• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.494-501
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• 2020

Objectives: Insomnia is a common condition that causes deterioration of cognitive function and physical function and has a negative impact on quality of life. Insomnia is experienced by more than one-third of the population of the world. Although sleeping pills are currently used as therapeutic agents, they have side effects, so safer treatment methods are needed. Therefore, we report a case of an outpatient who sleeps only one hour a day due to insomnia. Methods: The patient visited Korean Medicine Hospital 10 times for four weeks and was treated with Korean medicine therapies, including electroacupuncture on the back-Shu points and herbal medicine (Yukmijihwang-tang and Hwangnyeonhaedok-tang). Treatment progress was assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI). Results: After 29 days of treatment, the PSQI score decreased from 20 points and 14 points. The ISI score also decreased to decreased to 22 points from 26 points. The average daily sleeping time increased from 60 minutes to 197.1 minutes after treatment. No significant side effects were observed. Conclusions: Yukmijihwang-tang and Hwangnyeonhaedok-tang with electroacupuncture might be a recommended therapeutic option for insomnia patients.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.1
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• pp.51-62
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• 2014

Purpose : The purpose of this work was to ascertain the effects of cervical traction on the pain, the range of motion and the quality of sleep of the older women with the tension headache. Method : 25 subjects between ages 66 and 82 who agreed on this experiment and diagnosed with tension headache participated in this study. All subjects were treated with air-pressure cervical traction while 20 minutes a day, 3 times per week, for 4 weeks. The effects of air-pressure cervical traction were evaluated by PSQI(Pittsburgh sleep quality index), a pain last a day, VAS, and four ROMs. In order to investigate the effect of age on the treatment, subjects were divided into two groups, of less and of over than age 75. The measured data were analyzed by using one-way repeated ANOVA and two-way repeated ANOVA. Result : 1) The group of less than age 75 showed the significant improvements in all measurement variables, PSQI, a pain last a day, VAS and four ROMs. 2) The group of over than age 75 showed the significant improvements in all measurement variables excluding the flexion ROM of cervical. 3) No significant differences between two groups were showed in all measurement variables, but the interaction effect between group and period was significant in only VAS. Conclusion : From the results of this study, a cervical traction intervention using an air-pressure cervical traction proved to be effective on the reduction of tension headache and the improvement of the quality of sleep.

• The Journal of the Society of Stroke on Korean Medicine
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• v.19 no.1
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• pp.9-20
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• 2018

■ Objectives The purpose of this case report is to show the effect of Traditional Korean Medicine(TKM) on a patient with insomnia occurred after onset of thalamic hemorrhage. ■ Methods A patient with insomnia diagnosed as thalamic hemorrhage was treated with herbal medication, acupuncture, electro-acupuncture, cupping and moxibustion. Then we evaluated the improvement with the number of times the patient woke up, PSQI-K(Pittsburgh Sleep Quality Index-Korean), ISI-K(Insomnia Severity Index-Korean) and KESS(Korean version of Epworth sleepiness scale). ■ Results Decrease in scores of PSQI-K, ISI-K, KESS and the number of times the patients woke up were observed after the TKM treatment. ■ Conclusion This case showed the effect of TKM treatment on poststroke insomnia.

• Journal of Society of Preventive Korean Medicine
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• v.28 no.1
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• pp.109-118
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• 2024

Objectives : This study aimed to investigate the relationship between cold feet and sleep quality using polysomnography (PSG) and Pittsburgh Sleep Quality Index (PSQI). Methods : We divided 11 adults (6 females, 5 males) with Insomnia Severity Index score below 21 into cold feet (CF) and a non-cold feet (NCF) group based on the median feet temperature (Taichong, LR3). PSG and PSQI were administered to assess sleep characteristics and subjective sleep quality. Results : CF group exhibited significantly lower time in bed, sleep period time, and total sleep time compared to NCF group. While there were no significant group differences in sleep latency, wakefulness after sleep onset, or total arousal index, NCF group had significantly lower minimum oxygen saturation and apnea-hypopnea index in REM (rapid eye movement) sleep compared to CF group. Although the PSQI score and the proportion of poor sleepers were both higher in the CF group (7.40 and 80%) compared to the NCF group (5.50 and 50%), these differences did not reach statistical significance. Conclusions : This study showed that foot temperature affects sleep characteristics and suggests the need to utilize PSG in sleep research in Korean medicine.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.47.1-47.14
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• 2023

