• 제목/요약/키워드: Insomnia disorder

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DSM-V 분류에 따른 수면-각성장애의 한의학적 변증 연구 (The Study on Korean Medical Pattern Differentiation of Sleep-Wake Disorders by DSM-V Classification)

  • 나일두;박미선;김영목
    • 동의생리병리학회지
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    • 제31권2호
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    • pp.83-93
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    • 2017
  • This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.

담정격으로 호전된 불면증 치험례 (A Report on the Insomnia Treated Successfully by Acupuncture)

  • 이현수;임성철;김재수;이윤규;이현종;한창현;이봉효
    • Korean Journal of Acupuncture
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    • 제31권4호
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    • pp.234-239
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    • 2014
  • Objectives : The purpose of this study is to report that acupuncture of Damjeonggyeok(tonifying GB in Sa-Am acupucture) can be effective on chronic insomnia. Methods : The patients were treated with Sa-Am acupucture(Damjeonggyeok) added with HT8 and KI6, once a week. Treatments were performed for 20 minutes. The effectiveness was evaluated using total sleep hours and subjective sleep quality based on the Insomnia Severity Index. Result and Conclusions : In all patients, the sleep quality evaluated with the Insomnia Severity Index has shown amelioration and sleeping time was increased. Also, they quit the insomnia pills. Acupuncture at Damjeonggyeok added with HT8 and KI6 seems to be able to one of useful therapies for the sleep disorder in chronic insomnia.

인숙산(仁熟散)을 이용한 수면장애 소아 환자 치험례(治驗例) (A clinical study on the effect of Insook-san on disorder of sleep in childhood)

  • 이정림;하광수;신지나;송인선
    • 대한한방소아과학회지
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    • 제18권2호
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    • pp.201-208
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    • 2004
  • Objectives : The purpose of this study is to find out whether Insook-san has any effects on children with disorder of sleep. Methods : The subject are in regard to 6 children with disorder of sleep who visited Dong-so Oriental Medicine hospital from September 2003 to June 2004. The herbal therapy are applied. Result : After treatment, the symptoms (Insomnia, sleep terror, night-mare, night crying etc.) were improved. Conclusion : More studies about the Oriental medical treatment and conception on disorder of sleep are needed.

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혼재성 불안 및 우울장애 환자 1례 증례 보고 (A case of Mixed anxiety and depressive disorder)

  • 김보영;이지인;권순주;정대규;이승희
    • 동의신경정신과학회지
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    • 제14권2호
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    • pp.127-134
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    • 2003
  • This is a case report of a patient with mixed anxiety and depressive disorder treated by Punsimgieum. The symptoms of the patient were anxiety(agitation), numbness(paresthesia), nausea, dyspepsia, insomnia and hopelessness. In this case, we administrated Punsimgieum to a patient suffering from anxiety and depressive disorder symptoms. After administration of Punsimgieum medication clinical symptoms improved Punsimgieum showed desirable effect on anxiety and depressive disorder symptoms.

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태음조위탕(太陰調胃湯) 가(加) 대황(大黃) 장복 후 발생한 부면(不眠) 환자에 대한 사물탕가미방(四物湯加味方)의 치험(治驗) 1례(例) (Clinical report of Samultang-gamibang with insomnia occurred after taking Taeeumjoyutang-ga-daehwang)

  • 김민정;서향연;이용양;박원환
    • 대한한의진단학회지
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    • 제18권1호
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    • pp.45-50
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    • 2014
  • Objectives This study was designed to report the effect of Samultang-gamibang(四物湯加味方) for insomnia caused by blood deficiency (syndrome) after excessive weight control treatment with herbal medication Methods This is a retrospective case report. We reviewed the patient's medical record after taking the patient's informed consent. Results After treatment, a patient feels calm and satisfaction emotionally as sleeping time has increased from 2hours to 6hours, the fatigue after sleeping has been reduced, and the quality of sleep has become better. Conclusions This case report suggests that Samultang-gamibang can be effective in improving sleep duration and quality if the patient suffers insomnia due to hyul-heo syndrome. Also the woman who have symptom of hyul-heo(血虛) after weight control through decreased food consumption, should bo-hyul(補血).

수면장애와 동반된 임상증상에 따른 심박변이도와 수면 관련 설문간의 상관성 연구 (The Relation of HRV, PSQI and IQ with Symptoms of Insomnia Patients)

