• Title/Summary/Keyword: Insomnia disorder

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Sleep Apnea and Sleep Disturbances in Neurological Disorders (신경과 질환에 동반되는 수면무호흡증과 수면의 문제)

  • Hong, Seung-Bong
    • Sleep Medicine and Psychophysiology
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    • v.7 no.2
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    • pp.79-83
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    • 2000
  • Sleep disturbances are frequently associated with neurological disorders. Sleep disorders interfere with rehabilitation of patients with neurological disorders such as stroke and may increase the severity of their symptoms and recurrence rate of stroke. The treatment of sleep apnea syndrome is particularly important in managing patients with cerebral infarction of whom 50-80% have moderate to severe sleep apnea. Sleep apnea produces not only poor quality sleep but also excessive daytime sleepiness, fatigue and lack of energy. Sleep problems frequently found in patients with dementia are sleep-wake cycle abnormality, fragmentation of sleep, nocturnal insomnia, decreased slow wave sleep and REM sleep, and sleep disordered breathing. The management of sleep disturbances is very important for controlling symptoms such as nocturnal wandering and sundowning syndrome in patients with dementia. Parkinson's disease and epilepsy are other neurological disorders that may have sleep disturbances.

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Two Case Report of UL-syndrome(鬱症) Treated with Gamisoyosan(加味逍遙散) (가미소요산(加味逍遙散)으로 호전된 여성 울증 환자 치험 2례)

  • Je, Yun-Mo;Yoo, Dong-Youl
    • Journal of Haehwa Medicine
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    • v.19 no.2
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    • pp.187-193
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    • 2011
  • Purpose : This paper is aim to report the effects of Gamisoyosan(加味逍遙散) on the UL-syndrome(鬱症) Methods : This is two cases report of female patient suffering from headache, chest discomfort, heart burning, insomnia, dyspepsia, anorexia, fatigue and other symptoms due to chronic stress. 52 years old woman who diagnosed UL-syndrome(鬱症) was enrolled in this study. We gave her Gamisoyosan(加味逍遙散) 2 times, each for 3 weeks. During the treatments, we check changes of symptoms and HRSD. Results : After the oriental medical treatments, symptoms of UL-syndrome(鬱症) were decreased or disappeared. Conclusion : This clinical case indicate that Gamisoyosan(加味逍遙散) is effective in treatment of the depression disorder and symptoms of UL-syndrome(鬱症). More clinical data and studies are requested for the treatment of UL-syndrome(鬱症).

Sleep Problems in Autism Spectrum Disorder (자폐스펙트럼장애에서의 수면문제)

  • Yang, Young-Hui;Kim, Ji-Hoon;Lee, Jin-Seong
    • Sleep Medicine and Psychophysiology
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    • v.20 no.2
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    • pp.53-58
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    • 2013
  • Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.

A Conceptual Study of "Pyo (表)" in Gangpyeong-Shanghanlun Based on Two Cases of Bipolar Disorder Improved with Mahwang-tang (『강평상한론(康平傷寒論)』 '표(表)'에 대한 고찰 : 마황탕(麻黃湯)으로 호전된 양극성 장애 2례를 바탕으로)

  • Choi, Woon-yong;Lee, Sung-jun
    • 대한상한금궤의학회지
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    • v.13 no.1
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    • pp.81-98
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    • 2021
  • Objective : We explored the meaning of "Pyo (表)" in Gangpyeong-Shanghanlun through two cases. Methods : We analyzed the original form of 表 and its context in Shanghanlun. We also analyzed 2 clinical cases of bipolar disorder treated with Mahwang-tang (麻黃湯) according to the newly deduced definition of 表. Results : 表 can be interpreted as "pursuing something high-class seen from the outside." Both cases had various psychological symptoms including insomnia, mood swings, anxiety, and depression. We determined that the diseases in both cases occurred when 表 had not been achieved. We also found that 麻黃湯 can improve psychological status. Conclusions : 表 is different from "surface," which is the most widely used definition. After diagnosing these two patients with bipolar disorder using the Diagnostic and Statistical Manual of Mental Disorders (5th edition), we found that symptoms could be improved by administration of 麻黃湯 (46條). Although its potential for neuropsychiatric diagnosis has been suggested through etymological interpretation of 表 and analysis of two cases, more advanced clinical studies are needed in the future.

