• Title/Summary/Keyword: Insomnia,

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A Case Report of an Insomnia Patient Treated with Gamiguibi-tang (加味歸脾湯으로 호전된 불면 환자 치험 1례)

  • Kim, Geun-yeob;Park, Jong-il;Ko, Heung;Kim, Ki-tae;Shin, Son-mi
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.822-830
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    • 2016
  • Objective: To report the effect of Gamiguibi-tang (加味歸脾湯) as a treatment for insomnia. Methods: An insomnia patient who scored 27 points for her insomnia severity index was enrolled in this study. She received oriental treatment with herbal medication (Gamiguibi-tang), acupuncture, and moxibustion for 1 month. Results: After treatment, sleep duration and sleep quality were improved. After the patient had taken Gamiguibi-tang, her score for the Pittsburgh Sleep Quality Index (PSQI) decreased from 21 to 9, and associated symptoms were also improved without taking sleeping pills. Conclusions: Gamiguibi-tang is effective for the treatment of insomnia. More clinical data and studies are required in patients suffering from insomnia.

A Study on Emotional Characteristics with the Core Assessment Instrument Based on Chiljeong in Insomnia Patients (불면증 환자의 핵심감정평가도구를 활용한 정서적 특성 연구)

  • Choi, Sung-Youl;Lyu, Yeoung-Su
    • Journal of Oriental Neuropsychiatry
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    • v.26 no.2
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    • pp.191-200
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    • 2015
  • Objectives: We performed this study to certify the objectivity and significance of the Core Assessment Instrument Based on Chiljeong as a diagnostic measure in insomnia patients. Methods: We collected self-report questionnaires from inpatient and outpatient targets that had symptoms of insomnia. Descriptive statistics, Independent t-test, One-way repeated measure ANOVA and Pearson Correlation analysis were used for data analysis. Results: Bi and Kyeong emotion scores were higher but the Hui emotion score was lower for insomnia patients. Regarding the relationship between ISI score and the Core Assessment Instrument Based on Chiljeong, the more severe the insomnia, the higher the Sa and Kyeong emotion scores were, whereas the Hui emotion score was lower. Patients that were male, married, old, and had higher education showed a stronger correlation between Gyeong and ISI scores. Conclusions: Using the Core Assessment Instrument Based on Chiljeong for insomnia is thought to be helpful in both the diagnostic and clinical aspects of insomnia.

Network Analysis on Herbal Combinations in Korean Medicine for Insomnia (불면 처방 활용 본초의 네트워크 분석)

  • Kim, An-na;Kim, Hong-jun;Song, Beom-yong;Lee, Seung-ho;Cho, Yong-ho;Oh, Yongtaek
    • Journal of Korean Medical classics
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    • v.31 no.4
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    • pp.69-78
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    • 2018
  • Objectives : The aim of this study was to diversify the interpretation of formulas used for insomnia treatment by searching and analyzing herbal combinations in formulas used for insomnia treatment in Korean medicine. Methods : Frequency analysis was conducted on herbal combinations of 255 formulas related with insomnia, along with network analysis using Netminer 4.2.1. Results : This study has found herbal combinations used frequently in Korean medicine formulas used for insomnia treatment, and a result of network analysis composed of four communities. Each community consisted of herbs in affiliation of Yookmijihwangtang(六味地黃湯) and Samultang(四物湯), Bohyulchunghwatang(補血淸火湯) and Ondamtang(溫膽湯), Jungjihwan(定志丸) and Sanjointang(酸棗仁湯). Conclusions : This study could help in assisting researchers to diversify formula analysis in future studies. Moreover, the herbal combination in insomnia formulas could be used to search for insomnia formulas in other databases or creating a new prescription.

A case of insomnia incurable by neuropsychiatric medication alone, but made possible with Sarn-Hwang-Sa-Sim-Tang (신경정신과 약물을 복용해 온 우울증 환자의 불면증에 삼황사심탕(三黃瀉心湯)을 병행 투여하여 호전된 1례(例))

  • Seok, Seon-Hee;Kim, Joo-Ho;Kim, Geun-Woo;Koo, Byung-Soo
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.3
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    • pp.117-129
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    • 2006
  • Insomnia is one of the most common clinical symptom those almost patients with neuropsychiatric disorder complain. and the most common cause of insomnia in neuropsychiatric disorder is the major depressive disorder. We experienced a 59 year-old male who complained of recurrent insomnia in spite of taking medicines(nervines, antidepressants, etc,) during 30 years. We had given herbal medicine, acupuncture treatment and aroma therapy with continuing medications. The patient had several sypmtoms as anxiety, agitation, feeling thirsty, chronic constipation, and etc. beside the insomnia. After the patient took the herbal medicine, especially Sam-Hwang-Sa-Sim-Tang, he could have a sound sleep and be relaxed. In this case, we concluded that oriental medical treatment can be an effective remedy of chronic insomnia that responds to neuropsychiatric medications incompletely and Sam-Hwang-Sa-Sim-Tang is effective to a kind of insomnia with agitation, anxiety, thirsty, constipation, and etc.

