• 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 Oral Medicine and Pain
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• v.33 no.3
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• pp.257-267
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• 2008

The mentophysical disease causes diseases in digestive, respiratory, circulating systems, including chronic pain, through combined reactions from different individual characteristics, mental stress and temperamental factors. The most common symptom related to orofacial area is pain and the contributive factors include biological, behavioral, environmental, social, emotional, recognitive factors. These factors affect the course of the symptom according to individual's character and human nature. In pain, sleep acts as a contributive factor, and pain could bring about sleep disturbance and vice versa. Deterioration of sleep quality would act as a factor that aggravates mental stress. Therefore, relatively accurate and simple mental examinations and sleep quality test should be carried out for the patients with symptoms related to orofacial area. This study evaluated the mental state in relation to the sleep quality which could affect orofacial pain. The number of poor sleeper was 18 in male subjects, and 1 in female subjects and PSQI global index was higher in male($6.11{\pm}2.38$) than female($4.67{\pm}2.18$). SCL-90-R index showed no sex difference. Poor sleeper showed significantly high value in SOM, O-C, I-S, ANX, PHOB, PSY, GSI, PST. When SCL-90-R T scores were compared according to sleep quality, higher the subjective sleep quality score, O-C and I-S showed significant increase. As sleep disturbances score increased, PAR, PSY, PST showed statistically significant increase. In comparison of SCL-90-R T score according to daytime dysfunction, statistically significant increase in DEP, ANX, HOS, PHOB, PAR, GSI was observed. Therefore, the quality of sleep and psychological status have a high correlation. This is likely to influence chronic pain in the orofacial field. As a result, clinicians treating orofacial pain should evaluate the sleep quality and psychological status of the patient. Further studies of larger sample sizes including various age, occupation, and pain groups are necessary in order to apply the results to clinical practice.

• The Journal of Internal Korean Medicine
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• v.44 no.4
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• pp.726-740
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• 2023

Objectives: This review investigated the research on warm herbal foot bath therapy (WHFT) for insomnia. Methods: A search was conducted on the China National Knowledge Infrastructure (CNKI) database to collect relevant studies published up to August 29, 2023. Randomized controlled trials (RCTs) comparing WHFT and sleeping pills in patients with insomnia were included. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias assessment tool. The results of the meta-analysis were presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence intervals (CIs). Results: A total of 11 RCTs were included. WHFT as monotherapy resulted in a significantly higher total effective rate (TER) (RR, 1.25; 95% CI, 1.15 to 1.36; I²=25%) and an improved Pittsburgh Sleep Quality Index (PSQI) global sore (MD, -3.10; 95% CI, -4.24 to -1.95; I²=73%) compared to benzodiazepines. Additionally, WHFT as a combined therapy with benzodiazepines resulted in a significantly higher TER (RR, 1.15; 95% CI, 1.04 to 1.27; I²=0%) and an improved PSQI global score (MD, -2.23; 95% CI, -4.09 to -0.38; I²=80%) compared to benzodiazepines alone. In network analysis visualizing the components of HWFT, four clusters were discovered, and Polygoni Multiflori Ramuls and Ziziphi Spinosae Semen were the key herbs used in WHFT. Overall, the methodological quality of the included studies was poor. Conclusions: There was limited evidence that WHFT as a monotherapy or combined therapy was effective in improving insomnia. The findings can be used as basic data for future WHFT research in South Korea.

• Sleep Medicine and Psychophysiology
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• v.27 no.2
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• pp.56-66
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• 2020

