• 제목/요약/키워드: insomnia disorder

검색결과 194건 처리시간 0.026초

수면장애를 동반한 당뇨병성 소양증 환자에 대한 육미지황탕가미방(六味地黃湯加味方) 투여 1례 (A Case Study of Diabetic Pruritus and Insomnia Treated with Yukmizihwang-tang)

  • 왕덕중;김광호;김진우;이순이;정병주;장혜진;이지영
    • 대한한방내과학회지
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    • 제26권3호
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    • pp.725-732
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    • 2005
  • This study was designed to evaluate the effects of oriental medicine therapy on insomnia and diabetic pruritus. This clinical case was analysed on a patient with diabetus mellitus whose main symptom was sleep disorder, which was attributed to pruritus. The patient was admitted on July 16th, 2004, and departed on September 3rd, 2004. He was treated internally and externally with herbal medicine, acupuncture, and bloodletting therapy. After treatment, pruritus and sleep disorder decreased. The study suggests that orental medicime therapy is effective in treatment of diabetic pruritus accompanied by insomnia.

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수면질환과 사회경제적 비용 (Sleep Disorder and Socioeconomic Burden)

  • 강은호
    • 수면정신생리
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    • 제18권2호
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    • pp.72-75
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    • 2011
  • Sleep disorders such as insomnia, obstructive sleep apnea (OSA), and restless legs syndrome (RLS) are very common disorders and may cause significant burden in terms of individual as well as societal aspects. Sleep insufficiency from such sleep disorders may cause deleterious effects on daily work life and may be associated with other major medical or psychiatric disorders including cardiovascular disease, diabetes mellitus, depression, and anxiety disorder. Various motor or occupational accident may result from the sleep problems. In addition, recent researches provide the method to evaluate the lost productivity time in terms of absenteeism and presenteeism. Moreover, several studies on cost-effectiveness of treatment of sleep disorders show that it is cost-effective.

CP 기반 정신 평가 및 진단을 위한 심리검사의 활용 (Utilization of Psychological Tools for Critical Pathway Based Mental Evaluation and Diagnosis)

  • 홍성규;이현우;정선용;김종우
    • 동의신경정신과학회지
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    • 제33권4호
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    • pp.377-388
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    • 2022
  • Objectives: For diagnosis and evaluation, evaluation tools are needed. Various tools can be used to diagnose and evaluate mental disorders. Among them, psychological tests are widely used. For Korean Standard Classification of Diseases (KCD) diagnosis, psychological tests are also required. Currently developed critical pathway (CP) presented tools for diagnosis and evaluation of mental disorders. The CP suggests the use of tools based on the Clinical Practice Guideline (CPG). Therefore, CPG-based tools should be able to be used in the clinical scene of Korean Medicine for diagnosing and evaluating mental disorders according to CP. Methods: Tools suggested by CPs are summarized. The degree of utilization of tools in CPGs is also summarized. A review was conducted by Korean Medicine neuropsychiatrist experts on tools and user's usage plan. Results: As a result, developed CPs suggested using 19 tools for anxiety disorder, 13 tools for insomnia), 12 tools for Hwabyeong, and 9 tools for dementia. In CPG, 48, 34, 44, and 44 tools were used for anxiety disorder, insomnia, Hwabyeong, and dementia, respectively. Among tools presented in CP, HAM-A, HAM-D, CGI, SAS, and TESS for anxiety disorder, CPG, ISI, and PSQI for insomnia disorder, CPG, STAI, and STAXI for Hwabyeong were frequently used in CPG. For dementia CPG, MoCA, MMSE, HDS, ADL, and ADAS-cog were frequently used. Among them, MoCA, ADL, and ADAS-cog were suggested tools in CP. Conclusions: As a result of analyzing tools suggested and used in the developed CPs and CPGs, it was verified that various tools were used in each study. Most of them were symptom and behavioral evaluation scales. Therefore, symptoms and behavior evaluation scales used more frequently should be able to be used in the clinical scene of Korean Medicine.