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Insomnia in the Elderly (노인에서의 불면증)

  • Sohn, Chang-Ho
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.5-10
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    • 2001
  • The prevalence of insomnia and the degree of impairment due to insomnia is greater than in the of young. The cause for insomnia in the elderly are various factors among the elderly is known to be high including medical, psychiatric, drug issues, circadian rhythm changes, sleep disorders, and psychosocial. So the careful evaluation to find the cause of insomnia is needed for the eldery. Treatment options for insomnia include behavior modification and pharmacotherapy. Outcome data from previous studies indicate that behavioral approaches produce reliable and durable therapeutic benefits, as evidenced by improved sleep efficiency and continuity and enhanced satisfaction with sleep patterns. Treatment methods such as stimulus control and sleep restriction, which target maladaptive sleep habits, are especially beneficial for older insomniacs, whereas relaxation-based interventions aimed at decreasing arousal, produce more limited effects. Cognitive and educational interventions are instrumental in altering age-related dysfunctional beliefs and attitudes about sleep. The choice of hypnotics is based on matching the nature of the insomnia to the hypnotic agent. The ideal agent has rapid onset, duration of action that lasts through the night but no residual daytime effects, and no adverse effects. The key for the healthcare professional is finding the appropriate treatment or treatment combination, including behavioral modification and pharmacotherapy. When hypnotics are indicated, the most appropriate short-acting agent should be considered.

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Insomnia Treated with Baekho-tang Based on the Shanghanlun Disease Pattern Identification Diagnostic System (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 백호탕(白虎湯) 투여 후 호전된 불면증 증례 1례)

  • Jeong, Yeon-il;Kim, Chang-sig;Lee, Soong-in
    • 대한상한금궤의학회지
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    • v.13 no.1
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    • pp.165-178
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    • 2021
  • Objective: This study aimed to report the improvement of a patient with chronic insomnia who was treated with Baekho-tang based on the Shanghanlun disease pattern identification diagnostic system (DPIDS). Methods: The patient's symptoms were checked on days 19, 37, and 52 after taking Baekho-tang. Chronic insomnia was evaluated by the degree of insomnia, hours spent asleep, and the number of times the patient woke up during the night, which were all assessed by a visual analog scale (VAS) with the Leeds Sleep Evaluation Questionnaire. In addition, new clinical implications for the interpretation of the 350th Shanghanlun provision were reviewed. Results: After administering Baekho-tang for 52 days, based on the 350th Shanghanlun provision according to the DPIDS, the VAS score decreased from 10 to 1. Conclusions: The patient recovered from chronic insomnia. This case report suggests that the words "滑," "厥," and "裏" in the 350th provision of Shanghanlun mean physical and psychological causes of insomnia. In addition, Baekho-tang had a therapeutic effect in improving the chief complaint of the patient. Therefore, the interpretation of the 350th Shanghanlun provision requires a new definition that includes the patient's lifestyle, family conflict, and past history of the patient as a cause of chronic insomnia.

A Case Study of Parkinson's Disease Patient with Anxiety and Insomnia Treated with Korean-medicine Treatment, including Gyejigayonggolmolye-tang (계지가용골모려탕을 포함한 한방치료로 호전된 파킨슨병 환자의 불안 및 불면 치험 1례)

  • Eun-chai Cho;Ji-soo Yang;Jae-hwan Lew
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.846-854
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    • 2023
  • Objectives: The purpose of this study is to report the case of a patient with Parkinson's disease experiencing anxiety and insomnia treated with Korean medicine therapies. Methods: A patient diagnosed with Parkinson's disease with anxiety and insomnia was treated with Korean medicine therapies, including herbal medication (Gyejigayonggolmolye-tang), acupuncture, electro-acupuncture, and moxibustion, for 18 days. To evaluate the therapeutic effect, we checked the Beck Anxiety Inventory (BAI) and Insomnia Severity Index (ISI) scores to monitor anxiety and insomnia. Results: After treatment, the patient's BAI and ISI scores for anxiety and insomnia decreased. Further, the patient and her protector mentioned that their quality of life had improved. Conclusion: These results suggest that Korean medicine therapies with Gyejigayonggolmolye-tang have a beneficial effect on anxiety and insomnia in patients with Parkinson's disease.

