in men" 22 : 1407-1415, 2017

36 Xiang YQ, "Clinical features and correlates of excessive daytime sleepiness in Parkinson’s disease" 10 : 121-, 2019

37 Morin CM, "Chronic insomnia" 379 : 1129-1141, 2012

38 Beck AT, "Beck depression inventory–II"

39 Johns MW, "A new method for measuring daytime sleepiness : the Epworth sleepiness scale" 14 : 540-545, 1991