Non-Pharmacological Interventions for Behavioral and Psychological Symptoms of Neurocognitive Disorder (신경인지장애의 정신행동증상에 대한 비약물학적 개입)

  • Hyun Kim;Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.1-9
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    • 2023
  • Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

POSTOPERATIVE MANIC EPISODE BY SLEEP DEPRIVATION AND STRESSFUL EVENT (수면 결핍과 스트레스에 의한 술후 조증 삽화에 대한 증례보고)

  • Kong, Jun-Ha;Lee, Baek-Soo;Kim, Yeo-Gab;Kwon, Yong-Dae;Yoon, Byung-Wook;Choi, Byung-Joon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.30 no.1
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    • pp.114-116
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    • 2008
  • Mania in psychiatry describes not only the state of temporary elation of the mood but also of the general mental function such as contents of a thought, thinking process, motivation, enthusiasm, interest, behavior, slumber and physical activities. The time of period when the above changes of mood, mental and behavioral disorder appear is called a manic episode. Postoperative mania is very rare and it has been reported only 5 times in english literature. It's an extremely rare case which has not yet been reported in Oral and Maxillofacial surgery. Patients normally deny the symptoms and it is easy to miss the diagnosis since the patient tends to seem content and happy. Patients show the following initial symptoms of mania - postoperative insomnia, atypical gregariousness, euphoria and unstability. Patients who are not disaffected with insomnia can also be included.

Sleep in Menopause (폐경과 수면)

  • Lim, Weon-Jeong
    • Sleep Medicine and Psychophysiology
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    • v.9 no.2
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    • pp.96-99
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    • 2002
  • Menopause, the cessation of menstruation caused by the decline in estrogen production, occurs in 95% of women between 40 and 60 years. Sleep disturbance is a frequent complaint during the perimenopause period. In contrast to premenopausla women, menopausal women experience more reduction in the total sleep hours and report more sleep disturbances, such as insomnia, noctiria and sleep disordered breathing. But the prevalence, etiology and treatment of sleep disturbances in menopause are still controversal. So further investigations are required to elucidate the factors that account for the differences in sleep disturbance between premenopausal and postmenopausal women. There are suggestive data that estrogen and progesterone deficiency may increase the susceptibility for sleep disorder in menopause. Furthermore, there are suggestive evidence from observational studies and a limited number of randomized, controlled trials that hormone replacement therapy after menopause improves sleep. However, the clinical relevance of hormone replacement therapy is unproved. So the overall benefit of hormonal replacement in postmenopausal women with sleep related disorders should be individualized to avoid potential side effects. Several studies evaluated the role of melatonin, because this hormone has effects on core body temperature & insomnia. But the exact dosage and the effects of long-term use of melatonin are unclear. So, caution is indicated in melatonin administration.

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Difference in Sleep Characteristics between Restless Leg Syndrome With and Without Periodic Limb Movement during Wakefulness (각성 중 주기성사지운동 여부에 따른 하지불안증후군 환자의 수면 특성 차이에 대한 비교연구)

  • Shin, Yu Yong;Byun, Jung-Ick;Shin, Won Chul
    • 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.

A Prospective Observational Study of Herbal Medicines on Depressive Disorder (우울장애 한약치료에 대한 전향적 관찰연구)

