• 제목/요약/키워드: Sleep maintenance insomnia

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Understanding insomnia as systemic disease

  • Yun, Seokho;Jo, Sohye
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.267-274
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    • 2021
  • Sleep plays a critical role in homeostasis of the body and mind. Insomnia is a disease that causes disturbances in the initiation and maintenance of sleep. Insomnia is known to affect not only the sleep process itself but also an individual's cognitive function and emotional regulation during the daytime. It increases the risk of various neuropsychiatric diseases such as depression, anxiety disorder, and dementia. Although it might appear that insomnia only affects the nervous system, it is also a systemic disease that affects several aspects of the body, such as the cardiovascular, endocrine, and immune systems; therefore, it increases the risk of various diseases such as hypertension, diabetes mellitus, and infection. Insomnia has a wide range of effects on our bodies because sleep is a complex and active process. However, a high proportion of patients with insomnia do not seek treatment, which results in high direct and indirect costs. This is attributed to the disregard of many of the negative effects of insomnia. Therefore, we expect that understanding insomnia as a systemic disease will provide an opportunity to understand the condition better and help prevent secondary impairment due to insomnia.

A Clinical Analysis of Sleep Disorders in Korean Children and Adolescence Visiting the Korean Medicine Hospital (한방병원에 내원한 소아청소년기 수면 장애 환자에 대한 임상적 연구)

  • Lee, Jin Hwa;Han, Jae Kyung;Kim, Yun Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.27 no.3
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    • pp.65-73
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    • 2013
  • The subjects were composed of 308 children who visited the department of pediatrics, ${\bigcirc}{\bigcirc}$ korean medicine hospital from January 2010 to May 2013. Results 1. Among 308 patients, there were 188 boys and 120 girls; their ratio was 1.57:1. The age distribution showed that 38.3% were in the age less than 1 years, 38.0% in 1 years, 7.8% in 2 years, 5.2% in 3 years, 3.3% in 4~5 years, 4.5% in 6~10 years, 2.9% in 19~21 years. 2. It was found that 36.7% of the sleep disorder was caused without motivation, 17.2% caused by negligent accidents, 13.9% by traffic accidents, 10.4% by the unfamiliar environment, 8.1% by separation from parents, 7.5% after suffering disease, and 6.2% by irritating sound. 3. The sleep onset insomnia accounts for 17.2% of sleep disorder, sleep maintenance insomnia for 67.5%, poor sleep quality 24.4%, and daytime sleep disorder takes 19.8%. The ratio of sleep onset insomnia in adolescence comprises larger proportion (44.4%) than it of any other age groups. 4. The symptoms complicated with sleep disorder are the respiratory infection which takes 25.3%, being easily startled 18.2%, anorexia 14.6%, soft stools frequency 13.0%, greenish stools 10.7%, and skin rash 10.7%. Conclusions The causes of sleep disorders, changes of sleeping patterns, and complicated diseases show diversity in children and adolescence. Further study of sleep disorders in children and adolescence should be progressed as well.

The Effect of Hwangyeonhaedogtang-Gamibang on Insomnia in Stroke - 3-Case Report - (황연해독탕가미방으로 호전시킨 중풍 환자 불면증 3예)

  • 류순현;양대진;조기호;김영석
    • The Journal of Korean Medicine
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    • v.22 no.2
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    • pp.120-127
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    • 2001
  • Insomnia is a disorder of initiaton and maintenance of sleep that results in daytime sleepiness and dysfunction, and arises from multiple psychological, physiologic and environmental factors. A number of stroke patients suffer from insomnia classified as one of the sleep disorders associated with physical illness and on the contrary insomnia may have profound deleterious effects on the natural course of stroke. We experiened three cases of stroke patients with insomnia. In the point of Differentiation of Syndromes, these subjects were diagnosed as Excessive heat-fire syndrome of stroke and were administrated with Hwangyeonhaedog-tang Gamibang. After treatment, both sleep patterns and other accompanied symptoms improved.

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The Effect of Hypnotics on Sleep Quality and Cognitive Function in Patients with Brain Tumors

  • Chang, Min Cheol;Chun, Min Ho
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.261-267
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    • 2020
  • Objective : We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. Methods : From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). Results : At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. Conclusion : Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

Two Cases of Insomnia in Stroke Patiens Treated with Changpoulgeumtang (창포울금탕(菖蒲鬱金湯)으로 호전된 중풍환자 불면증(不眼症) 치험 2례)

  • Oh Yong-Seong;Lim Myung-Hyun;Jang Woo-Seok;Lee So-Yeon;Park Chi-Sang;Park Chang-Gook
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1055-1061
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    • 2003
  • Insomnia is a disorder of initiation and maintenance of sleep that is derived from multiple factors such as psychologic, physiological and environmental problems. A number of stroke patients suffer from insomnia classified as one of the sleep disorders associated with physical illness and on the contrary insomnia may have profound deleterious effects on the natural course of stroke. Sedative-hypnotics including benzodiazepine and non-benzodiazepine have widely been used in chronic insomniacs. However, most hypnotics cause dependence, tolerance, impaired daytime function and rebound insomnia. Therefore, we are looking forward to proposing an effective oriental treatment for insomnia. We report two cases of insomniacs, treated with Changpoulgeumtang. After the treatment, insomnia and other accompanied symptoms were improved.

