The Journal of Korean Medicine (대한한의학회지)

The Society of Korean Medicine (대한한의학회)
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Association of Cold/Heat Sensation with Sleep Quality and Insomnia in Middle-aged Women

중년 여성에서 신체의 냉/열감과 수면의 질 및 불면증의 연관성 분석

  • Sujeong Mun (KM Data Division, Korea Institute of Oriental Medicine) ;
  • Kihyun Park (KM Data Division, Korea Institute of Oriental Medicine) ;
  • Kwang-Ho Bae (KM Data Division, Korea Institute of Oriental Medicine) ;
  • Younghwa Baek (KM Data Division, Korea Institute of Oriental Medicine) ;
  • Siwoo Lee (KM Data Division, Korea Institute of Oriental Medicine)
  • 문수정 (한국한의학연구원 한의약데이터부) ;
  • 박기현 (한국한의학연구원 한의약데이터부) ;
  • 배광호 (한국한의학연구원 한의약데이터부) ;
  • 백영화 (한국한의학연구원 한의약데이터부) ;
  • 이시우 (한국한의학연구원 한의약데이터부)
  • Received : 2024.01.17
  • Accepted : 2024.02.16
  • Published : 2024.03.01
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Abstract

Objectives: Cold extremities have been suggested to correlate with sleep disturbances. This study aims to explore the relationship between thermal sensations in body, encompassing both cold and heat sensations, with sleep quality and insomnia. Methods: Self-administered questionnaires were utilized to assess thermal sensations in body, sleep quality and symptoms of insomnia in middle-aged women. A multiple logistic regression analysis was performed to ascertain the association between thermal sensations in body and both sleep quality and insomnia symptoms. Results: Among 899 participants, 255 (28.4%) were categorized in the cold sensation group, 95 (10.6%) in the heat sensation group, 70 (7.8%) in the group with both cold and heat sensations, and 479 (53.3%) in the no-sensation group. Pittsburgh Sleep Quality Index and Insomnia Severity Index were notably higher in the group experiencing both sensations when compared to the no-sensation group. After adjustments for covariates, the odds ratios for poor sleep quality, moderate/severe insomnia, and long sleep latency were significantly elevated in the group with both sensations when compared to the no-sensation group. The odds ratios for poor sleep quality in the cold sensation group and for moderate/severe insomnia and low sleep efficiency in the heat sensation group were significantly higher when compared to the no-sensation group. Conclusions: The risk for sleep disturbances varied depending on the presence of thermal sensations in body, with the greatest risk observed for low sleep quality and insomnia in individuals experiencing both cold and heat sensations.

Keywords

Acknowledgement

본 연구는 2024년도 한국한의학연구원의 "빅데이터 기반 한의 예방 치료 원천기술 개발(KSN1732121)" 과제의 지원을 받아 수행되었습니다.

