• Journal of Oriental Neuropsychiatry
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• v.24 no.1
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• pp.103-108
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• 2013

Objectives : Korea's average life expectancy is getting longer and longer and the pace of change in society has increased every year as people experience stress more easily. Under this situation, chronic sleep disorder is increasing, but there is no specific program for the treatment of sleep disorder in Korean medicine. Therefore, we studied a Korean medical treatment program for sleep disorder to apply to outpatient clinic patients. Methods : For this study, we evaluated the Insomnia Severity Index (ISI), BDI, STAI, FSS on 29 insomnia patients who visited Kyunghee Korean medical hospital from July 2010 to May 2012. Herbal medicine, acupuncture, herbal acupuncture, moxibustion, sleep hygiene, and medical qigong were applied. We compared ISI scores before treatment and after 4 weeks of treatment. Results : ISI score was improved after Korean medical treatment for sleep disorder. Before the treatment ISI score was 18.1, which means clinical insomnia. After the Korean medical treatment, the score was 7.5, which means no clinically significant insomnia. Conclusions : The study showed a significant effect on the Korean medical treatment program for sleep disorder to apply to outpatient clinic patients. ISI score was improved and the patients were satisfied with the treatment, so it would be more helpful to apply in sleep clinics.

• Journal of Preventive Medicine and Public Health
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• v.54 no.1
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• pp.46-54
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• 2021

Objectives: This study explored the relationship between shift intensity and insomnia among hospital nurses. Methods: The participants were 386 female hospital nurses who underwent a special health examination for night workers in 2015. The Korean Insomnia Severity Index (ISI), indices of shift work intensity, and other covariates such as amount of exercise, level of alcohol consumption, employment duration, and hours worked were extracted from the health examination data. The indices for shift intensity were (1) number of 3 consecutive night shifts and (2) number of short recovery periods after a previous shift, both assessed over the prior 3 months. Multiple logistic regression analysis adjusted for the aforementioned covariates was performed to evaluate the association of shift intensity with insomnia, defined as an ISI score of ≥8. Results: The nurses with insomnia tended to be younger (p=0.029), to have worked 3 consecutive night shifts more frequently (p<0.001), to have experienced a greater number of short recovery periods after the previous shift (p=0.021), and to have worked for more hours (p=0.006) than the nurses without insomnia. Among the other variables, no statistically significant differences between groups were observed. Experiences of 3 or more consecutive night shifts (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.29 to 4.20) and 3 or more short recovery periods (OR, 2.01; 95% CI, 1.08 to 3.73) were associated with increased odds of insomnia. Conclusions: The results suggest that decreasing the shift intensity may reduce insomnia among hospital nurses working rotating shifts.

• Journal of Oriental Neuropsychiatry
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• v.31 no.1
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• pp.1-12
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• 2020

Objectives: The purpose of this study was to evaluate the reliability and validity of the instrument on pattern identification for insomnia (PIT-Insomnia) and verify the correlation between PIT-Insomnia and psychological tests. Methods: Two evaluators examined the pattern identification of the participants who met insomnia disorder diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) and took the Insomnia Severity Index (ISI) score over 15 once manually and twice using the PIT-Insomnia to measure the inter-rater and test-retest reliability. We also conducted the following surveys: the Pittsburgh Sleep Quality Index (PSQI), the Korean version of Beck's depression inventory (K-BDI), the Korean version of the State-Trait Anxiety Inventory (STAI-K), the Korean Symptom checklist-95 (KSCL-95), and the EuroQol-5 dimension (EQ-5D), to measure concurrent validity and correlation between the PTI-Insomnia and psychological tests. Results: 1. The test-retest reliability analysis of the pattern identification results showed moderate agreement, and test-retest reliability analysis of each pattern identification score showed agreements from poor to moderate. 2. The inter-rater reliability analysis of the pattern identification results via manual showed slight agreement, when analysis was performed with calibration, the inter-rater reliability analysis of the pattern identification results via manual showed fair agreement. 3. The concordance analysis between results via manual and the PIT-Insomnia showed poor agreement, when the analysis was performed with calibration, concordance analysis showed fair agreement. 4. The concordance analysis between the PIT-Insomnia and the PSQI showed positive linear correlation. 5. The concordance analysis between the PIT-Insomnia and the PSQI, K-BDI, STAI-K, KSCL-95, and EQ-5D showed that non-interaction between the heart and kidney have positive linear correlation with the K-BDI, anxiety item of KSCL-95, dual deficiency of the heart-spleen have positive linear correlation with somatization item of KSCL-95, paranoia item of KSCL-95, heart deficiency with timidity have positive linear correlation with stress vulnerability item of KSCL-95, parania item of KSCL-95, phlegm-fire harassing the heart have positive linear correlation with K-BDI, paranoia item of KSCL-95, depressed liver qi transforming into fire have positive linear correlation with the anxiety item of KSCL-95, parania item of KSCL-95, all pattern identification have negative linear correlation with EQ-5D. Conclusions: The PIT-Insomnia has moderate agreement of reliability and reflects the severity of insomnia since it has some concurrent validity with the PSQI. There are some correlations between the PTI-Insomnia with specific psychological tests, so we could suggest it can be used appropriately in the clinical situation.

