• 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.

• Sleep Medicine and Psychophysiology
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• v.17 no.1
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• pp.34-40
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• 2010

Objectives: This study aimed to evaluate the clinical efficacy of individual cognitive behavioral therapy (CBT) for Patients with Primary or Secondary Insomnia. Methods: Participants were recruited from a primary care sleep clinic from January 2008 to June 2009. The study sample included 64 outpatients with primary insomnia (n=30) and secondary insomnia (n=34) according to the criteria of DSM-IV. Participants completed sleep diaries, Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS), State-Trait Anxiety Inventory (STAI) before CBT and shortly after completion of CBT. CBT was provided in 7 weekly, 40-50-minute individual therapy sessions. Results: Both groups of patients with primary and secondary insomnia showed significant improvement in the DBAS and sleep parameters including sleep onset latency, total sleep time, and sleep efficiency. Repeated-measures ANOVA of the DBAS and sleep parameters showed no significant group-by-time interactions between patients with primary and secondary insomnia, suggesting the efficacy of CBT for patients with secondary insomnia was equivalent to that of CBT for patients with primary insomnia. Conclusion: This study suggests that CBT is effective for the management of primary and secondary insomnia in a primary care setting.

• 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.

• 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.

• Sleep Medicine and Psychophysiology
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• v.10 no.1
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• pp.20-25
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• 2003

Many people suffer from chronic insomnia. Inappropriate sleep causes attention difficulties, decreased work efficiency, and increased traffic accidents and disasters. Evaluating the precise causes of insomnia prior to treatment is very important, because chronic insomnia can be a secondary symptom of other medical, psychiatric, and sleep disorders. Medication and behavior therapy are not exclusive of each other, and both treatments are beneficial to some patients, but currently many physicians and patients tend to be dependent only on medication. While long-term medication causes various degrees of dependency, tolerance, and withdrawal symptoms, behavior therapy has a stable effect over a long period. Behavior therapy is one of the most important treatment modalities for chronic insomnia. It shortens sleep latency, and decreases frequency of awakening during sleep. The rationale and practice of currently used behavior therapy and light therapy will be reviewed in this study.

• Korean Journal of Occupational Health Nursing
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• v.29 no.2
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• pp.133-139
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• 2020

Purpose: This study aimed to identify the influence of consecutive night-shift work and working time on insomnia among hospital nurses. Methods: A descriptive correlational research designutilizing secondary data analysis was adopted. Data on consecutive night-shift work, working time, and insomnia were collected from 64 hospital nurses using a Fitbit activity tracker and questionnaires, and analyzed using hierarchical logistic regression. Results: Consecutive night-shift work for more than three days had a significant influence on insomnia among hospital nurses. Weekly working hours also accounted significantly for the variance in insomnia, exceeding the influence of consecutive night-shift work. Conclusion: Development and implementation of proper schedules to control consecutive night-shift work and working time is important to alleviate insomnia among hospital nurses.

• Journal of Sasang Constitutional Medicine
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• v.28 no.4
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• pp.350-360
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• 2016

Objective The aim of this study was to report significant improvement of primary insomnia in a Soyangin Cold-related diarrhea accompanied by abdominal pain Symptomatic pattern Patient. Methods The patients were diagnosed with Soyangin Cold-related diarrhea accompanied by abdominal pain Symptomatology(身寒腹痛亡陰證) and treated with Hyungbangjihwang-tang(荊防地黃湯). The primary outcome measures for this study were condition of sleep using a questionnaire with Pittsburgh Sleep Quality Index (PSQI) Secondary outcome assessment included change of original symptoms such as patient's digestion, sweating and feces. Result The symptoms of primary insomnia improved by the end of the a treatment period without side effect. original symptoms were also changed. Conclusions This result show Hyungbangjihwang-tang(荊防地黃湯) can be used to treat primary insomnia in a Soyangin Cold related Mangeum Symptomatic Pattern accompanied by abdominal pain Symptomatology(身寒腹痛亡陰證). Meaning and process of primary insomnia are different according to Sasang Constitutions.

