• Title/Summary/Keyword: insomnia disorder

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Polysomnographic Evauation for Disorders of Initiating and Maintaining Sleep (불면증 평가를 위한 수면다원검사)

  • Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.1 no.1
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    • pp.9-19
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    • 1994
  • Disorders of intitating and maintaining sleep(DIMS : insomnia) may be a symptom of some other disease or the basic, root problem in some patients. DIMS is usually treated by private physicians or psychiatrists, initially. Many physicians can do to improve the quality of life of the sleep disordered patients by appropriate evaluation and management For the effective management of DIMS patients, the accurate differential diagnosis is essential. In polysomnographic evaluation for insomnia, the physician should consider the aspects of cost-effectiveness to provide the maximal benefits for the patients. For the purpose of this, evaluation of DIMS complaints outside the sleep disorder clinic, indication for referral to a sleep disorder clinic, the role of polysomnopraphy in evaluating DIMS, and polysomnographic findings of different types of DIMS are discussed, together with possible way to diagnose them.

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Diagnosis of Sleep Disorders Through Sleep Questionnaires (수면 설문지를 통한 수면장애의 진단)

  • Lee, Sung-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.2 no.1
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    • pp.44-54
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    • 1995
  • It is very difficult to evaluate sleep disorders by simple history taking, because which covers very comprehensive areas such as psychobiosocial fields. Although polysomnography is used for the method of final diagnosis, systemic history taking and sleep question-aires are still critically important especially in evaluation of insomnia. Proper informations through sleep questionnaires can provide very precise data for effective treatment as well as exact diagnosis. Sleep questionnaires consist of largely four kinds of questionnaires, which are screening questionnaire of sleep disorders, sleep diary and questionnaire of sleep hygine, diagnostic questionnaire for specific sleep disorder and questionnaire of special symptoms of sleep disorders including insomnia, daytime sleepiness, cognitive function, mental symptom and personality, parasomnia, physical illness and sexual function. However, for more conclusive diagnosis especially in excessive daytime sleepiness nocturnal polysomnography and multiple sleep latency test should be performed.

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An improved case by operating the traditional oriental medical remedy with mindfullness to the Hwa-Byung patient suffering from insomnia and physical symptoms (불면(不眠)과 신체증상(身體症狀)을 호소하는 화병 환자에게 한의학적(韓醫學的) 치료(治療)와 마음챙김명상을 병행하여 호전된 1례)

  • Park, Se-Hwan;Seok, Seon-Hee;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.3
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    • pp.231-244
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    • 2008
  • Insomnia is one of the highest frequency neuropsychosis of neuropsychiatry patients and is primarily caused by major depressive disorder. This case study is about a remedy for a 33 year-old woman who has insomnia and intense depressed mood caused by the continuous family jar. Also, she had the feeling of squeezing her body, pouring cold water into her body, anorexia and feeling cold and hot turn and turn. I operated mindfullness with accupuncture, herb-medication and aroma theraphy. Especially, mindfullness and Gagamguibi-tang were effective for relaxation and the sound sleep in quality and quantity. According to this study, the traditional oriental medical remedy such as accupuncture, herb-medication is effective for the cure of insomnia and mindfullness fortifies the oriental medical remedy.

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The Effect of Sayeok-san for Insomnia: A Systematic Review and Meta-Analysis (사역산(四逆散)의 불면 치료 효과 : 체계적 문헌 고찰 및 메타 분석)

  • Huh, Tae-young;Ha, Da-jung;Kim, Kyoung-min
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.547-562
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    • 2021
  • Objectives: This study evaluated the effectiveness of Sayeok-san for treating insomnia. Methods: We conducted a search using keywords, such as "Sayeoksan", "Si-ni-san", and "insomnia" in eight databases (CNKI, Wanfang, Pubmed, Embase, Cochrane, NDSL, OASIS, RISS) on July 17, 2012. There was no limit placed on the publication period of the papers, and we used Cochrane's risk of bias tool to assess their quality. Meta-analysis was classified according to the outcome measurements, such as total effective rate and PSQI. Results: Nine RCTs were selected. Meta-analysis showed that the treatment group, which used Sayeok-san, had a higher total effective rate than did the control group that used only Western medicine. The treatment group also had a lower average of PSQI and TSS (TCM symptom score) than did the control group. Conclusion: This study suggests that Sayeok-san is effective in treating insomnia. However, these findings should be interpreted cautiously due to unknown or high risk of bias of the included trials.