  • Kim, Ju Yeon;Kim, Hwan;Lee, Ji-Yoon;Jung, Jin-Hyeong;Yang, Changsop;Lee, Mi-Young;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.2
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    • pp.63-76
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    • 2020
  • Objectives: The purpose of this study was to verify the clinical effects of herbal medicines on patients with depressive disorder. Methods: A prospective observational study on patients with depressive disorder was conducted. The patients were treated with herbal medicines for eight weeks. The Korean Hamilton Depression Rating Scale (K-HDRS) was evaluated as the primary outcome and the Korean Beck's Depression Inventory (K-BDI), Instrument on Pattern Identification for Depression, Korean Symptom Checklist-95 (KSCL-95), Insomnia Severity Index (ISI), Korean State-Trait Anxiety Inventory (STAI-K), Korean State-Trait Anger Expression Inventory (STAXI-K), EuroQol five-dimensional Questionnaire (EQ-5D), Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Heart Rate Variability (HRV) were measured as the secondary outcome. Adverse events were assessed for safety. Results: A total of 35 participants were observed for 12 weeks. The K-HDRS improved significantly in four, eight, and 12 weeks and the K-BDI showed significant differences in four, and eight weeks. There were no significant improvements in other evaluation scales. Gyejibongnyeong-hwan was the most frequently and continuously prescribed, showing significant improvements of K-HDRS after eight weeks of treatment. Conclusions: In our observational study, herbal medicine was effective for relieving the depression of patients with depressive disorder and Gyejibongnyeong-hwan showed the most significant effectiveness.

Psychophysiological Characteristics of Insomnia Patients Measured by Biofeedback System (바이오피드백을 이용하여 측정한 불면증 환자의 정신생리적 특징)

  • Huh, Sung-Young;Lee, Jin-Seong;Kim, Sung-Gon;Kim, Ji-Hoon;Jung, Woo-Young
    • Sleep Medicine and Psychophysiology
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    • v.22 no.2
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    • pp.70-76
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    • 2015
  • Background and Objectives: Insomnia is the most prevalent sleep disorder in the general population and is considered to be a disorder of hyperarousal. The aim of this study was to measure the psychophysiological responses in insomnia patients using a biofeedback system, and to compare them with results from normal healthy subjects. Materials and Methods: Eighty patients with primary insomnia (35 males and 45 females, average age $49.71{\pm}12.91years$) and 101 normal healthy controls (64 males and 37 females, average age $27.65{\pm}2.77$) participated in this study. Electromyography (EMG), heart rate (HR), skin conductance (SC), skin temperature (ST), and respiratory rate (RR) were recorded using a biofeedback system during 5 phases (baseline, stress 1, recovery 1, stress 2, recovery 2) of a stress reactivity test, and average values were calculated. Difference in values between the two groups in each corresponding phase was analyzed with independent t-test, and change in values across phases of the stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). Results: Compared to normal controls, insomnia patients had higher EMG in all 5 phases (baseline : $7.72{\pm}3.88{\mu}V$ vs. $4.89{\pm}1.73{\mu}V$, t = -6.06, p<0.001 ; stress 1 : $10.29{\pm}5.16{\mu}V$ vs. $6.63{\pm}2.48{\mu}V$, t = -5.84, p<0.001 ; recovery 1 : $7.87{\pm}3.86{\mu}V$ vs. $5.17{\pm}2.17{\mu}V$, t = -5.61, p<0.001 ; stress 2 : $10.22{\pm}6.07{\mu}V$ vs. $6.98{\pm}2.98{\mu}V$, t = -4.37, p<0.001 ; recovery 2 : $7.88{\pm}4.25{\mu}V$ vs. $5.17{\pm}1.99{\mu}V$, t = -5.27, p<0.001). Change in heart rate across phases of the stress reactivity test were higher in normal controls than in insomnia patients (stress 1-baseline : $6.48{\pm}0.59$ vs. $3.77{\pm}0.59$, t = 3.22, p = 0.002 ; recovery 1- stress 1 : $-5.36{\pm}0.0.59$ vs. $-3.16{\pm}0.47$, t = 2.91, p = 0.004 ; stress 2-recovery 1 : $8.45{\pm}0.61$ vs. $4.03{\pm}0.47$, t = 5.72, p<0.001 ; recovery 2-stress 2 : $-8.56{\pm}0.65$ vs. $4.02{\pm}0.51$, t = -5.31, p<0.001). Conclusion: Psychophysiological profiles of insomnia patients in a stress reactivity test were different from those of normal healthy controls. These results suggest that the sympathetic nervous system is more highly activated in insomnia patients.