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Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis (수면장애가 있는 중장년 환자에게 적용한 비약물적 중재의 효과: 메타분석)

  • Kim, Ji Hyun;Oh, Pok Ja
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.13-29
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    • 2016
  • Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

Sleep and Temperature (수면과 온도)

  • Kim, Hye-Geum;Seo, Wan Seok
    • Sleep Medicine and Psychophysiology
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    • v.23 no.2
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    • pp.47-52
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    • 2016
  • Changes in core body temperature are closely related to initiation and maintenance of sleep, and are influenced by various factors such as air temperature, room temperature, clothing, human activities, and medications. These factors are closely related to sleep fragments, insomnia and other sleep disorders. Understanding the effect of the temperature related to human surroundings on the core body temperature and sleep, will be useful for understanding the physiology of sleep and to treat sleep disorders.

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

  • Yang, Dong-Ho;Oh, Kyong-Min;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.3
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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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A clinical study of acupuncture and auricular acupuncture effect on insomnia (불면(不眠)을 호소(呼訴)하는 중풍환자(中風患者)에 대한 체침(體針)과 이침(耳針) 자침시(刺鍼時) 효과(效果)의 임상적(臨床的) 고찰(考察))

  • Lee Jeong-A;Lee Sang-Mu;An Ho-Jin;Park Sang-Dong;Park Se-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.12 no.2
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    • pp.135-146
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    • 2001
  • Insomnia is one of the most common symtoms of Neuropsychiatry patients. These are many approaches to treat insomnia, but it is difficult to be resolved completely. Acupuncture and Auricular acupuncture have been used for relief insomnia. But it is not sufficient to compare the effect of Acupuncture treatment and Auricular acupuncture treatment. Thus we investigate the effect of Acupuncture treatment group and Auricular acupuncture treatment group. A clinical analysis was carried out for 40 patients who was treated insomnia with Acupuncture(20 patients) and Auricular acupuncture(20 patients) in Seoul Dong-Seo Oriental Hospital. 1. Total duration of sleeping time showed $1.55{\pm}1.1574$ hours increased in Acupuncture group and $0.925{\pm}1.184$ hours increased in Aricular acupuncture group. especially Acupuncture were much more effective method than Aricular acupuncture. P-value was 0.033 (P <0.05) 2. Delaying time before the onset of sleep showed $0.7375{\pm}0.8940$ hours decreased in Acupuncture group and $0.7969{\pm}1.3298$ hours decreased in Auricular acupuncture group. (P <0.05) 3. The wake times showed $0.9167{\pm}1.7299$ times decreased in Acupuncture group and $1.2308{\pm}1.1658$ times decreased in Auricular acupuncture group in sleep maintenance insomnia. (P <0.05) 4. Change in quality of sleep showed Excellent 30%, Good 50%, Fair 15%, Poor 5% in Acupuncture group and Excellent 20%, Good 45%, Fair 30%, Poor 5% in Aruricular acupuncture group.

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Effects of Visiting Laughter Therapy on Depression and Insomnia among the Vulnerable Elderly (방문웃음요법이 취약계층 노인의 우울과 불면증에 미치는 효과)

  • Park, Eunok
    • Research in Community and Public Health Nursing
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    • v.24 no.2
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    • pp.205-213
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    • 2013
  • Purpose: The purpose of this study is to investigate the effects of visiting laughter therapy on depression and insomnia in the vulnerable elderly. Methods: A quasi-experimental nonequivalent control group pretest-posttest design was used for this study. The participants were 87 elderly who were registered in the Tailored Visiting Health Program of public health centers. Data were collected from September to November 2010. The experimental group received visiting laughter therapy froma visiting nurse who had taken laughter training provided by laughter therapy experts. The experimental group received 10~15 min of laughter therapy once a week for 8 weeks. The instruments included Geriatric Depression Scale and Insomnia Severity Index to measure depression and sleep problems before and after the laughter therapy. Results: The results showed that visiting laughter therapy was effective in decreasing depression and insomnia among the vulnerable elderly. Conclusion: These findings indicate that laughter therapy may be an effective nursing intervention to improve depression and insomnia Further studies would be needed to identify the difference of effects according to time, interval, or period of visiting laughter therapy and to evaluate the lasting effect of visiting laughter therapy.