• Title/Summary/Keyword: Insomnia,

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The Causes and Treatment of Complicated Chronic Insomnia (까다로운 만성불면증의 원인과 치료)

  • Lee, Sung-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.2 no.2
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    • pp.138-145
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    • 1995
  • The causes of complicated chronic insomnia are very various and interact with vicious circle. Patient with this insomnia has generally a strong fear and frustration about failing to control of sleep and a deep mistrust toward doctor. To solve this complicated problems detailed history taking and sleep questionnaires are needed with objective polysomnography. Through these procedures, doctor should clarify causes of insomnia and explain them to patient in details and kindly. This process would be very helpful to restore the mistrustful relationship between patient and doctor and reduce patient's vague fear for insomnia. In treatment of complicated chronic insomnia, it is most important for patient to understand his problems and participate in the treatment schedule actively with assurance. Also doctor should encourage patient persistently not to be drop out. Most important factor for prognosis is patient's personality. Causes of complicated chronic insomnia are like these, overdose of hypnotics and sedatives, daily drinking alcohol with hypnotics, insomnia associated depression, delayed sleep phase syndrome, sleep state misperception, marked fear for insomnia, hyperarousal at bed, insomnia associated periodic leg movement and sleep apnea, chronic hypnotic insomnia, and immature personality. And possible treatments of these insomnias were discussed.

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Prevalence of Insomnia and Its Related Factors in Korean Women

  • Shin, Su Jin;Shin, Kyung Rim
    • Korean Journal of Adult Nursing
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    • v.19 no.5
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    • pp.150-161
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    • 2007
  • Purpose: The purposes of this study were to investigate the prevalence of insomnia and to compare sleep patterns, demographic characteristics, and obstacles for sleep between women with and without insomnia. Methods: This was a descriptive study. Study participants were 1,679 Korean women aged over 20 years. Information on symptoms of insomnia, sleep patterns, and related factors was assessed by questionnaire. Symptoms of insomnia included difficulties in initiating and maintaining sleep and early morning awakening. Results: This study found that 32.0% of the study participants had insomnia, subjects with insomnia had bad sleep patterns compared to comparison group, lower educational level and menopause were closely related to insomnia, and noise, temperature, lighting, presence of bed partner, intake of caffeine, frequent urination, and pain or itching were associated with insomnia. Conclusion: This study suggests that insomnia is prevalent in women and closely associated with education level and menopausal status.

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Clinical Application of Digital Therapeutics for Insomnia (불면증 디지털 치료제의 임상 적용)

  • Cho, Chul-Hyun
    • Sleep Medicine and Psychophysiology
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    • v.28 no.1
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    • pp.6-12
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    • 2021
  • Insomnia is one of the most common sleep disorders experienced by modern people, and treatment is often not adequate due to various limitations. Digital therapeutics for insomnia are expected to play a revolutionary role in supplementing and satisfying unmet needs in real-world clinical treatment. Digital therapeutics for insomnia were developed based on cognitive-behavioral therapy for insomnia, which is the first standard treatment for insomnia. The effectiveness of digital therapeutics for insomnia developed by several companies has been proven through well-designed clinical research. Various approaches have been used for practical application of digital therapeutics for insomnia. Thus far, meaningful results have been drawn, but there are areas that need to be improved upon based on real-world evidence. Sleep researchers need to validate the safe and effective application of digital therapeutics for the treatment of insomnia.

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 Study on Zhang Jiebin's Discussion of Treating Insomnia (장개빈(張介賓)의 불면(不眠) 논치(論治) 연구(硏究))

  • Bak, Gi-ho;Bae, Jeong-woon;Lyu, Jeong-ah
    • Journal of Korean Medical classics
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    • v.36 no.1
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    • pp.79-107
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    • 2023
  • Objectives : This study aims to improve the diagnosis and treatment of contemporary insomnia by examining Zhang Jiebin's discussion on treating insomnia. Methods : The classical texts from the 'Insomnia' chapter of the Jingyue Quanshu were examined threefold in terms of symptom, treatment, and prescription analysis, after which the treatment discussion part was examined within the historical context of discussions on insomnia in major medical texts starting from the Huangdineijing. Results : According to Zhang, the cause of insomnia could be divided into two, after which criteria for diagnosis and treatment were set as excess pathogen and vital qi deficiency. He argued that insomnia could be naturally resolved through improvement of various pathogenic situations. Discussions on insomnia from various medical texts since the Huangdineijing suggest that pathology related to psychological function and emotions gradually increased and expanded over time. Conclusions : Zhang's discussion on symptom, treatment and prescriptions of insomnia suggests a new framework that could improve treatment effects through a Korean Medical Mind-Body approach, rather than the contemporary classification of organic insomnia and non-organic insomnia.

A Case Report of Primary Insomnia treated by Oryeong-san decoction (오령산(五苓散)으로 호전된 일차성 불면증 1례 임상 보고)

  • Park, Jae Kyung
    • 대한상한금궤의학회지
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    • v.7 no.1
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    • pp.45-52
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    • 2015
  • Objective : This case report aims to demonstrate the effect of Oryeong-san on Insomnia. Methods : A 26 year old woman suffered from insomnia with mental and physical exhaustion, reduced stamina, lack of concentration in daytime. According to Diagnostic system based on Shanghanlun provisions, the patient was diagnosed with Taeyang-byung and treated by Oryeong-san decoction. The result of administration was evaluated by Insomnia Severity Index. Results : After administration of Oryeong-san decoction for 1 month, Insomnia Severity Index was decreased from 24(clinical insomnia, severe) to 1(no clinically significant insomnia). Conclusions : The patient completely recovered from insomnia and daytime symptoms as treated by Oryeong-san decoction according to Diagnostic system based on Shanghanlun provisions.