Survey of Knowledge on Insomnia for Sleep Clinic Clients (수면클리닉을 방문한 환자들의 불면증에 대한 인식조사)

  • Soh, Minah
    • Sleep Medicine and Psychophysiology
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    • v.26 no.1
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    • pp.23-32
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    • 2019
  • Objectives: Insomnia is not only the most common sleep-related disorder, but also is one of the most important. Knowledge of the comorbidities of insomnia is essential for proper treatment including pharmacological and non-pharmacological methods to prevent disease chronification. This study aimed to determine sleep clinic patients' knowledge of insomnia. Methods: This study recruited 44 patients (24 males and 20 females; mean age $54.11{\pm}16.30years$) from the sleep clinic at National Center for Mental Health. All subjects were asked to complete a self-report questionnaire about their reasons for visiting a sleep clinic and about their knowledge of treatment and comorbidities of insomnia. Results: The reasons for visiting the sleep clinic were insomnia symptoms of daytime sleepiness, irregular sleeping time, nightmares, snoring, and sleep apnea, in that order. Of the responders, 72.7% had a comorbidity of insomnia, and 22.7% showed high-risk alcohol use. In addition, 70.5% of responders chose pharmacological treatment of insomnia as the first option and reported collection of information about treatment of insomnia mainly from the internet and medical staff. More than half (52.3%) of the respondents reported that they had never heard about non-pharmacological treatments of insomnia such as cognitive behavioral treatment (CBT-I) or light therapy. The response rate about comorbidities of varied, with 75% of responders reporting knowledge of the relation between insomnia and depression, but only 38.6% stating awareness of the relation between insomnia and alcohol use disorder. Of the total responders, 68.2% were worried about hypnotics for insomnia treatment, and 70% were concerned about drug dependence. Conclusion: This study showed that patients at a sleep clinic had limited knowledge about insomnia. It is necessary to develop standardized insomnia treatment guidelines and educational handbooks for those suffering from insomnia. In addition, evaluation of alcohol use disorders is essential in the initial assessment of sleep disorders.

A Clinical Study of Insomnia in 33 Admission Cases (불면증(不眠症)을 주소(主訴)로 입원(入院)한 환자(患者) 33례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Choi Byung-Man;Lee Sang-Ryong;Kim Myung-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.12 no.1
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    • pp.169-182
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    • 2001
  • The clinical study was carried out the 33 patients with insomnia who were treated in Daejeon University Oriental Hospital from 17 March 1997 to 12 May 2001. The results were summarized as follows. 1. The ratio of male and female was 10:23 and sleep initiation insomnia and sleep maintenance insomnia were the highest frequence(97%), the beginning of insomnia was frequent at 30s(27.3%). 2. Living accident by mental attack was the most inducing factor and many patients came to our hospital by way of west-neuropsychiatry(55.6%). 3. In admission period most of the patients were within 15 days(78.8%) and Liver-Qi- depression was the main cause and in classification of Four Human coporeal constitution the number of patients Sho-Eum-In(少陰人) was remarked mostly and in distribution of the prescription drugs of growing heart and warming gall bladder such as GUIBIONDAMTANG(歸脾溫膽湯) and ONDAMTANGGAMI (溫膽湯加味) were many, 4. Relatively most patients were well treated(69.7%) and insomnia was mainly caused by Anxiety Disorder and Depression and Hwabyoung and in the age distribution the highest frequence was 30s but we know insomnia appeared at all ages. 5. In distribution of the period of the clinical history was various and within 15 days were all improved and the treatments group of drug and acupuncture and aid treatments etc. and hypnotics was more improved than not used hypnotics treatments group but using hypnotics was temporal. I.

