• Korean Journal of Adult Nursing
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• v.27 no.6
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• pp.718-727
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• 2015

Purpose: The purpose of this study was to identify the levels of physical activity and its relationships with depression, health-related quality of life (QoL), sleep disturbance, and physiological indicators in hemodialysis patients. Methods: The participants in this study were 139 patients undergoing hemodialysis in the hospitals in Busan and Yangsan-si. Data were collected using hematologic tests and questionnaires that contained items about individual characteristics, International Physical Activity Questionnaires (IPAQ), Center For Epidemiological Studies Depression Scale (CES-D), a 12-item Short-Form Health Survey (SF-12), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using descriptive statistics, one way ANOVA, and correlation. Results: Mean age of the participants was $59.91{\pm}12.63$ and mean physical activity levels were $1,660.35{\pm}1,654.17$. Patients who performed higher physical activities during their daily activities reported lower levels of depression (F=4.16, p=.018) and higher levels of QOL (PCS: F=5.00, p=.008, MCS: F=8.66, p<.001) than those of the others who did not perform physical activities. Conclusion: This study showed that the levels of physical activity among hemodialysis patients was significantly associated with their depression and QOL. Developing strategies for enhancing physical activity is warranted to improve depression and QOL among hemodialysis patients.

• Sleep Medicine and Psychophysiology
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• v.17 no.1
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• pp.16-20
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• 2010

Objectives: We review the sleep problems of the alcohol dependence patients. Especially we are interested in the prevalence, the severity of symptoms, anxiety, depression, and sleep quality of restless legs syndrome (RLS) in the alcohol dependence patients. Methods: We recruit 86 alcohol dependence patients who were admitted from October 6th, 2008 to October 17th, 2008. We interviewed each patient and evaluated sleep questionnaires such as the Sleep Disorder Questionnaire (SDQ), the Pittsburgh Sleep Quality Index (PSQI) and the International Restless Legs Syndrome Study Group (IRLSSG) rating scale. The presence of RLS and its severity were assessed using the IRLSSG diagnostic criteria and the IRLSSG severity scale, respectively. Depression and anxiety were evaluated by the Beck Depression Inventory (BDI) and the Beck anxiety inventory (BAI). Results: Of all 86 patients, 59 patients have insomnia, 33 patients have RLS, 30 patients have Periodic limb movement disorder (PLMD), 29 patients have nightmare. RLS patients have more high score in the BAI ($21.70{\pm}10.36$ vs $14.67{\pm}11.98$), and their sleep quality was poor in the PSQI ($11.09{\pm}4.08$ vs $7.92{\pm}3.91$) than non-RLS patients. Conclusion: This study shows that alcohol dependence patients show many sleep problems such as insomnia and RLS. So we should notice that the sleep problems of alcohol dependence patients are important in clinical approach and treatment.

• Journal of Oral Medicine and Pain
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• v.40 no.4
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• pp.140-145
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• 2015

Purpose: Bruxism is commonly considered a major risk factor for temporomandibular disorders (TMD), and the psychosocial factors had been one of the etiologic factor of bruxism. But there are still unsolved issues on the relationship between sleep bruxism and TMD and the etiologic factors of bruxism. This study is aim to evaluate the clinical and psychosocial characteristics according to diagnostic grade of bruxism in TMD patients. Methods: Three hundred subjects were enrolled who were under the stabilization splint therapy for TMD. Recently international consensus proposed a diagnostic grading system of "possible", "probable", and "definite" sleep or awake bruxism for clinical and research purpose. According to their suggestion, we classified these subjects as self-reported bruxism (SRB) and wear facet bruxism (WFB). We investigated the clinical characteristics (sex, age, chief complaint, pain duration, visual analogue scale), sum of tenderness (temporomandibular joint, masticatory muscles, cervical muscles), diagnosis of TMD according to research diagnostic criteria (the Research Diagnostic Criteria for Temporomandibular Disorders, RDC/TMD), headache, subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI), and psychosocial characteristics (Symptom Checklist-90-Revised, SCL-90-R) in enrolled subjects. We compared the clinical and psychosocial characteristics between these bruxism groups. Results: There were no significant correlation between self-reported and WFB (p=0.13). SRB subjects more reported pain as a chief complain than subject who did not report bruxism (p=0.014). The mean score of global PSQI was significantly higher in SRB than in did not report positively subjects (p=0.045). The mean score of anxiety and phobic anxiety was significantly higher in SRB than in did not reported positively subjects (p=0.045, p=0.041). Conclusions: Although bruxism is regarded as risk factor of TMD, this study showed inconsistent result between SRB and clinically detected bruxism by wear facet on slpint. We suggest that the clinician should consider with extreme caution when they assess SRB.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1122-1133
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• 2022