References

  1. Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D. et al. (2015). Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion. Journal of Clinical Sleep Medicine, 11(08), 931-952. https://doi.org/doi:10.5664/jcsm.4950 
  2. Lallukka, T., Sivertsen, B., Kronholm, E., Bin, Y. S., Overland, S. & Glozier, N. (2018). Association of sleep duration and sleep quality with the physical, social, and emotional functioning among Australian adults. Sleep Health, 4(2), 194-200. https://doi.org/10.1016/j.sleh.2017.11.006 
  3. Chung, S., Cho, S. W., Jo, M. W., Youn, S., Lee, J. & Sim, C. S. (2020). The Prevalence and Incidence of Insomnia in Korea during 2005 to 2013. Psychiatry Investig, 17(6), 533-540. https://doi.org/10.30773/pi.2019.0218 
  4. Simonsick, E. M., Meier, H. C. S., Shaffer, N. C., Studenski, S. A. & Ferrucci, L. (2016). Basal body temperature as a biomarker of healthy aging. Age (Dordr), 38(5-6), 445-454. https://doi.org/10.1007/s11357-016-9952-8 
  5. Te Lindert, B. H. W. & Van Someren, E. J. W. (2018). Skin temperature, sleep, and vigilance. Handb Clin Neurol, 156, 353-365. https://doi.org/10.1016/B978-0-444-63912-7.00021-7 
  6. Campbell, S. S. & Broughton, R. J. (1994). Rapid decline in body temperature before sleep: fluffing the physiological pillow? Chronobiol Int, 11(2), 126-131. https://doi.org/10.3109/07420529409055899 
  7. Krauchi, K., Cajochen, C., Werth, E. & Wirz-Justice, A. (1999). Warm feet promote the rapid onset of sleep. Nature, 401(6748), 36-37. https://doi.org/10.1038/43366 
  8. Krauchi, K., Konieczka, K., Roescheisen-Weich, C., Gompper, B., Hauenstein, D., Schoetzau, A. et al. (2014). Diurnal and menstrual cycles in body temperature are regulated differently: a 28-day ambulatory study in healthy women with thermal discomfort of cold extremities and controls. Chronobiol Int, 31(1), 102-113. https://doi.org/10.3109/07420528.2013.829482 
  9. Pache, M., Krauchi, K., Cajochen, C., Wirz-Justice, A., Dubler, B., Flammer, J. & Kaiser, H. J. (2001). Cold feet and prolonged sleep-onset latency in vasospastic syndrome. Lancet, 358(9276), 125-126. https://doi.org/10.1016/S0140-6736(01)05344-2 
  10. Krauchi, K., Gasio, P. F., Vollenweider, S., Von Arb, M., Dubler, B., Orgul, S. et al. (2008). Cold extremities and difficulties initiating sleep: evidence of co-morbidity from a random sample of a Swiss urban population. J Sleep Res, 17(4), 420-426. https://doi.org/10.1111/j.1365-2869.2008.00678.x 
  11. van den Heuvel, C., Ferguson, S. & Dawson D. (2006). Attenuated thermoregulatory response to mild thermal challenge in subjects with sleep-onset insomnia. Sleep, 29(9), 1174-1180. https://doi.org/10.1093/sleep/29.9.1174 
  12. Van Someren, E. J., Dekker, K., Te Lindert, B. H., Benjamins, J. S., Moens, S., Migliorati, F. et al. (2016). The experienced temperature sensitivity and regulation survey. Temperature (Austin), 3(1), 59-76. https://doi.org/10.1080/23328940.2015.1130519 
  13. Bae, K. H., Yoon, Y., Yeo, M., Kim, H. S., Lee, Y. & Lee, S. (2016). Development on the Questionnaire of Cold-Heat Pattern Identification Based on Usual Symptoms for Health Promotion. Journal of Physiology and Pathology in Korean Medicine, 30(2), 116-123.  https://doi.org/10.15188/kjopp.2016.04.30.2.116
  14. Lee, B.-J., Jung, H.-J., Choi, J.-Y., Kang, W.-C. & Jung, S.-K. (2012). Preliminary Study to Develop a Korean Oriental Medical Assessment Tool for Syndrome Differentiation of Chronic Obstructive Pulmonary Disease. Journal of Korean Medicine, 33(3), 82-94. 
  15. Baek, Y., Seo, B. N., Jeong, K., Yoo, H. & Lee, S. (2020). Lifestyle, genomic types and non-communicable diseases in Korea: a protocol for the Korean Medicine Daejeon Citizen Cohort study (KDCC). BMJ Open, 10(4), e034499. https://doi.org/10.1136/bmjopen-2019-034499 