Insomnia in Medical Illnesses:The Secondary Insomnia (내과적 질환에 동반된 불면증:이차성 불면증)

  • Lim, Se-Won;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.11-16
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    • 2005
  • Sleep can be easily disrupted by variety of conditions. Most of medical illnesses could be a primary condition causing secondary insomnia. The common underlying mechanism of secondary insomnia is presumed to be stress effects on sleep. The assessment and treatment of secondary insomnia are often complicated. Establishing an causal inference between primary condition and insomnia is the key to assessment. However, it can be difficult even for experienced clinicians due to diagnostic ambiguity of secondary insomnia. Therefore, through medical evaluation and integrative understanding of primary condition is essential to manage secondary insomnia properly. Although treatment have been usually focused on the primary medical illnesses per se, nonpharmacologic interventions, such as sleep hygiene, might be effective in many cases.

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A Case Series of Insomnia Patients Treated with Ondam-tanggami(Wendan-tangjiawei) (온담탕가미(溫膽湯加味) 투여 후 수면의 질이 개선된 환자 치험 3례)

  • Park, Dae-Myung;Lee, Sang-Ryong;Jung, In-Chul
    • Journal of Oriental Neuropsychiatry
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    • v.22 no.4
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    • pp.111-124
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    • 2011
  • Objectives : This case series was conducted to report the efficacy of Ondam-tanggami for insomnia. Methods : Insomnia patients with more than 15 points on Insomnia Severity Index scale were assessed using SCL-90-R, STAI, STAXI, BDI. Being treated with Ondam-tanggami after 2 weeks, ISI, STAI, STAXI, BDI were re-measured to determine the progress of insomnia. It is measured that total sleep time, number of awaking times during sleep, satisfaction of sleep daily. Results : After treatment, quality of sleep has improved and ISI, STAI, STAXI, BDI score have decreased. Conclusions : According to the study, treatment with Ondam-tanggami for insomnia has shown positive results. Further use of Ondam-tanggami is much anticipated for future treatment of insomnia cases.

Association between insomnia and absenteeism or presenteeism among Korean employees

  • JongHyun Hwang;Seong-Sik Cho;Jung Il Kim
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.41.1-41.10
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    • 2022
  • Background: In Korea, few studies clarify insomnia and its association and absenteeism or presenteeism. Therefore, this study aims to examine the association between insomnia and absenteeism/presenteeism using the sixth Korean Working Conditions Survey. Methods: Insomnia was evaluated by the Minimal Insomnia Symptoms Scale (MISS). Absenteeism and presenteeism were assessed by asking if the employee had experienced absence or working despite being ill for the prior 12 months at the point of the survey. Multiple logistic analyses were conducted to explore insomnia and its association with absenteeism and presenteeism. Results: The odds ratios of insomnia for absenteeism and presenteeism were 3.48 (95% confidence interval [CI]: 2.76-4.39) and 3.68 (95% CI: 3.18-4.26) in the fully adjusted model. As the MISS scores increased, absenteeism and presenteeism showed the increasing trend that odd ratios increased accordingly from the first to the fourth quartile. Conclusions: This study observed that insomnia was related to both absenteeism and presenteeism among Korean employees.

The Causes and Developmental Mechanism of Insomnia (불면증의 원인과 발생기전)

  • Lee, Sung-Hoon
    • Sleep Medicine and Psychophysiology
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    • v.1 no.1
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    • pp.3-8
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    • 1994
  • With the recent development of sleep medicine, insomnia has been perceived as a disease from a simple symptom. As there are various causes in a disease, proper treatment according to each cause is necessary for a more effective treatment In general, insomnia is classified into five categrories of physical, physiological, psychological, psychiatric and pharmacological aspects. However, such categorizations are often insufficient in treating insomnia. Furthermore understanding of the developmental mechanisms of insomnia is required. The function of sleep is developed and maintained through the balance of the reciprocal forces of sleep and arousal. These forces are contantly regulated by what is called a circadian rhythm. Sleep is induced by this rhythm which is affected by factors such as awakening time in the morning, amount of intellectual function, amount and time length of physical exercise and sunlight Insomnia could develop when this rhythm is delayed and leads to a "forbidden zone" which is a very difficult period for inducing sleep about two to four hours before the routine bedtime. Whereas sleep gradually develops in line with the circardian rhythm, arousal can occur very abruptly by any cause triggered by emotional discomfort or anxiety. Such characteristic and emotional factors as perfectionism, separation anxiety, secondary gain, insecurity, and negative cognition may provoke the inner anxiety and fear for insomnia, which can lead acute insomnia to a chronic one. As chronic insomnia is developed by multiple causes and factors, integrated approaches through analysis of above mentioned factors will be more effective in the treatment of insomnia than a simple administration of hypnotics.

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