Objectives: The aim of this study was to retrospectively evaluate the efficacy and safety of Ongyeong-tang (OGT) in the treatment of insomnia in patients afflicted with neurological diseases, according to the medical records of one medical institution. OGT is a herbal prescription that originates from the "Synopsis of Prescriptions of the Golden Chamber" and has been used for menopausal symptoms, uterine diseases, skin diseases, insomnia, and other neuropsychiatric symptoms. Methods: Medical records of patients who visited Kyung Hee University Korean Medicine Hospital from January 1, 2021 to June 30, 2022, received outpatient or inpatient treatment, and met the inclusion criteria were used in this study. Results: Twenty-four patients satisfied the inclusion criteria and were included. The Pittsburgh Sleep Quality Index-Korean version (PSQI-K) score was used to evaluate the outcomes before and after treatment. After an average of 14.42±9.2 days of OGT extract intake, 20 patients (83.3%) experienced improvement. The remaining four (16.7%) had no change in their symptoms, but none demonstrated worsening of symptoms. The total PSQI-K score showed a statistically significant decrease from 13.08±4.54 to 10.42±4.58 (p<0.001). Sleep quality, sleep duration, sleep disturbance, use of sleeping medications, and daytime dysfunction also showed statistically significant improvements. Conclusions: Administration of OGT extract may be a relatively safe and effective therapeutic option for insomnia in patients with neurological diseases.

• 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 Rhinology
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• v.25 no.2
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• pp.69-74
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• 2018

Background and Objectives: Sleep disturbances and excessive daytime sleepiness (EDS) are the major symptoms of obstructive sleep apnea (OSA). This study aimed to investigate clinical implications of insomnia and EDS in patients with OSA using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Materials and Method: We evaluated 131 subjects with suspected OSA who were undergoing polysomnography (PSG) and performing the PSQI and ESS surveys. OSA was diagnosed when the apnea-hypopnea index was five or more. EDS was defined when ESS score was 11 points or higher. Detailed history and questionnaire were used to categorize insomnia. We compared clinical variables and PSG results in subgroups with or without insomnia and EDS. Results: There were no significant differences of PSQI and ESS score between controls and OSA. OSA with insomnia had significantly increased total score (p<0.001) and decreased total sleep time (p=0.001) and sleep efficiency (p=0.001) on the PSQI compared to those without insomnia. OSA with EDS showed significantly increased PSQI score (p=0.022) and decreased total sleep time (p=0.018) on PSG compared to those without EDS. Neither PSQI nor ESS score had a correlation with respiratory variables such as AHI and oxygen saturation. Total sleep time had a significant effect on both insomnia and EDS in patients with OSA. Conclusion: Decreased total sleep time had important effects on subjective symptoms of OSA and comorbid insomnia. Therefore, restoration of decreased sleep time is important in the management of OSA.

• Korean Journal of Psychosomatic Medicine
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• v.22 no.2
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• pp.112-120
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• 2014

Objectives : The aim of this study is to evaluate the clinical characteristics of night eating syndrome(NES) in bipolar disorder outpatients. Methods : The 14 items of self-reported night eating questionnaire(NEQ) was administered to 84 bipolar patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating & weight-related quality of life using Beck's Depression Inventory (BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. Results : The prevalence of night eating syndrome in bipolar outpatients was 14.3%(12 of 84). Comparisons between NES group and non-NES group revealed no significant differences in demographic characteristics, BMI and clinical status except economic status and comorbid medical illnesses. However, compared to non-NES, patients with NES was more likely to have binge eating pattern and poorer weight-related quality of life. Conclusions : This study is to be the first to describe the clinical correlates of night eaters in bipolar outpatients. Although there were few significant correlates of NES in bipolar outpatients, relatively high prevalence of NES suggest that clinicians should be aware to assess the patients with bipolar disorder on NES, regardless of obesity status of patients.

• 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.

• Journal of Sasang Constitutional Medicine
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• v.28 no.4
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• pp.350-360
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• 2016

Objective The aim of this study was to report significant improvement of primary insomnia in a Soyangin Cold-related diarrhea accompanied by abdominal pain Symptomatic pattern Patient. Methods The patients were diagnosed with Soyangin Cold-related diarrhea accompanied by abdominal pain Symptomatology(身寒腹痛亡陰證) and treated with Hyungbangjihwang-tang(荊防地黃湯). The primary outcome measures for this study were condition of sleep using a questionnaire with Pittsburgh Sleep Quality Index (PSQI) Secondary outcome assessment included change of original symptoms such as patient's digestion, sweating and feces. Result The symptoms of primary insomnia improved by the end of the a treatment period without side effect. original symptoms were also changed. Conclusions This result show Hyungbangjihwang-tang(荊防地黃湯) can be used to treat primary insomnia in a Soyangin Cold related Mangeum Symptomatic Pattern accompanied by abdominal pain Symptomatology(身寒腹痛亡陰證). Meaning and process of primary insomnia are different according to Sasang Constitutions.

• Sleep Medicine and Psychophysiology
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• v.20 no.1
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• pp.15-21
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• 2013

Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.