• Journal of Sleep Medicine
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• v.15 no.2
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• pp.62-67
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• 2018

Objectives: Restless leg syndrome (RLS) is a common sensorimotor disorder and is frequently associated with periodic limb movement in sleep (PLMS). Also about one third of patient with RLS have periodic limb movement during wakefulness (PLMW). However there is little research on the correlation between PLMW and RLS. We aimed to evaluate difference in sleep characteristics between patients with RLS with PLMW and those without PLMW. Methods: Our study included twenty eight RLS patients. Subjects underwent suggested immobilization test (SIT) prior to one full-night polysomnography study. Patients were classified into two groups according to the presence of PLMW based on SIT-PLMW index. Polysomnographic findings, subjective sleep quality, and hematologic results were analyzed and compared between the two groups. Results: Mean age of patient with frequent PLMW (SIT-PLMW ${\geq}40/hr$) was significantly higher. RLS patients with frequent PLMW were also significantly related to insomnia severity. The PLMS index was higher in patients with PLMW and showed a significant correlation with the PLMW index. Conclusions: PLMW influence sleep quality such as insomnia and is correlated with movement during sleep.

• The Journal of Korean Medicine
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• v.44 no.3
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• pp.126-139
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• 2023

Objectives: The purpose of this study was to evaluate the effectiveness of insomnia treatment applied with Giungoroen-therapy in relieving adhesive capsulitis. Methods: There is a patient who has had insomnia symptoms for 2 years ago and complained of shoulder pain from 5 months ago. Korean medicine treatment like acupuncture, pharmacopuncture, herbal medicine and Giungoroen -therapy was applied to this patient. As evaluation tools, the numeral rating scale(NRS), a tool for pain evaluation and the Insomnia Severity Index(ISI), a sleep quality evaluation tool, were used. After 12 days of treatment, the range of motion of the shoulder joint increased and the NRS score improved from 8 to 5 and the ISI score improved from 22 to 16. Conclusion: For the treatment of adhesive capsulitis, it can be effective to relieve insomnia by applying Korean medicine treatments, including Giungoroen-therapy.

• Journal of Korean Medicine for Obesity Research
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• v.20 no.1
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• pp.40-51
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• 2020

Objectives: We aimed to compare the quality of sleep, tongue diagnosis, oral microbiology differences in insomnia of Liver qi stagnation (LQS) and Non-Liver qi stagnation (NLQS). Methods: 56 patients were classified as LQS or NLSQ type insomnia through the insomnia differentiation questionnaire. The depression scores between the groups were compared through beck depression inventory (BDI), and the sleep quality was compared through Pittsburgh sleep quality index (PSQI) and Insomnia Severity Index (ISI). We analyzed the sleep efficiency, total sleep time, total awake frequency, total and average awake time through actigraph. For the tongue diagnosis, the distribution of tongue coating in six areas were measured through Winkel tongue coating index (WTCI). Linear discriminant analysis was performed to observe the differences in composition of microbial strains between the groups. Results: The scores of BDI, ISI and PSQI were significantly higher in LQS group. The total sleep time in LQS group was significantly less than that of NLQS group. Among the areas of tongue, according to the WTCI, the amount of tongue coating in zones A and C was significantly small. In oral microbial analysis, there was no significant difference between the groups at the phylum level. At the genus level, Prevotella, Veillonella, and Streptococcus were predominant in LQS group, whereas Prevotella, Neisseria, and Streptococcus in NLQS group. Conclusions: It was meaningful that insomnia was more likely in LQS group than in NLQS group, and the composition of oral microorganisms was significantly different, which could lead to the diseases caused by stress.