Objectives: In this study, the clinical characteristics of OSA patients and the quality of life before and after CPAP use were compared to determine the degree of improvement in quality of life according to CPAP use. Methods: Age, sex, height, weight, body mass index, Epworth Sleepiness Scale, Modified Mallampatti Score, Montreal Cognitive Assessment-Korean, and Pittsburgh Sleep Quality Index were compared between men and women through medical records. To understand the degree of improvement in quality of life resulting from use of CPAP, a personal telephone call was made to compare the VAS scores for quality of life before and after CPAP use. Results: In height (HT) (Z = -4.525, p < 0.001), weight (BW) (Z = -2.844, p < 0.05), sleep quality (PSQI) (Z = -2.671, p < 0.05), and arousal index (AI) (Z = -2.105, p < 0.05), there was a difference between men and women (p < 0.05). There was no difference in the remaining variables. Cross-analysis (Chi-square test) confirmed a difference between severity and sex of OSA. It has been found that there is no statistically significant order in size according to level-specific severity of OSA for PreCPAP QOL, PostCPAP QOL, CPAPUse Months, and CPAP4Hr/d (%) (p > 0.05). The difference between AHI before and after CPAP was 36.48 ± 21.54 (t = 11.609, p < 0.001) and the difference between QOL before and after CPAP was -25.43 ± 22.06 (t = -7.901, p < 0.001), both of which were significant (p < 0.001). Conclusion: Among OSA patients, there were differences in height (HT), weight (BW), sleep quality (PSQI), arousal index (AI), and severity of OSA between men and women, but the quality of life before and after CPAP was different. However, there was no difference between men and women in quality of life before and after CPAP. In addition, quality of life in OSA patients improved after using CPAP.

• Journal of Oral Medicine and Pain
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• v.33 no.2
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• pp.205-218
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• 2008

Interaction between pain and sleep has long been proved through many researches, and various studies are being conducted to identify its mechanism. However, these studies have targeted on patients with systemic disease, such as rheumatic disease and fibromyalgia. There are few researches on patients with orofacial pain including temporomandibular disorder(TMD). In this study, we studied interaction between pain aspect and sleep quality in 229 patients with TMD, who visited the TMJ and Orofacial pain clinic. Pittsburgh Sleep Quality Index(PSQI), Epworth sleepiness scale(ESS) questionnaire were surveyed and sleep-screening device was operated. PSQI showed that sleep quality in TMD patients with pain was poorer than that in TMD patients without pain. The ratio of poor sleeper was higher in TMD patients with pain. Especially, TMD patients with chronic pain showed obviously poorer sleep quality than TMD patients with acute pain. The result of ESS showed that patients with painful TMD showed more daytime sleepiness than painless TMD patients. The ratio of TMD patients with chronic pain who had daytime sleepiness was higher than TMD patients with acute pain, and the amount of daytime sleepiness was higher in the group of chronic pain. In TMD patients with chronic pain, only the poor sleeper(PSQI>5) presented mean ESS>10(diagnostic criteria of daytime sleepiness). There was no correlation between pain intensity and sleep quality or daytime sleepiness. The result of ApnealinkTM for screening of sleep related breathing disorder showed that only 1 patient presented AHI>5 among 19 participants. TMD patients with chronic pain presented poor sleep quality and excessive daytime sleepiness similar to other chronic pain patients. Evaluation of sleep state by questionnaire might be useful for diagnosis and management of TMD, because sleep disturbance decreases pain threshold and pain disturbs sleep. In addition, sleep-screening device would be useful for screening sleep related breathing disorder in dental clinic.

• Journal of Acupuncture Research
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• v.30 no.5
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• pp.247-252
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• 2013

Objectives : The purpose of this study was to observe the clinical effects of acupuncture therapy and Ecklonia cava extract on sleep disturbance in ALS patients. Methods : In this study one patient received acupuncture therapy and took Ecklonia cava extract. The effects of the combined administration of these treatments were evaluated using Numeric Rating Scale and Pittsburgh Sleep Quality Index. Results : The NRS score for sleep disturbance decreased from 10 to 1 and the PSQI score decreased from between 12~13 to 8. After treatment, the patient stopped taking sleeping pills and antidepressant. Conclusions : Combined administration of acupuncture therapy and Ecklonia cava extract could be effective in improving sleep disturbances in ALS patient.

