• Journal of Oriental Neuropsychiatry
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• v.27 no.4
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• pp.223-234
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• 2016

Objectives: This study was carried out to develop a standard tool of pattern identifications for insomnia in Korean Medicine. Methods: The advisory committee for this study was organized by 17 Korean Medicine neuropsychiatry professors who were faculty members of different Korean Medicine colleges. The pattern identifications and symptoms for this tool were extracted from published Korean and Chinese literature. The Instrument on Pattern Identifications for Insomnia was developed following discussions among internal experts and after consultations with members of the advisory committee. Results: 1) Five pattern identifications were set for the tool. 2) The mean weights which represent the importance of each symptom and scored on a hundred-point scale were obtained. 3) The Instrument on Pattern Identifications for insomnia was designed in the self-reporting format composed of 47 questions. Conclusions: An Instrument on Pattern Identifications for Insomnia was created in this study. However, owing to any clinical trials has not been set yet. Therefore its validity and reliability were not confirmed. To make up for this limitation, the further clinical study would be performed in the near future.

• Journal of Oriental Neuropsychiatry
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• v.27 no.4
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• pp.235-248
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• 2016

Objectives: The aim of this review was to investigate whether evidence of complementary and alternative medicine (CAM) was reflected in clinical practice guidelines (CPGs) for insomnia based on relevant clinical trials. Methods: We conducted a systematic search on domestic and international CPG databases and medical databases. In addition, we conducted manual searches of relevant articles. Three authors independently searched and selected relevant studies; any disagreement was resolved by discussion. We extracted and analyzed the following data: published language, country, development group, participants, interventions, presence or absence of recommendations for CAM, level of evidence, grade of recommendation for CAM, and methods of development. Results: We identified 8,241 records from domestic and international databases, and 22 CPGs were included. Eleven of the 22 CPGs mentioned CAM interventions including herbal medicine, relaxation, acupuncture moxibustion, Tai Chi, meditation, hypnosis, biofeedback, Tuina, and external herbal medicine. However, most of the CPGs indicated 'no recommendation' or 'weak recommendation' for CAM interventions. Only Valeriana dageletiana Nakai and relaxation were considered to have experimental evidence. Valeriana dageletiana Nakai was recommended for improvement of sleep latency, sleep maintenance, total sleeping time, and sleep cycle. Relaxation was recommended as effective intervention for relieving physical and psychological arousal. Conclusions: Despite systematic reviews and randomized controlled trials on CAM for insomnia, most of the CPGs for insomnia did not reflect the evidence obtained. Further CPGs for insomnia should be developed by considering the current advanced studies in the field of CAM.

• Sleep Medicine and Psychophysiology
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• v.2 no.1
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• pp.82-90
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• 1995

Objectives : Insomnia is significantly influenced by the pre-sleep arousal, self efficacy, sleep hygiene, depression and anxiety. The authors tried to explore how these factors are related with the clinical features of sleep. Methods : Fifty three patients diagnosed as insomnia by DSM-IV criteria were studied. They filled up the pre-sleep arousal scale(PSAS), sleep efficacy scale(SES), sleep hygiene awareness and practice scale, BDI, and state and trait anxiety scales. Results: 1) The mean values of sleep-related variables were as follows : Sleep latency,136.89 minutes ; frequences of awakening during a night, 2.28 ; minutes to get back to sleep, 42.70 ; total sleep time, 180.19 minutes ; duration of illness, 72.00 months. 2) The mean scores of scales were as follows : PSAS(cognitive), 22.40 ; PSAS(somatic), 17.32 ; SES, 20.16 ; sleep hygiene knowledge, 25.96 ; caffein knowledge, 59.78 ; sleep hygiene practice, 42.12 ; BDI. 18.2 ; state anxiety, 41.24 ; trait anxiety ; 44.50. 3) In the subjects with superimposed depression, the mean frequency of awakening during a night and the mean pre-sleep arousal scale score were higher than in those without depression. 4) Frequency of awakening were correlated positively with a PSAS(a tight tense feeling in your muscle) and sleep hygiene awareness. PSAS(cognitive) were correlated positively with a PSAS(somatic). BDI correlated positively with a PSAS item(a jittery, nervous feeling in your body)and a SES item (not allow a poor night's sleep to interfere with daily activities). Anxiety scales were correlated positively with sleep hygiene practice scale sleep, and PSAS were correlated negatively with SES. Conclusions : The mean scores of PSAS, SES, sleep hygiene awareness and practice scale, BDI, state and trait anxiety scales of insomniacs were correlated either positively or negatively in insomnia patients. These factors seem to contribute to the development and maintainence of insomnia.

• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.235-245
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• 2017

Purpose: Reported insomnia and decreased sleep quality are common among older adults. The purpose of this study was to identify factors contributing to insomnia and decreased sleep quality among elderly persons living within a community. The data will be verified with Actigraph which is a non-invasive measurement of rest/activity cycles. Methods: 137 participants over 65 years old were recruited from a senior welfare center. Their mean age was $74.07{\pm}5.18years$ old and majority was women (69.3%). The quality and quantity of nighttime sleep were assessed using Varren-synder-Halper Sleep Scale and a sleep log. Depression and fatigue were assessed using Geriatric Depression Scale Short Form and Fatigue Severity Scale, respectively. Pain was assessed using 11-point Numeric rating scale. An actigraph was used to verify the self-reported sleep. Results: Ninety-two participants (67.2%) reported insomnia. Sixty-eight subjects (49.6%) reported good sleep. Of the participants, 56.2% reported depression and 33.6% reported fatigue. In logistic regression, depression was related to insomnia (OR=3.09, p=.003). Sleep quality was related to depression (OR=2.13, p=.045) and fatigue (OR=2.24, p=.044). The data from the Sleep logs correlated with data obtained from the actigraph. Conclusion: Depression significantly influenced insomnia and sleep quality whereas fatigue only influenced sleep quality. Thus, depression and fatigue should be closely monitored among elderly persons with sleep disturbances.

• The Journal of Korean Medicine
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• v.36 no.1
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• pp.86-92
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• 2015

Objectives: The purpose of this study is to present two treatment cases of psoriasis with insomnia. Methods: We administered Guibi-tang medication to the psoriasis patients with insomnia and tested the results by Psoriasis Area and Severity Index(PASI) and Insomnia Severity Index(ISI) as well. Results: After the treatment both the patients showed improvements in PASI and ISI as well. PASI of Patient 1 changed from 15.2 to 1.2 along with the change of ISI from 27 to 2. In case of Patient 2, PASI changed from 14.6 to 1.8 while ISI changed from 21 to 6. Conclusions: The results suggest that Guibi-tang can be an effective treatment for insomnia and psoriasis as well. Further studies will be needed to demonstrate conclusively the effect of Guibi-tang on psoriasis cure.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.3
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• pp.54-64
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• 2017

Objectives: The purpose of this study is to demonstrate Heart Rate Variability characteristics of menopausal patients with insomnia. Methods: From March 1, 2014 to June 20, 2017, Heart Rate Variability was measured in 102 menopausal patients who visited Cheonan Korean Medicine Hospital of Daejeon University. We compared accompanying symptoms and Heart Rate Variability values depending on sleep quality in menopausal women. Results: The accompanying symptoms of menopausal patients were as follows: hot flushes (45.1%), tiredness (25.49%), chest discomfort and palpitations (23.53%), headache (17.65%), arthralgia and muscular pain (17.65%), cold sensitivity of hands and feet (15.69%), urinary frequency (14.71%) and anxiety (10.78%). The frequency of chest discomfort and palpitation was significantly higher in the menopausal insomnia group than in normal sleep group. Comparing Heart Rate Variability between two groups, Standard deviation of the NN interval (SDNN), Total Power (TP), and Low Frequency (LF) values were significantly lower in insomnia group. Conclusions: Chest discomfort and palpitations were more frequent in insomnia patients in menopausal women than normal sleep group, and Standard deviation of the NN interval (SDNN), Total Power (TP), Low Frequency (LF) were significantly lower in HRV values.