  • 양동호;오경민;김보경
    • 동의신경정신과학회지
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    • 제19권3호
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    • pp.143-169
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    • 2008
  • Objective: This study was to investigate the relation of what insomnia patients' symptoms with Heart Rate Variability(HRV), Pittsburgh Sleep Quality Index (PSQI) and Insomnia Questionaire(IQ). Methods: For this study, we carried out HRV, PSQI and IQ of 43 patients with insomnia who have come to Donguei oriental hospital of Donguei university from September 2007 to May 2008. We studied the relationship HRV with PSQI and IQ. For every symptom, this study classified the patients as none-symptom, symptom groups and analyzed each group's HRV, PSQI and IQ. Result : 1. The rate of xerostomia in female group is significantly higher than male group. 2. P1 (hypnagogic time), P3(awakening time), LF has negative correlation with age. The score of PI (hypnagogic time), P3(awakening time), P4(time of recoverable sleep) in the group whose age is more than 50 are higher than the group whose age is lesser than 50. 3. The frequency of using hypnotics(P6) in the group whose duration of onset are over 1 year was significantly higher than the score in the group whose duration of onset were below 1 year. 4. The accompanied symptoms in the group who started sleep disorder after stressor are higher than the number in the group whose duration of onset were poor-defined. 5. The drinking group have lower rate of anorexia, higher score of P1 (hypnagogic time) and TP than non-drinking group. 6. The score of P-total(general quality of sleep) have negative correlation with NNSO, HF, TP and positive correlation with LF/HF. 7. The score of P1(hypnagogic time) have negative correlation with LF. 8. The score of P5a(frequency of delayed hypnagogue) have positive correlation with LF/HF. 9. The score of P5e(frequency of cough or snoring) have negative correlation with RMSSD. 10. The score of I1a(degree of onset insomnia), I1b(degree of maintenance insomnia) have negative correlation with NN50, pNN50, HF. 11. The score of I1c(degree of termination insomnia) have negative correlation with RMSSD, NN50, pNN50, HF, TP and positive correlation with MHR, LF/HF. 12.. The score of P5i(frequency of night pain), LF/HF in the group with headache are higher than the group without headache. 13. The score of P5a(frequency of delayed hypnagogue), P5c(frequency of awakening for urine of stool) in the group with xerostomia are higher than the group without xerostomia. 14. The score of P9(degree of unrecoverable sleep) and I5a(degree of onset insomnia) in the group with chest discomfort are lower than the group without chest discomfort. 15. The score of P7(frequency of drowsiness for daytime) in the group with palpitation are lower than the group without palpitation. 16. The score of P5c(frequency of awakening for urine of stool), P5f(frequency of burning sensation), P5h(frequency of nightmare), I1c(degree of termination insomnia) in the group with burning sensation of upper trunk are higher than the group without burning sensation. 17. The score of NN50, pNN50, LF, TP in the group with anorexia are lower than the group without anorexia. 18. The score of P-total(general quality of sleep), P2(duration for sleep start) in the group with constipation are higher than the group without constipation. 19. The score of P4(recoverable sleep time) in the group with depression are higher than the group without depression. 20. In the group with anxiety, the score of P1(time of hypnagogue), P5a(frequency of onset insomnia) are lower and the score of I1b(degree of maintenance insomnia), I4(objective degree of impairment by insomnia) are higher than the group without anxiety. 21. The score of NN50, pNN50, HF, TP in the group with inertia are lower than the group without inertia. 22. The accompanied symptoms haver posirive correlation with P5f(frequency of burning sensation), P5h(frequency of nightmare), P5i(frequency of night pain) and LF/HF. Conclusion: This study provides insights into the complicated relations of the pattern of sleep disorder with many symptoms such as headache, chest discomfort, depression and any others. And this study showed that autonomic nervous system have important function in the regulation of sleep.

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우울증 환자에서 불면과 자살, 세로토닌의 연관성 (Insomnia in Relation to Suicide and Serotonin in Patients with Major Depressive Disorder)

  • 박영민;강승걸;이헌정;김린
    • 수면정신생리
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    • 제21권1호
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    • pp.29-32
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    • 2014
  • 목 적: 세로토닌 활성도와 척도를 이용하여 세로토닌과 수면, 세로토닌과 자살 사고, 자살과 수면과의 상호 관련성을 평가하려고 하였다. 방 법: 주요우울증으로 진단된 65명을 대상으로 선택적 세로토닌 재흡수 억제제를 투여 받기 전 우울증의 심각도, 수면 양상, 자살 사고 정도를 평가하고 소리 자극과 뇌파를 이용하여 세로토닌 활성도 수치를 측정하였다. 결 과: Beck Depression Inventory (BDI) 중 불면 척도를 기준으로 두 군으로 나누어 비교한 결과 불면증이 있는 군은 없는 군에 비해 총 BDI 점수와 BDI 중 자살 항목 점수가 유의하게 높았다. 하지만 두 군 간의 세로토닌 활성도에서 유의한 차이는 없었다. 자살 시도 과거력이 있는 군과 자살 시도 과거력이 없는 군으로 나누어 비교한 결과 자살 시도군이 비시도군보다 BDI 중 자살 항목 점수가 유의하게 높았다. 또한 세로토닌 활성도는 통계적 유의성은 없었으나 자살 시도군에서 세로토닌 활성도가 더 낮은 경향성을 보였다. 결 론: 현재까지의 연구로는 자살, 수면, 세로토닌 모두가 서로 연관되어 있을 것이라는 가설은 아직까지 유효한 것 같다. 하지만 이러한 가설을 보다 명확하게 증명하기 위해서는 더 많은 연구가 필요할 것으로 보인다.