• Journal of Pharmacopuncture
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• v.21 no.1
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• pp.7-13
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• 2018

Objective: Hwa-byung is one of the cultural concept of distress in Korea resulted from chronic accumulated anger. It is characterized by various symptoms like stuffy in the chest, hot or heat sensation, something pushing up in the chest, feeling of mortification, and a flush of anger. This protocol aims to explore the efficacy and safety of Huanglian-jie-du decoction on various somatic symptoms and insomnia in patients with Hwa-byung. Methods: This is study protocol for a randomized, double-blind, placebo-controlled trial. A total of 44 patients will be randomly assigned to the experimental group or the placebo group in a 1:1 ratio. All medications will be taken orally 3 times per day for 7 consecutive days. The primary outcomes are the mean changes in Patient Health Questionnaire of physical symptoms (PHQ-15) and Insomnia Severity Index (ISI) after the 7 days of administration. The secondary outcomes include the scales to assess stress response, symptoms of Hwa-byung, and state anger. Conclusion: The results of this study will provide high quality and explorative evidence to investigate the effect of Huanglian-jie-du decoction on Hwa-byung.

• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.422-432
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• 2009

Purpose: In this study rest-activity rhythm, sleep pattern and quality of life of patients with restless legs syndrome were compared with those of a normal group. Methods: The participants in this study were 36 patients with restless legs syndrome diagnosed by a neurologist and 36 participants in the normal group. An actigraph, sleep diary, Pittsburgh Sleep Quality Index and Insomnia Severity Index scale were used as measurement tools for the study. Chi-square test, Lamda test, t-test and Kendall's correlation with SPSS 12.0 program were used to analyze the data. Results: Patients with restless legs syndrome had a higher rest-activity rhythm curve of Least 5 hr's activity(L5) and Most 10 hr's activity(M10) than those of normal group and sleep problems included decreased sleep efficiency and increased sleep latency, wake time and number of awakenings. The scores for the subscales of quality of life in patients with restless legs syndrome were lower than the normal group for general health, physical functioning, role limitations due to emotional problems, role limitation due to physical problems, social functioning, bodily pain, vitality and mental health. Conclusion: The results suggest that further studies are needed to identify rest-activity rhythm according to symptom severity and to develop nursing interventions which consider rest-activity rhythm.

• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.3
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• pp.157-174
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• 2021

Objectives: This case report aims to report the clinical effectiveness of the combination treatment of Korean medicine with Guibiondamtang-gamibang on Hwa-byung patients. Methods: Case 1 experienced stress at work and complained of chest discomfort, nausea, dizziness, insomnia. Case 2 experienced huge stress about money, and complained of palpitation, chest discomfort, dizziness and insomnia. They received combination treatment of Korean medicine during hospitalization. The treatment included Guibiondamtang-gamibang, acupuncture, moxibustion, pharmacoacupuncture, and fumigation. The effects were evaluated through Hwa-byung scale, instrument of oriental medical evaluation for Hwa-byung, insomnia severity index (ISI) and heart rate variability (HRV) test. Results: After the treatment, the clinical symptoms such as chest discomfort, palpitation, dizziness, nausea and insomnia were improved. Conclusions: This case report shows that the combination treatment of Korean medicine with Guibiondamtang-gamibang may be effective for treating Hwa-byung patients.

• Journal of Oriental Neuropsychiatry
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• v.29 no.4
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• pp.305-314
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• 2018

Objectives: The objective of this study was to report the clinical effectiveness of the complex Korean medicine therapy and M&L (Mindfulness & Loving presence) psychotherapy on the patient with panic disorder. Methods: The subject for this study was the patient diagnosed with panic disorder who complained about intermittent panic attack and accompanying insomnia. During the treatment period, the patient received complex Korean therapy and M&L psychotherapy. The clinical effects were evaluated through Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory (STAI), Panic Disorder Severity Scale (PDSS), and Pittsburgh Sleep Quality Index (PSQI). Results: After the complex Korean medicine therapy and M&L psychotherapy, the overall symptoms of depression, anxiety, panic disorder and insomnia of the patient were lessened in a relatively short period. No specificities or adverse effects were reported during the treatment period. Conclusions: This study established that the complex Korean medicine therapy and M&L psychotherapy was effective in treating patients with panic disorder.