Background: This study aimed to examine the impact of chronotype on depressive symptoms and explore the mediating effects of sleep quality, pre-sleep cognitive arousal, and social jetlag in a sample of wage earners. Methods: A total of 3,917 waged workers were surveyed online in July 2022. Logistic regression and mediation analysis were used to assess the relationship between chronotype (morningness, intermediate, and eveningness) and depressive symptoms (Patient Health Questionnaire ≥ 5), and the mediating effects of Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Pre-Sleep Arousal Scale (PSAS). All analyses were adjusted for age, education level, income level, marital status, coffee consumption, alcohol consumption, physical activity, occupation, employment status, and working hours to calculate odds ratios (ORs). Results: The chronotypes of all the participants were divided into morningness (4.7%), intermediate (93.5%), and eveningness (1.8%). Multiple logistic regression analysis showed an increased risk of depression in the eveningness chronotype (OR: 2.96; 95% confidence interval [CI]: 1.51, 5.86). Regarding the mediation analysis, ISI mediated 28.44% (95% CI: 16.39-40.5), PSQI for 31.25% (95% CI: 19.36, 43.15), and PSAS-Cognitive Score (PSAS-C) for 23.58% (95% CI: 10.66, 36.50) of the association between chronotype and depressive symptoms. However, social jetlag did not significantly mediate this relationship. (percentage mediated = 0.75%, 95% CI: -3.88, 5.39) Conclusions: Evening chronotypes exhibit an increased risk of depressive symptoms, which ISI, PSQI, and PSAS-C partially mediated. This suggests that interventions to improve sleep quality and maintain adequate sleep habits may effectively prevent and treat depression in employees with an eveningness chronotype.

• Sleep Medicine and Psychophysiology
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• v.20 no.1
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• pp.15-21
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• 2013

Objectives: Cognitive impairment in restless legs syndrome (RLS) patients can be affected by sleep deprivation, anxiety and depression, which are common in RLS. The objective of this study is to investigate relationship between cognitive impairment and RLS in the non-medicated Korean elderly with controlling for psychiatric conditions. Method: The study sample for this study comprised 25 non-medicated Korean elderly RLS patients and 50 age-, sex-, and education- matched controls. All subjects were evaluated with comprehensive cognitive function assessment tools- including the Korean version of Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K), severe cognitive impairment rating scale (SCIRS), frontal assessment battery (FAB), and clock drawing test (CLOX). Sleep quality and depression were also assessed with Pittsburgh sleep quality index (PSQI) and geriatric depression scale (GDS). Results: PSQI and GDS score showed no difference between RLS and control group. There was no significant difference between two groups in nearly all the cognitive function except in constructional recognition test, in which subjects with RLS showed lower performance than control group (t=-2.384, p=0.02). Subjects with depression ($GDS{\geq}10$) showed significant cognitive impairment compared to control in verbal fluency, Korean version of Mini Mental Status Examination in the CERAD-K (MMSE-KC), word list memory, trail making test, and frontal assessment battery (FAB). In contrast, no difference was observed between subjects who have low sleep quality (PSQI>5) and control group. Conclusions: At the exclusion of the impact of insomnia and depression, cognitive function was found to be relatively preserved in RLS patients compared to control. Impairment of visual recognition in RLS patients can be explained in terms of dopaminergic dysfunction in RLS.

• Journal of Oriental Neuropsychiatry
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• v.19 no.3
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• pp.143-169
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• 2008