• Journal of Oriental Neuropsychiatry
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• v.34 no.3
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• pp.151-161
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• 2023

Objectives: To examine effect of Korean medical treatment on patients with insomnia and correlations among changes in psychological scales before and after treatment. Methods: Medical records of 38 patients diagnosed with insomnia based on DSM-V who received Korean medical treatment (herbal-medication, acupuncture, Korean psychotherapy) for at least 8 weeks were retrospectively reviewed. Psychological scales including Insomnia Severity Scale (ISI), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and State-Trait Anger Expression Inventory (STAXI) were measured every four weeks and analyzed. Results: After eight weeks of treatment, ISI, BDI-II, BAI, STAI-X-1/2, and STAXI-S/T showed statistically significant decreases. Psychological scale pairs that showed a statistically significant correlation were ISI and BDI-IIㆍSTAI-X-1ㆍSTAI-X-2ㆍTA, BDI-II and BAIㆍSTAI-X-1ㆍSTAI-X-2ㆍAX-I, BAI and STAI-X-1ㆍSTAI-X-2ㆍSAㆍTA, STAI-X-1 and STAI-X-2, SA and TA, and TA and AX-I. In women, the improvement of AX-C was high. The improvement in AX-I score was significant when the disease duration was more than one year. A lower pretreatment BAI value predicted a greater decrease in ISI score after treatment. Conclusions: Korean medical treatment including herbal medicine, acupuncture, and Korean psychotherapy was effective in improving insomnia symptoms and accompanying symptoms such as depression, anxiety, and anger. In the future, more in-depth follow-up research is needed on the mechanisms by which various psychological problems (depression, anxiety, anger, etc) cause and worsen insomnia and the psychological symptoms secondary to insomnia.

• Journal of Pharmacopuncture
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• v.21 no.1
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• pp.7-13
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• 2018

Objective: Hwa-byung is one of the cultural concept of distress in Korea resulted from chronic accumulated anger. It is characterized by various symptoms like stuffy in the chest, hot or heat sensation, something pushing up in the chest, feeling of mortification, and a flush of anger. This protocol aims to explore the efficacy and safety of Huanglian-jie-du decoction on various somatic symptoms and insomnia in patients with Hwa-byung. Methods: This is study protocol for a randomized, double-blind, placebo-controlled trial. A total of 44 patients will be randomly assigned to the experimental group or the placebo group in a 1:1 ratio. All medications will be taken orally 3 times per day for 7 consecutive days. The primary outcomes are the mean changes in Patient Health Questionnaire of physical symptoms (PHQ-15) and Insomnia Severity Index (ISI) after the 7 days of administration. The secondary outcomes include the scales to assess stress response, symptoms of Hwa-byung, and state anger. Conclusion: The results of this study will provide high quality and explorative evidence to investigate the effect of Huanglian-jie-du decoction on Hwa-byung.

• Sleep Medicine and Psychophysiology
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• v.25 no.2
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• pp.68-73
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• 2018

Objectives: The purpose of this study was to explore insomniac demographic characteristics and the type of consultation provided to hospitalized patients asked to the Department of Psychiatry for insomnia and to compare patient insomnia characteristics by consultation type. Methods: We performed a retrospective chart review of 4,966 patients who were hospitalized from August 1, 2005 to December 31, 2011 that received consultation in the Department of Psychiatry. Among them, 236 patients were referred for insomnia. We compared the differences in demographic characteristics and types of consultation between the insomnia patient group and other patient group. We also compared the difference between demographic characteristics and type of consultation by dividing total subjects into 'with reconsultation' and 'without reconsultation' groups. Results: Our results came from the analysis of 9,689 consecutive consultation requests. There were 4,966 patients that participated in the study over 6 years and 6 months. The overall consultation rate was 3.3% of all admissions and insomnia patients comprised 4.8% of those. The ratio of re-consultation for insomnia was 27.5%. There was no significant difference in mean age between the insomnia 'with reconsultation group' and the insomnia 'without reconsultation group', but the 'with reconsultation' group had significantly more male patients and medical patients than the 'without re-consultation' group. For insomnia patients, consultation types were in the order of Mending request (51.3%), Paralle request (36.6%), Complementary request (9.0%) and this composition differed from that of total admission patients. Conclusion: Hospitalized patients referred for insomnia showed a higher proportion of male patients, lower rates of re-consultation compared with other patients, and most of these were for secondary insomnia. Each doctor should be aware of the possibility of inpatient insomnia, conduct positive assessments and referrals as necessary, and psychiatrists who might be asked for consultation need to prepare an active intervention with initial diagnosis and treatment, as well as recommendations for the timing of reconsultation.