  16. Zeng, L. N., Zong, Q. Q., Yang, Y., Zhang, L., Xiang, Y. F., Ng, C. H. et al. (2020). Gender Difference in the Prevalence of Insomnia: A Meta-Analysis of Observational Studies. Front Psychiatry, 11, 577429. https://doi.org/10.3389/fpsyt.2020.577429 
  17. Jang, J.-B., Lee, K.-S. & Song, B.-K. (1995). Epidemiologic Study of Female's Part-Cold Hypersensitivity Syndrome. Journal of Korean Medicine, 16(1), 21-35. 
  18. Karjalainen, S. (2012). Thermal comfort and gender: a literature review. Indoor Air, 22(2), 96-109. https://doi.org/10.1111/j.1600-0668.2011.00747.x 
  19. Sohn, S. I., Kim, D. H., Lee, M. Y. & Cho, Y. W. (2012). The reliability and validity of the Korean version of the Pittsburgh Sleep Quality Index. Sleep Breath, 16(3), 803-812. https://doi.org/10.1007/s11325-011-0579-9 
  20. Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman S. R. & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res, 28(2), 193-213. https://doi.org/10.1016/0165-1781(89)90047-4 
  21. Cho, Y. W., Song, M. L. & Morin, C. M. (2014). Validation of a Korean Version of the Insomnia Severity Index. J Clin Neurol, 10(3), 210-215.  https://doi.org/10.3988/jcn.2014.10.3.210
  22. Morin, C. M., Belleville, G., Belanger, L. & Ivers, H. (2011). The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep, 34(5), 601-608. https://doi.org/10.1093/sleep/34.5.601 
  23. Bastien, C. (2001). Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Medicine, 2(4), 297-307. https://doi.org/10.1016/S1389-9457(00)00065-4 
  24. Ezzati, M., Lopez, A. D., Rodgers, A. A. & Murray, C. J. L. (2004) Comparative quantification of health risks : global and regional burden of disease attributable to selected major risk factors / edited by Majid Ezzati ... [et al.]. World Health Organization, Geneva. 
  25. Armstrong, T. & Bull, F. (2006). Development of the World Health Organization Global Physical Activity Questionnaire (GPAQ). Journal of Public Health, 14(2), 66-70. https://doi.org/10.1007/s10389-006-0024-x 
  26. Rabin, R. & Charro, F. d. (2001). EQ-SD: a measure of health status from the EuroQol Group. Annals of Medicine, 33(5), 337-343. https://doi.org/10.3109/07853890109002087 
  27. Park, K., Jaekal, E., Yoon, S., Lee, S. H. & Choi, K. H. (2019). Diagnostic Utility and Psychometric Properties of the Beck Depression Inventory-II Among Korean Adults. Front Psychol, 10, 2934. https://doi.org/10.3389/fpsyg.2019.02934 
  28. Gompper, B., Bromundt, V., Orgul, S., Flammer, J. & Krauchi, K. (2010). Phase relationship between skin temperature and sleep-wake rhythms in women with vascular dysregulation and controls under real-life conditions. Chronobiol Int, 27(9-10), 1778-1796. https://doi.org/10.3109/07420528.2010.520786 
  29. Riemann, D., Spiegelhalder, K., Feige, B., Voderholzer, U., Berger, M., Perlis, M. & Nissen, C. (2010). The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med Rev, 14(1), 19-31. https://doi.org/10.1016/j.smrv.2009.04.002 
  30. Bonnet, M. H. & Arand, D. L. (1995). 24-Hour metabolic rate in insomniacs and matched normal sleepers. Sleep, 18(7), 581-588. https://doi.org/10.1093/sleep/18.7.581 
  31. Lee, H.-S., Kim, H., Yun, Y.-G., Lee, S., Jeon, J.-H., Kim, B.-K. et al. (2016). Preliminary Study to Develop the Instrument on Pattern Identifications for Insomnia. Journal of Oriental Neuropsychiatry, 27(4), 223-234. https://doi.org/10.7231/jon.2016.27.4.223 
  32. Na, I. D., Park, M. S., & Kim, Y. M. (2017). The Study on Korean Medical Pattern Differentiation of Sleep-Wake Disorders by DSM-V Classification. Journal of Physiology & Pathology in Korean Medicine, 31(2), 83-93. https://doi.org/10.15188/kjopp.2017.04.31.2.83