만성불면증 환자에게 적용한 단기 인지행동중재의 효과 (Effects of the Abbreviated Cognitive Behavioral Therapy for Chronic Insomniacs)

  • 최수정;이영희
    • 중환자간호학회지
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    • 제1권1호
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    • pp.19-31
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    • 2008
  • Purpose: This study was conducted to exam the effects of the Abbreviated Cognitive Behavioral Therapy(ACBT) on chronic insomnia. Methods: Study was one-group interrupted time series study that involved 13 adults(mean age=51.7, aged 25-77 years) with chronic primary insomnia who visited sleep disorder clinic of S Hospital from November 2004 to October 2005. The subjects received 2-session individual ACBT with 2 week-interval($1^{st}$: 1.5- 2hrs, $2^{nd}$: 20-30min). To measure the subjective insomnia severity and sleep patterns, 3 times of insomnia severity index and sleep logs were completed(before ACBT, after ACBT, and 3-month after ACBT). The main outcomes were subjective insomnia severity and sleep patterns(sleep onset latency, waking after sleep onset, and total sleep time, sleep efficiency). The data were analyzed with SPSS 10.0 version program by Friedman test, Wilcoxon signed rank test with Bonferroni correction. Results: There were statistically significant decrease in insomnia severity index, sleep onset latency, and waking after sleep onset, and increase total sleep time and sleep efficiency. Conclusion: ACBT was effective in reducing subjective insomnia severity and improving sleep patterns. Sleep improvement was better sustained over time with ACBT.

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계지거작약가촉칠모려용골탕으로 호전된 COVID-19 백신 접종 이후 발생한 불면증 환자 1례 (A Case Report of Insomnia after COVID-19 Vaccination Treated with Gyejigeojakyakgachokchilmolyeoyonggol-tang)

  • 허태영;이영서;김경민
    • 대한한방내과학회지
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    • 제43권2호
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    • pp.212-218
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    • 2022
  • Objective: This study reports the effects of Gyejigeojakyakgachokchilmolyeoyonggol-tang (GCMYT) in a patient with insomnia after COVID-19 vaccination. Methods: GCMYT was used to treat insomnia following vaccination, and symptoms were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and a visual analog scale (VAS). Results: The patient's PSQI, ISI, and VAS scores decreased from 21 to 11, from 25 to 13, and from 7 to 3, respectively. Conclusion: GCMYT is an effective treatment for insomnia following COVID-19 vaccination.

불면증 변증도구 신뢰도와 타당도 평가 및 심리검사와의 상관성에 대한 초기연구 (A Pilot Study of Evaluating the Reliability and Validity of Pattern Identification Tool for Insomnia and Analyzing Correlation with Psychological Tests)

  • 정진형;이지윤;김주연;김시연;강위창;임정화;김보경;정인철
    • 동의신경정신과학회지
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    • 제31권1호
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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.

주요 우울증과 불면증이 신체화 증상에 미치는 영향 (Effect of Major Depressive Disorder and Insomnia on Somatization)

  • 전진용;김석주;이유진;조성진
    • 수면정신생리
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    • 제19권2호
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    • pp.84-88
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    • 2012
  • 배 경: 본 연구에서는 주요 우울장애와 불면증이 각각 신체화 증상에 미치는 영향을 알아보려고 하였다. 방 법: 심각한 신체질환이 없는 181명의 성인(남자 73명, 여자 108명, 평균연령 $41.59{\pm}8.92$세)이 연구에 참여하였다. 정신과적 진단평가를 위한 구조화 면담과 불면증의 국제진단 분류를 근거로 주요우울장애와 불면증을 각각 진단하였다. 이를 기준으로 연구 대상을 1) 정상 대조군(n=127), 2) 일차성 불면증군(n=11), 3) 불면증상이 없는 우울증군(n=14), 4) 불면증상이 있는 우울증군(n=29) 이상 4개군으로 나누었다. 각 군의 신체화 증상 정도를 평가하기 위해 간이정신건강진단검사(Symptom Checklist-90, SCL-90)의 신체화 증상 차원의 12문항을 자가 작성하게 하였다. 결 과: 각 군의 신체화 증상 척도 점수는 서로 유의한 차이가 있었다(F=25.30, p<0.001). 불면증상이 있는 우울증군은 정상 대조군(p<0.001), 일차성 불면증군(p=0.01), 불면증상이 없는 우울증군(p<0.001)에 비해 모두 신체화 증상 척도 점수가 높았다. 일차성 불면증군은 정상 대조군에 비해 신체화 증상 척도 점수가 높았다(p<0.01). 그러나 불면증이 없는 우울증 환자의 신체화 척도 점수는 정상 대조군과 유의한 차이가 없었다. 다중 회귀분석에서 불면증은 신체화 증상척도 점수를 유의하게 예측하였으나(beta=0.44, p<0.001), 주요 우울증은 통계적으로는 유의하지 않은 경향성만을 보여주었다(beta=0.14, p=0.08). 결 론: 불면증은 주요 우울증 유무와 독립적으로 신체화 증상과의 관계를 보였다. 일차성 불면증이 있는 경우 신체화 증상이 심했으며, 우울증이 있는 환자에서도 불면증이 동반된 경우에만 신체화 증상이 심했다. 이러한 결과들은 불면증상이 신체화 증상과 매우 밀접한 관련이 있음을 시사한다.

