• Journal of Oral Medicine and Pain
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• 제48권3호
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• pp.87-95
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• 2023

Purpose: To quantify the relationship between perceived pain intensity and psychological variables in a sample of participants with temporomandibular disorder, with or without central sensitization (CS). Methods: A cross-sectional study with nonprobability convenience sampling was conducted from January 1, 2022, to June 30, 2023. Pain intensity (Numeric Pain Rating Scale), anxiety (State-Trait Anxiety Questionnaire, STAI), catastrophizing (Pain Catastrophizing Scale, PCS), perceived stress (Perceived Stress Scale, PSS), and sleep quality (Pittsburgh Sleep Quality Index, PSQI) were assessed. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Co.), which included descriptive and normality analyses and the calculation of strength of multiple correlational regression. Results: A total of 52 (n=34 female 65.4%; n=18 male 34.6%) subjects with diagnosis of temporomandibular disorders (TMD) were finally included. A total of 26 participants (n=26, 50.0%) were cases suffered from CS (TMD-CS mean=46.62±11.24) while the remaining participants (n=26, 50.0%) were the controls (TMD-nCS mean=26.77, standard deviation [SD]=8.42). The pain intensity was moderate in both groups TMDCS (mean=7.62, SD=0.83) and TMD-nCS (mean=7.05, SD=0.86), anxiety (TMD-CS STAI mean=53.27, SD=11.54; TMD-nCS STAI mean=49, SD=11.55), catastrophizing (TMD-CS PCS mean=46.27, SD=9.75; TMD-nCS PCS mean=26.69, SD=4.97), perceived stress (TMDCS PSS mean=30.35, SD=4.91; TMD-nCS PSS mean=26.12, SD=6.60) and sleep quality (TMD-CS PSQI mean=15.81, SD=3.65; TMD-nCS PSQI mean=12.77, SD=2.76) levels were measured in both groups. In TMD-CS and TMD-nCS, higher anxiety levels were moderately and significantly associated with greater pain intensity β=0.4467 (t=2.477, p=0.021) and β=0.5087 (t=2.672, p=0.014). Nevertheless, catastrophizing, perceived stress and sleep quality were not associated to pain intensity in neither of group. Conclusions: In both TMD-CS and TMD-nCS patients, elevated anxiety levels were moderately and significantly associated with increased pain intensity. However, heightened levels of pain catastrophizing, perceived stress, and poor sleep quality were not significantly associated with increased pain intensity in either of the two analyzed groups.

• 재활치료과학
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• 제9권2호
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• pp.73-86
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• 2020

목적 : 본 연구의 목적은 여대생의 인지(자책, 숙고) 및 행동적 회피요인과 수면의 질의 관계에서 우울증상의 매개효과를 검증하는 것이다 연구방법 : 본 연구는 지역사회 1,000명의 여대생을 대상으로 우울증상(CES-D), 반추적 반응(K-RRS), 인지-행동 회피(CBAS), 수면의 질(PSQI)을 평가하였다. 최종 분석대상은 총 947명이었다. 자료분석은 SPSS 18.0과 AMOS 22.0 통계프로그램을 사용하였다. 결과 : 첫째, 자책과 수면의 질의 관계에서 우울증상의 완전매개효과가 유의미한 것으로 나타났다. 둘째, 숙고와 수면의 질의 관계에서 우울증상의 매개효과는 유의하지 않았으며, 숙고는 우울증상을 예측하지 않았다. 셋째, 행동적 회피와 수면의 질의 관계에서 우울증상의 매개효과가 유의미한 것으로 나타났다. 또한 행동적 회피는 수면의 질을 직접적으로 예측하였다. 결론 : 본 연구는 지역사회의 일반 여대생의 우울증상과 수면문제에 대한 자책의 더 병리적인 특성을 숙고와 비교하여 입증하였다. 또한 수면문제에 영향을 미치는 우울증상과 행동적 회피 요인의 주요한 역할을 밝혔다는데 의의가 있다.

• 대한지역사회작업치료학회지
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• 제4권1호
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• pp.85-92
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• 2014

목적 : 본 연구의 목적은 운동 강도에 따른 지속적인 운동습관이 수면장애 성인에게 어떠한 영향을 줄 수 있는지 알아보고 수면장애에 효과적인 운동 강도를 알아보고자 하였다. 연구방법 : 본 연구는 K시에 거주하는 수면장애를 가진 30, 40대 성인 남성 90명을 대상으로 하였다. 집단은 고강도 운동집단 30명, 중강도 운동집단 30명, 저강도 운동집단 30명으로 구성하였다. 세 집단의 총 수면지수와 멜라토닌 농도의 비교를 통하여 수면장애의 운동 강도별 효과를 비교하였다. 결론 : 수면장애의 운동 강도별 운동을 수행한 결과, 운동 수행 전, 후의 총 수면지수에서 고강도와 중강도의 운동이 유의성이 있었지만 수면장애에서는 중강도 운동이 효과적이었고, 운동수행 전, 후의 멜라토닌 농도 변화에서도 중강도 운동이 효과적이었다. 결론 : 본 연구의 결론은 성인의 수면장애는 지속적인 운동이 효과가 있지만 저강도 운동과 고강도 운동보다는 중강도 운동이 효과적임을 알 수 있었다.