Objective: This study was to investigate the relation of what insomnia patients' symptoms with Heart Rate Variability(HRV), Pittsburgh Sleep Quality Index (PSQI) and Insomnia Questionaire(IQ). Methods: For this study, we carried out HRV, PSQI and IQ of 43 patients with insomnia who have come to Donguei oriental hospital of Donguei university from September 2007 to May 2008. We studied the relationship HRV with PSQI and IQ. For every symptom, this study classified the patients as none-symptom, symptom groups and analyzed each group's HRV, PSQI and IQ. Result : 1. The rate of xerostomia in female group is significantly higher than male group. 2. P1 (hypnagogic time), P3(awakening time), LF has negative correlation with age. The score of PI (hypnagogic time), P3(awakening time), P4(time of recoverable sleep) in the group whose age is more than 50 are higher than the group whose age is lesser than 50. 3. The frequency of using hypnotics(P6) in the group whose duration of onset are over 1 year was significantly higher than the score in the group whose duration of onset were below 1 year. 4. The accompanied symptoms in the group who started sleep disorder after stressor are higher than the number in the group whose duration of onset were poor-defined. 5. The drinking group have lower rate of anorexia, higher score of P1 (hypnagogic time) and TP than non-drinking group. 6. The score of P-total(general quality of sleep) have negative correlation with NNSO, HF, TP and positive correlation with LF/HF. 7. The score of P1(hypnagogic time) have negative correlation with LF. 8. The score of P5a(frequency of delayed hypnagogue) have positive correlation with LF/HF. 9. The score of P5e(frequency of cough or snoring) have negative correlation with RMSSD. 10. The score of I1a(degree of onset insomnia), I1b(degree of maintenance insomnia) have negative correlation with NN50, pNN50, HF. 11. The score of I1c(degree of termination insomnia) have negative correlation with RMSSD, NN50, pNN50, HF, TP and positive correlation with MHR, LF/HF. 12.. The score of P5i(frequency of night pain), LF/HF in the group with headache are higher than the group without headache. 13. The score of P5a(frequency of delayed hypnagogue), P5c(frequency of awakening for urine of stool) in the group with xerostomia are higher than the group without xerostomia. 14. The score of P9(degree of unrecoverable sleep) and I5a(degree of onset insomnia) in the group with chest discomfort are lower than the group without chest discomfort. 15. The score of P7(frequency of drowsiness for daytime) in the group with palpitation are lower than the group without palpitation. 16. The score of P5c(frequency of awakening for urine of stool), P5f(frequency of burning sensation), P5h(frequency of nightmare), I1c(degree of termination insomnia) in the group with burning sensation of upper trunk are higher than the group without burning sensation. 17. The score of NN50, pNN50, LF, TP in the group with anorexia are lower than the group without anorexia. 18. The score of P-total(general quality of sleep), P2(duration for sleep start) in the group with constipation are higher than the group without constipation. 19. The score of P4(recoverable sleep time) in the group with depression are higher than the group without depression. 20. In the group with anxiety, the score of P1(time of hypnagogue), P5a(frequency of onset insomnia) are lower and the score of I1b(degree of maintenance insomnia), I4(objective degree of impairment by insomnia) are higher than the group without anxiety. 21. The score of NN50, pNN50, HF, TP in the group with inertia are lower than the group without inertia. 22. The accompanied symptoms haver posirive correlation with P5f(frequency of burning sensation), P5h(frequency of nightmare), P5i(frequency of night pain) and LF/HF. Conclusion: This study provides insights into the complicated relations of the pattern of sleep disorder with many symptoms such as headache, chest discomfort, depression and any others. And this study showed that autonomic nervous system have important function in the regulation of sleep.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.5
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• pp.451-458
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• 2018

This study was conducted to determine the association between quality of sleep (QOL) and the general characteristics, the health-behavioral factors, and the occupational characteristics of firefighting officers. The survey was conducted in October 2016 with a self-administered questionnaire using the Pittsburgh Sleep Quality Index (PSQI) developed by Pittsburgh University, targeting 600 male firefighting officers working at five fire stations in D city. As a result, the QOL of the study subjects measured by the PSQI revealed 13.2% to be good, and 86.8% to be poor. In relation to general characteristics and health habits, the rate of the group who had poor quality sleep was significantly higher in those with a lower subjective health status, in the non-smoking group, and in the low sleep-quality group, compared to the good sleep-quality group. For occupational characteristics, the rate of those with poor quality sleep was significantly higher in groups such as the fire suppression group, the shift work group, the hard physical labor group, the group with a lower sense of satisfaction in their work, and in the group classed as unfit for the job but who were not considering quitting their jobs, compared to their respective counterparts. Multiple regression analysis revealed factors of influence with explanatory powers of 24.4% for subjective health status, alcohol use, subjective quality of sleep, career, job position, and physical labor. The results of this study suggest that the quality of sleep for firefighting officers is significantly related to general characteristics, health-behavioral characteristics, and occupational characteristics.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.10
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• pp.374-383
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• 2019

This study was conducted to investigate the relationship between sleep quality and depression level of male workers in the manufacturing industry. The survey subjects were 856 male workers in the manufacturing industries in D city. Data collection was conducted through a self-administrated questionnaire survey during the period from March 1 to April 30, 2019. The distribution of depressive level among subjects differed significantly according to various variables of sociodemographic characteristics, health related behaviors and job related characteristics. In addition, the distribution of the depressive group was significantly higher in the group with worse quality of sleep (PSQI). Depression level showed a significant positive correlation with sleep quality. The risk ratio of the depressed group was significantly higher than that of the sleep quality. The results of this study suggest that the depressive level of male workers in the manufacturing industry is significantly related to the quality of sleep as well as sociodemographic, health related and job related characteristics. Therefore, it is necessary to make efforts to improve sleep quality to reduce the level of depression of workers.

• Journal of Oriental Neuropsychiatry
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• v.32 no.3
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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).