불면환자의 수면의 질 척도와 한방진단시스템 병기(病機)와의 연관성 연구 (Study on the Association of DSOM Pathogenic Factor in the Insomnia Patients)

  • 이동화;김보경
    • 동의신경정신과학회지
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    • 제21권1호
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    • pp.89-108
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    • 2010
  • Objectives: This study was to investigate the relation of Pittsburgh Sleep Quality Index(PSQI) and Diagnos system of oriental medicine(DSOM) in the Insomnia Patients. Methods: For this study, we carried out PSQI and DSOM of 92 patients with insomnia who have come to Kijang public health center and Donguei oriental hospital of Donguei university from November 2008 to October 2009. We verified the association of PSQI and DSOM using crosstabulation analysis, independent sample T-test, one-way ANOVA and correlation analysis. Results: 1. Blood-deficiency(血虛) is the most frequent pathogenic factor and frequency of nightmare has positive correlation with that factor including heart(心) in total insomnia patients. 2. Female patients have a higher percentage of chronic insomnia than male patients. 3. As patients aged, maintaining sleep gets harder, sleep time is lessening, taking hypnotics is increasing and quality of sleep gets worse. 4. There is high frequency of chronic insomnia in 40~50 years and over 60 years old. Also, the people who are over 60 years of age tend to sleepless and urinated frequently during the middle of the night. The people with the age of 20~30 years tend to take less sleeping pills and frequency of sleeping during daytime is higher than the other age groups but the quality of sleep is quite good. 5. The patient with over 6 months of chronic insomnia tend to be older in age than the patient with less than 6 months. And the patient with chronic sleeping disorder has frequent pain and the quality of sleep is very poor. 6. The patient who took hypnotics tend to be older than hypnotics non-user and frequency of urination was relatively high. 7. The patient who visited oriental medical hospital were tend to be older and get difficult in maintaining sleep. And frequency of taking hypnotics and urinating during night were tend to be higher and the quality of sleep was poor compared with the patient who visited public health center. Conclusions: This study provides insights into the complicated relations of the associated symptom of insomnia with Diagnos system of oriental medicine. And especially this study showed apparent correlation between nightmare in insomnia patients and pathogenic factor of blood-deficiency and heart. Specific correlations and characteristics in this study could be connect develop of new questionaire of insomnia.

공황장애의 임상적 특성과 Brain-Derived Neurotrophic Factor 농도와의 관계 (Associations between Clinical Characteristics and Plasma BDNF Levels of Panic Disorder)

  • 황인호;박종일;양종철
    • 대한불안의학회지
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    • 제11권2호
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    • pp.129-135
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    • 2015
  • Objective : Brain-derived neurotrophic factor (BDNF) is implicated in the pathophysiology of several neuropsychiatric disorders. However, there are few studies on BDNF of panic disorder. In this study, we investigated plasma BDNF levels in patients with panic disorder, and evaluated whether there are associations between clinical characteristics of panic disorder and plasma BDNF levels. Methods : We included 110 patients with panic disorder and 110 health controls in the current study. Plasma BDNF levels were measured by the enzyme-linked immunosorbent assay (ELISA). Plasma BDNF level differences were evaluated according to the clinical characteristics, such as duration of illness, recent stressful life event, agoraphobia, and insomnia. Results : The mean plasma BDNF levels of patients with panic disorder were significantly lower, as compared with those of controls (192.50 pg/mL vs. 693.75 pg/mL, t=8.838, p<0.001). The mean plasma BDNF levels of patients who had recent stressful life events were significantly higher, as compared with those who did not ($269.79{\pm}358.96pg/mL$ vs. $136.94{\pm}187.06pg/mL$, t=-2.525, p=0.013). Conclusion : These results suggested that BDNF plays a potential role in the pathophysiology of panic disorder.

사업장 교대근무자와 비교대근무자의 수면문제와 건강상태 비교 (Comparison of Health Status and Sleep Patterns between Shift Workers and Non-shift Workers in Manufacturing Plants)

  • 김은주;김명애;권경례
    • 한국직업건강간호학회지
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    • 제17권1호
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    • pp.45-54
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    • 2008
  • Purpose: This study was conducted to compare and estimate sleep patterns and health status of the shift and non-shift factory workers. Methods: The subjects of this study were 290 male workers in 13 companies, which manufacture automobile parts in Daegu, Korea. Survey data were collected from March 5th, 2007 to April 5th, 2007. PSQI was scored to check the quality of sleep, ESS for excessive daytime sleep disorder, ISI for insomnia, and SF-36 for health status. The data were analyzed by $X^2$ and t-test using SPSS 12.0 for windows. Results: There was a difference in quality of sleep patterns between shift and non-shift workers (p=.033). A difference in the pattern of excessive daytime sleep (P=.005) and in the degree of insomnia (p=.030) were observed between the two groups. However, there were no significant difference in health status between the two groups. Conclusion: Based on these results, shift workers are in need of careful and continuous monitoring regarding sleep disorders and we need to develop health promotion programs including sleep hygiene for shift workers.

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