• Safety and Health at Work
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• v.13 no.2
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• pp.240-247
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• 2022

Background: Although insomnia and constipation are highly prevalent worldwide, studies examining a possible association between them are lacking. We examined the relationship between insomnia and constipation in shift workers who have a high prevalence of insomnia and other diseases. Methods: This study had a multicenter cross-sectional design and conducted using health examination data including self-reported questionnaires. In total, 12,879 and 4,650 shift workers were enrolled in Severance Hospital and Wonju Severance Hospital, respectively, during 2015-2017. Multivariate logistic regression models and subgroup analysis were performed in each center with the same protocol, using a common data model. Results: The mean age of the total population was 44.35 (standard deviation = 8.75); the proportion of males was 56.9%. Female sex, being underweight and non-smoker were strongly associated with an increased risk of constipation symptom (p < 0.001). Pooled odds ratios (ORs) were calculated using ORs of both centers with weights; there was a significant dose-response relationship (sub-threshold 1.76 [95% confidence interval [CI] 1.62-1.91]; moderate 2.28 [95% CI 2.01-2.60]; severe 4.15 [95% CI 3.18-5.41] in the final model, p for trend < 0.001). Subgroup analysis performed by stratifying sex and pooled ORs showed a similar trend to that of the entire group. Conclusion: We observed a strong correlation between insomnia and constipation in this population. Our findings may help in formulating guidelines and policies to improve quality of life in shift workers through the management of sleep quality and proper bowel function. This study is the first to report this relationship among people working in shifts.

• The Journal of the Society of Stroke on Korean Medicine
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• v.20 no.1
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• pp.1-8
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• 2019

A case of a 46-year-old Korean male with post-stroke insomnia that induced by intracranial hemorrhage was presented. He was treated with Transcutaneous electric acupoint stimulation (TEAS) at BL62 and KI6 once per a day for 17 days. We recorded the patient's sleep time and time of asleep, and used PSQI-K to assess severity of patient's insomnia symptom. After using TEAS, there was improvement in patient's insomnia severity and the time of sleep. From the result of this case, electrical stimulation at acupoint can may be effective in treating post-stroke insomnia.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.3
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• pp.56-73
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• 2022

Objectives: This study was aimed to review the effect of acupuncture for insomnia in climacteric syndrome. Methods: Researchers searched data through 5 online databases up to December 2021. The data was limited to randomized controlled trial studies on patients diagnosed with insomnia in climacteric syndrome. Results: 8 Randomized controlled trials were included in this study. 6 of studies were published in Chinese, in China. 2 were published in English. Intervention of treatment group were composed of simple acupuncture. Intervention of control group were made up with Estazolam, Alprazolam, Lorazepam and sham-acupuncture. Outcome measurements were Total effective rate, Pittsburgh Sleep Quality Index (PSQI), Kupperman index, Menopause Quality of Life scales (Men-QoL), the level of hormones (E2, FSH, LH) etc. In all outcome measurements, treatment group were more effective than control group and it was statistically significant. Conclusions: Acupunture therapy is effective for treating insomnia in climacteric syndrome. Pittsburgh Sleep Quality Index (PSQI) is most frequently used for sleep assessment indicator. 神門 (HT7) is the most frequently used acupoint for treatment group. However because insomnia in climacteric syndrome is easy to recur, additional long-term research is needed.

• Journal of Oriental Neuropsychiatry
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• v.34 no.3
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• pp.181-212
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• 2023

Objectives: To examine the efficacy and safety of cupping therapy for insomnia disorder and provide clinical evidence that could contribute to further research. Methods: We searched randomized controlled trials (RCTs) that verified effects of cupping therapy for insomnia disorder from 11 domestic and foreign databases. Included studies were evaluated using Risk of Bias (RoB). Results: Nineteen RCTs were selected. Wet cupping was more frequently used than dry cupping. Moving cupping was mostly used among dry cupping methods. Dry cupping was mainly performed in Bladder Meridian on the back. Wet cupping was mainly performed on BL18, LR14, and BL15. The most common treatment period was 4 weeks. The average number of treatments per week was about 2.4 times for all types of cupping, about 3.2 times for dry cupping and about 1.9 times for wet cupping. All selected studies showed a significant sleep improvement compared to the control group. As a result of the meta-analysis, in terms of effective rate, SAS score, and SDS score, the wet cupping in combination with acupuncture was significantly more effective than acupuncture alone, although the quality of selected RCTs was low. Conclusions: Cupping therapy is effective for insomnia disorder. Based on results of this study, it is reasonable to use wet cupping two times per week on BL18, LR14, and BL15 or use moving cupping three times per week in Bladder Meridian on the back for 4 weeks to treat insomnia disorder.