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Sleep in Borderline Personality Disorder Individuals (경계성 인격 장애 환자의 수면)

  • Lee, So-Jin
    • Sleep Medicine and Psychophysiology
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    • v.19 no.2
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    • pp.59-62
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    • 2012
  • Borderline personality disorder (BPD) is characterized by identity and interpersonal problem, affective dysregulation and pervasive severe impulsivity. Although sleep disturbances are not primary symptoms of BPD, they are important aspects of this disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of BPD yet. Measured by nocturnal polysomnography, increased sleep latency as well as reduced total sleep time and sleep efficiency, and 'depression-like' REM abnormalities (i.e., reduced REM latency and increased REM density) are found in BPD patients. Co-morbid sleep disorders such as chronic insomnia, nightmare disorder or circadian rhythm sleep disorder associated with BPD have been reported. Clinicians should focus on the sleep complaints of BPD patients, and carefully manage such symptoms with sleep hygiene education, cognitive psychotherapy or light therapy.

Study on The Rhythmical Rules of The Circulation of Yeong(營) and Wi(衛) during Sleep (시론영위주야절률성재수면활동중적작용(试论营卫昼夜节律性在睡眠活动中的作用))

  • Lu, Ying
    • Journal of Korean Medical classics
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    • v.22 no.4
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    • pp.47-50
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    • 2009
  • This paper according to the sleep theory of Yeonggi(營氣) and Wigi(衛氣)'s circulation in "Naegyeong(內經)", explains that Yeonggi and Wigi's circulation is the internal basic for human's sleep-wake rhythm, and it's relationship with other sleep theories, such as mental activity sleep theory, soul sleep theory, Jangbu(臟腑) organs sleep theory etc. It can be seen that the circulation law of Yeonggi and Wigi for day and night is the key of sleep activities, and Yeonggi and Wigi's circulation disorder is the key of insomnia, so we should use coordination of Yeonggi and Wigi as basic method for treating insomnia, based on treatment after differentiation of syndromes.

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The Effect of Intradermal Acupuncture on The Patients suffering from Insomnia after Stroke (중풍환자(中風患者)의 불면증(不眠症)에 피내침(皮內針)의 유효성(有效性) 및 적응증(適應證) 평가(評價))

  • Lee Sang-Ho;Kim Eun-Ju;Kim Lee-Dong;Yun Sang-Pil;Lee Cha-Ro;Hong Jin-Woo;Jeong Dong-Won;Moon Sang-Kwan;Cho Ki-Ho;Kim Young-Suk
    • The Journal of Internal Korean Medicine
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    • v.25 no.1
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    • pp.138-148
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    • 2004
  • Objective : Insomnia is the disorder of initiation or maintenance in sleeping that results in daytime sleepiness and dysfunction, and it arises from multiple psychological, physiological and environmental factors. A number of stroke patients suffer from insomnia are classified as sleep disorder patients with physical illness. In addition, insomnia may have profound deleterious effects on the natural course of stroke. We are to assess the effectiveness of intradermal acupucture on stroke combined with insomnia. Methods : We recruited hospitalized patients with insomnia after stroke. Then, the subjects were allocated into a treatment group and a control group by randomization. The treatment group received intradermal acupuncture therapy at He-7(神門), EH-6(內關) correctly. However in control group, intradermal acupuncture were just attached to He-7(神門), EH-6(內關) without insertion. Treatment over time at first day and second day a various indexes were repeatedly checked such as sleep latency, total sleep time, sleep quality, condition on awakening, ability of concentration, morning sleepiness, Insomnia Severity Index, and Athens Insomnia Scale. In the second analysis, we divided the treatment group into a response and a non-response group by their response to intradermal acupuncture. With the acupuncture treatment, accompanied symptoms were checked Results : Among thirty two subjects, two of them were dropped out: One complained the pain from needle insertion, and the other underwent the change of his herbal medication. At baseline investigation with the residual 30 subjects, the control and the treatment group were assessed to have an equal comparability. In the treatment group, sleep latency, total sleeping time, a number of awakenings, sleep quality and ability of concentration showed improvement significantly compared with the control group. The non-response Group showed symptoms such as nausea and halitosis, belching and acid regurgitation, abundant expectoration, while Responder Group showed palpitation, oppressed feelings in chest and sleep disorder. Conclusions: The result of this clinical study suggests that the intradermal acupuncture at He-7(神門), EH-6(內關) is one of the effective treatments for the insomnia after stroke.

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The Study on Korean Medical Pattern Differentiation of Sleep-Wake Disorders by DSM-V Classification (DSM-V 분류에 따른 수면-각성장애의 한의학적 변증 연구)

  • Na, Il Doo;Park, Mi Sun;Kim, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.31 no.2
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    • pp.83-93
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    • 2017
  • This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.