• Journal of Sasang Constitutional Medicine
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• v.29 no.1
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• pp.50-58
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• 2017

Objective Insomnia is a common symptom among cerebral infarction patients. The purpose of this study is to report a case which showed sypmtoms improvement after treatment with Hyeongbangsabaek-san. Method To evaluate the results of this treatment, Insomnia severity index(ISI), Pittsburgh sleep quality index(PSQI), Korean version of Beck depression inventory(K-BDI), Sleep dairy results were measured. Result The patient who suffered from severe insomnia after cerebral infarction attack was treated by Hyeongbangsabaek-san and acupuncture therapy for about 3 weeks. She refused to take Western medicine for insomnia, and after treated with Hyeongbangsabaek-san and acupuncture, her sleep quality showed improvement. Conclusion This study suggests that using Sasang constitutuional medical treatment is effective for Soyangin patient with insomnia after cerebral infarction attack.

• Korean Journal of Occupational Health Nursing
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• v.28 no.1
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• pp.36-43
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• 2019

Purpose: The purposes of this study were to investigate sleep quality and the related factors among clinical nurses. Methods: Data were collected from 208 nurses in general hospitals through self-report. Pittsburgh Sleep Quality Index (PSQI), Korean Epworth Sleepiness Scale (KESS), Insomnia Severity Index (ISS) were used. The data were analyzed t-test, ANOVA, $Scheff{\acute{e}}$ test, and multiple regression using the SPSS 20.0 program. Results: The mean scores of the subjects were $7.58{\pm}3.61$ on daytime sleepiness, $9.93{\pm}6.22$ on insomnia, and $7.29{\pm}3.05$ on sleep quality. The sleep quality in clinical nurses significantly influenced by insomnia (${\beta}=.55$, t=8.14, p<.001), daytime sleepiness (${\beta}=.16$, t=2.83, p=.005), and work satisfaction (${\beta}=-.15$, t=-2.35, p=.020). The three variables explained 55.9% of variance of sleep quality (F=10.73, p<.001). Conclusion: Sleep quality was influenced by daytime sleepiness, insomnia, and job satisfaction. To improve sleep quality, hospitals managers or leaders need to provide sleep promotion programs for preventing daytime sleepiness and insomnia.

• International Journal of Contents
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• v.15 no.1
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• pp.25-31
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• 2019

Personality, especially neuroticism has been found related to be related with poor sleep quality. This study focused on emotion regulation, reappraisal and suppression, which can buffer or aggravate the effect of neuroticism influencing sleep quality. One hundred and forty two ordinary adults were used in this study and were recruited and required to complete a package of questionnaires including: the Eysenck personality Questionnaire/EPQ, the Emotion Regulation Questionnaire/ERQ, and the Pittsburgh Sleep Quality Index/PSQI. The result was that participants with higher neuroticism had poorer sleep qualities than those with lower neuroticism. Moreover, participants that had high neuroticism and high reappraisal had better sleep qualities. This means that there was an interaction effect of neuroticism and reappraisal on sleep quality. However, suppression did not have a moderating effect on the relation between neuroticism and sleep quality. These findings inferred that reappraisal plays an important moderating role (buffering effect) on the relationship between neuroticism and sleep quality. Reappraisal cannot only prevent people high in neuroticism from sleep problems but can also buffer symptoms of sleep disorder by treating patient's negative emotions.

• The Journal of the Society of Stroke on Korean Medicine
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• v.13 no.1
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• pp.118-125
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• 2012

Object : The purpose of this study is to evaluate the effect of Hwangryunhaedok-tang herbal-acupuncture therapy for Agitation(Byun-jo) caused by cerebral infarction. Methods : One patient was admitted who was suffering from insomnia, chest discomfort, anxiety, palpitation of Agitation(Byun-jo), after cerebral infarction. In the point of Differentiation of Syndromes(辨證), we diagnosed this patient as Excessive heat-fire syndrome of stroke(中風火熱證) and treated with Hwangryunhaedok-tang herbal-acupuncture therapy at CV17, BL15, GB20. Results : After Hwangryunhaedok-tang herbal-acupuncture therapy, symtoms of Agitation(Byun-jo) were improved remarkably, and the score of State-Trait Anxiety Inventory(STAI), Pittsburgh Sleep Quality Index(PSQI) were decreased. Conclusions : Hwangryunhaedok-tang herbal-acupuncture therapy has meaningful effect on the symptoms of Agitation(Byun-jo) caused by cerebral infarction and more researches should be followed.