• 동의신경정신과학회지
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• 제23권3호
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• pp.129-142
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• 2012

본 증례에서는 상기한 바와 같이 화병을 주로 한 심리상태 변화에 의해 악화된 진전증을 주소로 본원 한방신경정신과에 입원한 환자에게 한약치료와 침치료, 한방정신치료를 병행한 결과 제반증상 및 심리 상태 상 양호한 효과를 보여 이에 보고하는 바이다. 1. 18일간의 한약치료, 침치료, 정신요법 및 부항, 뜸의 기타치료를 통해 전신의 본태성진전증과 화병의 증세의 동반 호전을 경험하였다. 2. 화병 및 신체 상태를 심신불교(心腎不交)로 변증하고 황련아교탕(黃連阿膠湯) 처방을 기본 방제로서 증세변화에 따라 가감투여했으며, 정서적 안정과 기타 신체증상과 함께 진전증이 호전됨을 확인하였다.

• Environmental Analysis Health and Toxicology
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• 제29권
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• pp.6.1-6.6
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• 2014

Objectives Hospitalized patients are vulnerable to sleep disturbances because of environmental stresses including noise. While most previous studies on hospital noise and sleep have been performed for medical machines in intensive care units, there is a limited data for patients hospitalized in medical wardrooms. The purpose of present study was to measure noise level of medical wardrooms, identify patient-perceived sources of noise, and to examine the association between noise levels and sleep disturbances in hospitalized patients. Methods Noise dosimeters were used to measure noise level in 29 inpatient wardrooms at a university hospital. Sleep pattern and disturbance were assessed in 103 hospitalized patients, using the Pittsburgh Sleep Quality Index (PSQI) and Leeds Sleep Evaluation Questionnaire. Results The mean equivalent continuous noise level for 24 hours was 63.5 decibel A (dBA), which was far higher than 30 dBA recommended by the World Health Organization for hospital wardrooms. Other patients sharing a room were perceived as the most common source of noise by the patients, which was usually preventable. Of the patients in the study, 86% had bad sleep as assessed by the PSQI. The sleep disturbance was significantly correlated with increasing noise levels in a dose response manner. Conclusions Systemic organizational interventions are needed to keep wardrooms private and quiet to reduce sleep disturbance.

• Journal of Acupuncture Research
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• 제35권3호
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• pp.120-128
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• 2018

Background: Adhesive capsulitis (AC) is a common condition that includes shoulder pain and limited movement. Despite more than 100 years of AC treatment, the most efficacious treatment remains unclear. The aim of this study was to evaluate the feasibility of a randomized controlled trial (RCT) using acupuncture for AC. Methods: Thirty participants with AC were randomly assigned to acupuncture (A) or sham acupuncture (SA) groups. The participants received 15 acupuncture sessions over 6 weeks, and follow-up occurred for an additional 4 weeks thereafter. The primary clinical outcome was the numeric rating scale (NRS) for shoulder pain 6 weeks from the baseline. Secondary outcomes included range of motion (ROM) in the shoulder, the shoulder pain and disability index (SPADI), the EuroQol-5 dimensions (EQ-5D), the Pittsburgh sleep quality index (PSQI), and the patient global impression of change (PGIC). Results: Thirty participants were enrolled out of 37 screened individuals. Recruitment was conducted between August 2014 until May 2015. A total of 28 participants (93%) completed the 6-week intervention, and 26 participants (87%) completed the study. NRS, ROM, SPADI, EQ-5D, PSQI, and PGIC scores improved in both the experimental group and the sham group after 6 weeks, but the difference between the groups was not statistically significant. Adverse events were reported by 12 participants, although these events were not associated with acupuncture. Conclusion: A future RCT for AC may be feasible with some modifications to the recruitment plan and the secondary outcome measurement methods.