A Clinical report on insomnia following hospitalization improved by the Chuna Manual Relaxation Therapy (입원 후 발생한 불면증에 추나 수기 이완요법으로 호전된 치험 1례)

  • Han, Chang;Kim, Ji-Hyung;Ryu, Ki-Joon;Ahn, Keon-Sang;Kwon, Seung-Ro
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.3
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    • pp.309-317
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    • 2008
  • For this study, the Chuna Manual Relaxation Therapy, a therapeutic procedure in Oriental Medicine was carried out on patients suffering from insomnia following hospitalization. If a patient with no prior medical history in insomnia should suffer from insomniac symptoms, the following procedure was carried out on thos patients showing 15 points on the Insomnia Severity Index starting on the day when the patient first complains of symptoms associated with insomnia, stages 1, 2 & 3 of the 'JS Cervical Shinyoun Therapy' in accordance with the Korea Chuna medical Index standard was carried out on the patient's bed from 8pm to 9pm everyday for 1 week. After the 1 week procedure, a medical examination by interview was carried out the following day, and the Insomnia Severity Index measured again. (1 being when the patient's state of sleep is at its worst, and 10 being when it is the most satisfactory. In case of 5 patients, Insomnia is disappeared, and the quality of sleep improved. In regards to insomnia suffered after hospitalization, Stage 1,2 and 3 of "JS Cervical Shinyoun Therapy" for relaxing tension showed effective results to the patient.

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Sleep Onset Insomnia and Depression Discourage Patients from Using Positive Airway Pressure

  • Park, Yun Kyung;Joo, Eun Yeon
    • Journal of Sleep Medicine
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    • v.15 no.2
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    • pp.55-61
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    • 2018
  • Objectives: Despite the accumulating evidence of the effectiveness of positive airway pressure (PAP) therapy in obstructive sleep apnea (OSA) syndrome, adherence to PAP therapy is not high. Several factors reportedly affect PAP adherence; however, it remains unclear whether patients' symptoms were detrimental to adherence rate. This study is aimed at investigating the relationship between insomnia symptoms and adherence. Methods: Retrospective analyses were performed in 359 patients with OSA (mean age $58.4{\pm}13.2$ years; females, n=80). Logistic regression analyses were performed between PAP adherence with clinical factors and questionnaires, such as Epworth Sleepiness Scale, Insomnia Severity Index, and Beck Depression Inventory (BDI). Results: PAP adherence was defined as the use of PAP for ${\geq}4h$ per night on 70% of nights during 30 consecutive days. The median follow-up time was 55 days (interquartile range, 30-119 days), and 54.3% showed poor adherence. Non-adherent patients showed more severe sleep onset insomnia, higher BDI, and higher nadir oxygen saturation ($SaO_2$). Patients with good adherence had higher apnea-hypopnea index, oxygen desaturation index, and respiratory arousal to total arousal ratio. Sleep onset insomnia [odds ratio (OR)=1.792, p=0.012], BDI (OR = 1.055, p=0.026), and nadir $SaO_2$ (OR=1.043, p=0.040) were independently associated with PAP non-adherence. Conclusions: Not the severity of insomnia but sleep onset insomnia was associated with PAP adherence, as well as depressive mood. It suggests that different interventions for reducing insomnia and depressive mood are needed to increase PAP adherence in patients with OSA.

Brain Metabolite Changes in Insomnia and Obstructive Sleep Apnea (수면장애에서 나타나는 뇌 대사물질의 변화 : 불면증과 폐쇄수면무호흡증을 중심으로)

  • Hong, Haejin;Lee, Hyangwon;Yoon, Sujung;Kim, Jungyoon
    • Sleep Medicine and Psychophysiology
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    • v.28 no.1
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    • pp.18-26
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    • 2021
  • Sleep is essential to brain function and mental health. Insomnia and obstructive sleep apnea (OSA) are the two most common sleep disorders, and are major public health concerns. Proton magnetic resonance spectroscopy (1H-MRS) is a non-invasive method of quantifying neurometabolite concentrations. Therefore, 1H-MRS studies on individuals with sleep disorders may enhance our understanding of the pathophysiology of these disorders. In this article, we reviewed 1H-MRS studies in insomnia and OSA that reported changes in neurometabolite concentrations. Previous studies have consistently reported insomnia-related reductions in γ-aminobutyric acid (GABA) levels in the frontal and occipital regions, which suggest that changes in GABA are important to the etiology of insomnia. These results may support the hyperarousal theory that insomnia is associated with increased cognitive and physiological arousal. In addition, the severity of insomnia was associated with low glutamate and glutamine levels. Previous studies of OSA have consistently reported reduced N-acetylaspartate (NAA) levels in the frontal, parieto-occipital, and temporal regions. In addition, OSA was associated with increased myo-inositol levels. These results may provide evidence that intermittent hypoxia induced by OSA may result in neuronal damage in the brain, which can be related to neurocognitive dysfunction in patients with OSA. The current review summarizes findings related to neurochemical changes in insomnia and OSA. Future well-designed studies using 1H-MRS have the potential to enhance our understanding of the pathophysiology of sleep disorders including insomnia and OSA.