섬소약침이 수면장애 환자의 불면 및 우울 증상에 미치는 영향에 대한 임상적 고찰 (Clinical Research of the Effects of Sumsu (Bufonis venenum) Pharmacopuncture on Insomnia and Depression in Patients with Sleep Disorder)

  • 서동균;신소연;김신영;서종철;서연주;박종현;윤현민;장경전;송춘호;김철홍
    • Journal of Acupuncture Research
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    • 제32권3호
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    • pp.175-183
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    • 2015
  • Objectives : The purpose of this study is to investigate the effects of Sumsu (Bufonis venenum) pharmacopuncture on insomnia and depression. Methods : We investigated 32 patients with a sleep disorder who had been recruited at a Korean medical hospital from March $1^{st}$, 2014 to April $16^{th}$, 2015. We divided subjects into two groups : The control group(N=15) was treated with Normal Saline and the experimental group(N=17) was treated with Sumsu(Bufonis venenum) pharmacopuncture. The subjects were injected with 0.05 ml~0.1 ml, for a total of 0.6 ml on each acupuncture point. These were Pungbu ($GV_{16}$), Pungi ($GB_{20}$), Gyeonjeong ($GB_{21}$), and Anmyun(EX-$HN_{20}$). Both groups were evaluated with the beck depression inventory(BDI) and given an insomnia score before treatment, after one week, two weeks and four weeks from the initial visit. Results : The Insomnia score and BDI decreased significantly in the experimental group. In comparing the control group with the experimental group, there was a more significant improvement of the insomnia score in the experimental group during all periods of this study. However, the difference of change in BDI between the control group and experimental group was only significant in the first week. Conclusions : Sumsu (Bufonis venenum) pharmacopuncture can be used as an effective treatment for patients with insomnia and depression.

불면 장애에 대한 약침술 치료법 제안을 위한 체계적 문헌 고찰과 메타 분석 연구 (A Systematic Review and Meta-Analysis of Pharmacopuncture Treatment for Insomnia Disorder)

  • 조민우;임정화;김보경
    • 동의신경정신과학회지
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    • 제32권3호
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    • pp.185-206
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    • 2021
  • Objectives: The objective of this study was to perform a systematic review and meta-analysis of pharmacopuncture treatment for insomnia disorder to derive clinical evidence and recommendation grades. Methods: Studies that verified effects of pharmacopuncture on primary insomnia were included. Characteristics and quality of included studies were assessed using Risk of Bias (RoB). Results: A total of 25 studies were selected. Pittsburgh Sleep Quality Index (PSQI) and effective rate were primarily used for outcome measurement. Vitamin B12 was the most used pharmacopuncture material. The most frequently used acupuncture point was Anmian (Ex-HN). The volume of the acupuncture solution ranged from 0.25 mL to 2 mL. Acupuncture treatment depth was 0.5 cm to 2 cm. In three studies, the procedure was performed at 16:00. Meta-analysis of studies revealed that the effective rate of the pharmacopuncture group was significantly higher than the group using sleeping pills group (RR: 1.21, 95% CI: 1.01 to 1.45, p=0.04, I2=69%). PSQI was decreased in the intervention group (MD=-2.19, 95% CI: -2.90 to -1.48, p<0.00001, I2=0%). Effective rates of pharmacopuncture and acupuncture groups were higher than that of the acupuncture group (RR: 1.11, 95% CI: 1.05 to 1.17, p=0.0002, I2=0%). PSQI was decreased in the intervention group (MD=-1.87, 95% CI: -2.36 to -1.38, p<0.00001, I2=0%). Although the effectiveness rate of the pharmacopuncture group was not significantly higher than that of the acupuncture group (RR: 1.12, 95% CI: 0.98 to 1.27, p=0.1, I2=9%), the PSQI was decreased in the pharmacopuncture group (MD=-2.10, 05% CI: -3.29 to -0.91, p=0.0005, I2=34%). The quality of clinical studies was poor. Conclusions: Based on results of this study, it is proper to use 0.5 to 2 mL of pharmacopuncture solution such as Danshen and Ciwujia with a depth of 0.5 to 2 cm at around 4 p.m. to treat insomnia disorder, focusing on Anmian (Ex-HN) and Sameumgyo (SP6).