• Journal of Oral Medicine and Pain
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• 제40권4호
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• pp.155-162
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• 2015

Purpose: The association between pain and sleep is described as a vicious cycle and psychological distress is well known as comorbid condition in the patients with pain and sleep problems. The aim of the study was to evaluate the prevalence of self-reported sleep disturbance and its relationship to clinical and psychological profiles in temporomandibular disorder (TMD) patients. Methods: The sample consisted of 123 TMD patients (90 women and 33 men), with a mean age of $39.9{\pm}15.4years$. Self-report measures of sleep quality, pain and psychological profile were conducted via the Pittsburgh Sleep Quality Index (PSQI), the Brief Pain Inventory and the Symptom Checklist-90-Revision at the initial visit. The primary diagnosis of TMD were categorized as TMD with internal derangement without pain, TMD with joint pain, TMD with muscle pain and TMD with joint-muscle combined pain. The chi-square test, independent t-test, oneway ANOVA and multiple linear regression analysis were used for statistics. Results: The patients was grouped as good sleepers (n=32, scores of 5 and lower) and poor sleepers (n=91, scores of 6 and higher) according to the recommended cutoff point of the global PSQI score (>5). TMD patients with pain showed poor sleep quality than TMD patients with internal derangement without pain. Poor sleepers had high pain interference and elevated psychological distress. Among them, pain interference and depression were significant predictors to sleep quality. Conclusions: The results suggest that sleep disturbance is a prevalent complaint in TMD patients, and sleep problems in TMD patients are associated with pain and psychological distress.

• Journal of Oral Medicine and Pain
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• 제40권4호
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• pp.140-145
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• 2015

Purpose: Bruxism is commonly considered a major risk factor for temporomandibular disorders (TMD), and the psychosocial factors had been one of the etiologic factor of bruxism. But there are still unsolved issues on the relationship between sleep bruxism and TMD and the etiologic factors of bruxism. This study is aim to evaluate the clinical and psychosocial characteristics according to diagnostic grade of bruxism in TMD patients. Methods: Three hundred subjects were enrolled who were under the stabilization splint therapy for TMD. Recently international consensus proposed a diagnostic grading system of "possible", "probable", and "definite" sleep or awake bruxism for clinical and research purpose. According to their suggestion, we classified these subjects as self-reported bruxism (SRB) and wear facet bruxism (WFB). We investigated the clinical characteristics (sex, age, chief complaint, pain duration, visual analogue scale), sum of tenderness (temporomandibular joint, masticatory muscles, cervical muscles), diagnosis of TMD according to research diagnostic criteria (the Research Diagnostic Criteria for Temporomandibular Disorders, RDC/TMD), headache, subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI), and psychosocial characteristics (Symptom Checklist-90-Revised, SCL-90-R) in enrolled subjects. We compared the clinical and psychosocial characteristics between these bruxism groups. Results: There were no significant correlation between self-reported and WFB (p=0.13). SRB subjects more reported pain as a chief complain than subject who did not report bruxism (p=0.014). The mean score of global PSQI was significantly higher in SRB than in did not report positively subjects (p=0.045). The mean score of anxiety and phobic anxiety was significantly higher in SRB than in did not reported positively subjects (p=0.045, p=0.041). Conclusions: Although bruxism is regarded as risk factor of TMD, this study showed inconsistent result between SRB and clinically detected bruxism by wear facet on slpint. We suggest that the clinician should consider with extreme caution when they assess SRB.

• 동의신경정신과학회지
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• 제23권1호
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• pp.31-48
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• 2012

Objectives: The purpose of this research is to examine the effects of acupuncture treatment on Hwa-byung patient's insomnia. Methods: The study was performed through a patient-assessor blind, randomized, placebo-controlled trial in which the volunteers, data collectors and analysts were unaware of individuals who were receiving the treatment. A total of thirty-seven volunteers were divided into 2 groups. 18 subjects were placed into a trial group and 19 subjects into a control group by a randomization table. The trial group was treated on bilateral Shigu, Ahnmyun, B62 (Shinmaek), and K6 (Chohae), while the control group was not given any other treatment. The ISI(Insomnia Severity Scale) was measured as the 1st evaluative instrument, and then a comparative analysis was conducted by comparing the results with those measured by a Likert scale for major symptoms of Hwa-byung, PSQI, Hwa-byung scale, BDI, STAI, and STAXI. Results: In the ISI, PSQI, and the Likert scale regarding major symptoms of Hwa-byung, Hwa-byung scale, BDI, and STAI, more significant decreases were found in those concerning the trial group compared to those of the control group from a statistical perspective. However, in the STAXI, regarding the trial group, there was no significant decrease compared to the control group. Conclusions: The results suggest that acupuncture treatment is effective in the treatment regarding Hwa-byung patients who suffer from insomnia.

• 대한한방내과학회지
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• 제37권5호
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• pp.691-697
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• 2016

Methods: A stroke patient with hot flashes was treated for 4 weeks with acupuncture, herbal acupuncture, and herbal medicine. We then evaluated the frequency, intensity, and score (frequency×intensity) of the hot flashes, as well as the Pittsburgh Sleep Quality Index (PSQI), which shows subjective sleep quality. Results: After 4 weeks of traditional Korean medicine (TKM) treatment, the patient showed reductions in the frequency of hot flashes from a score of 7 to 4, the intensity of hot flashes from a score of 4 to 2, the scoring (frequency×intensity) of hot flashes from 28 to 4, and the PSQI from 13 to 4. Conclusions: This study validated the effect of TKM as a treatment for hot flashes in patients with stroke.