Insomnia is the most common sleep complaint encountered in primary care. It affects both the individual and society through the burden of medical, psychiatric, interpersonal and social consequences. The management of patients affected by insomnia depends on the accurate diagnosis of the condition, consideration of the possible aetiologies, the duration of the insomnia and its impact on both the individual and society. Herein, we discuss the appropriate management of insomnia in the community.
Headache ; diagnosis ; Humans ; Sleep ; Sleep Initiation and Maintenance Disorders ; diagnosis ; physiopathology ; psychology

This article describes the experiences of professor CHEN Quan-xin, an old famous TCM doctor, in the treatment of insomnia. He believes that insomnia stems from incoordination between nutrient qi and defensive qi and deficient cultivation of cardiac spirit, and treatment of insomnia need to regulate spirit and quiet heart coherently. Painless acupuncture method of Chen's flying needling is adopted including to select Shenmen (HT 7), Sanyinjiao (SP 6) and Anmian (Extra) as the main points and take special needling technique and grading reinforcing and reducing manipulations. During treatment, he pays attention to understanding patients' psychological and mental status through "watching one's expressions and weighing his words carefully".
Acupuncture Therapy ; Heart ; physiopathology ; Humans ; Sleep ; Sleep Initiation and Maintenance Disorders ; physiopathology ; psychology ; therapy ; Spirituality

As insomnia is a common symptom caused by diverse disorders, treatment tools for the insomnia differ depending on the underlying cause. Hypnotics can be used for primary insomnia. As hypnotics show excellent short-term efficacy, they would be useful as short-term ( < 4 weeks) treatments for transient insomnia. There has been much controversy over long-term hypnotic use for chronic insomnia. Evidence supporting safety and efficacy of the long-term hypnotic use is insufficient. Therefore, rather than using hypnotics alone, non-pharmacological treatments are recommended more for chronic primary insomnia. Although various benzodiazepines have widely been used as hypnotics, there have been concerns over tolerance, rebound insomnia, dependency, cognitive decline and psychomotor slowness. In efforts to relieve these concerns, selective benzodiazepine agonists like zolpidem have been introduced as novel hypnotics. Sedating antidepressants, melatonin and anti-histamine have also been used in order to manage insomnia. However, their efficacy for primary insomnia has yet to be proven.
Antidepressive Agents ; Benzodiazepines ; Dependency (Psychology) ; Hypnotics and Sedatives ; Melatonin ; Pyridines ; Sleep Initiation and Maintenance Disorders

PURPOSE: The purpose of this study was to explore the effects of the lavender fragrance on sleep and depression in women college students. METHOD: Forty-two women college students who complained of insomnia were studied during a four-week protocol(control treatment week, 60% lavender fragrance treatment week, washout week, 100% lavender fragrance treatment week). All subjects were in the department of nursing in "K" college and the study was a single blind repeated measurements experiment. For the duration of the study, weekly evaluations of sleep, patterns of sleep disturbance, severity of insomnia scale, self satisfaction with sleep, and severity of depression were performed. RESULT: Among sleep variables, length of time taken to fall asleep, severity of insomnia, and self satisfaction with sleep were improved for the 60%(p=.000, p=.000, p=.000) and 100%(p=.000, p=.000, p=.000) week while the severity of depression was improved only for the 100%(p=.002)week. CONCLUSION: According to the study results, it can be concluded that the lavender fragrance had a beneficial effect on insomnia and depression in women college students. Repeated studies are needed to confirm effective proportions of lavender oil and carrier oil for insomnia and depression.
Students/*psychology ; Sleep Initiation and Maintenance Disorders/*therapy ; *Lavandula ; Humans ; Female ; Depression/*therapy ; *Aromatherapy ; Adult

PURPOSE: The purpose of this study was to explore the effects of the lavender fragrance on sleep and depression in women college students. METHOD: Forty-two women college students who complained of insomnia were studied during a four-week protocol(control treatment week, 60% lavender fragrance treatment week, washout week, 100% lavender fragrance treatment week). All subjects were in the department of nursing in "K" college and the study was a single blind repeated measurements experiment. For the duration of the study, weekly evaluations of sleep, patterns of sleep disturbance, severity of insomnia scale, self satisfaction with sleep, and severity of depression were performed. RESULT: Among sleep variables, length of time taken to fall asleep, severity of insomnia, and self satisfaction with sleep were improved for the 60%(p=.000, p=.000, p=.000) and 100%(p=.000, p=.000, p=.000) week while the severity of depression was improved only for the 100%(p=.002)week. CONCLUSION: According to the study results, it can be concluded that the lavender fragrance had a beneficial effect on insomnia and depression in women college students. Repeated studies are needed to confirm effective proportions of lavender oil and carrier oil for insomnia and depression.
Students/*psychology ; Sleep Initiation and Maintenance Disorders/*therapy ; *Lavandula ; Humans ; Female ; Depression/*therapy ; *Aromatherapy ; Adult

OBJECTIVETo compare the efficacy of different points combination in the treatment of menopausal insomnia.

METHODSNinety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia.

RESULTSThe parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P < 0.05, P < 0.01). The SL and awaking time (AT) in group C [SL (401.08 +/- 16.54) min and AT (4.87 +/- 2.64) times] were significantly superior to those in the other two groups [SL (50.36 +/- 18.47) min, (54.87 +/- 20.92) min, AT (5.98 +/- 2.11) times, (6.13 +/- 3.04) times, all P < 0.05]. The S(3+4) (%) in group C was also significantly higher than those in the other two groups (both P < 0.05). It was indicated by PSQI that the sleep quality of group C (0.78 +/- 0.12) was significantly superior to that in group B (1.32 +/- 0.29), the total score and cured and markedly effective rate in group C [(4.34 +/- 1.43), 68.8% (22/32)] were superior to those in group A [(7.48 +/- 3.09), 53.1% (17/32), both P < 0.05].

CONCLUSIONEar acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Menopause ; psychology ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

The authors studied anxiety, using Zung's Self-Rating Anxiety Scale (SAS), in the subjects of 3,499 male and 1,335 female college freshmen of Yeungnam University. The authors collected the reports of SAS during the periods from January to February, 1986, and applied ANOVA and t-test on anxiety scores in order to compare them between various psychosocial factors, and sexes. The results are as follows: There was significant difference in the mean averages of total anxiety scores between male and female students: male students scored 32.91±7.70, female students scored 34.48±6.00, (P<0.001). The anxiety scores relating to the items of sweating, apprehension, restlessness, and insomnia were relatively higher in both groups. The anxiety scores relating to the items of faintness, mental disintegration, tremors, dizziness were lower in both groups. Thirty-nine male students (1.1%) showed seriously high anxiety scores of 50 or higher, while twenty-one female students (1.6%) showed the same scores. So the authors inferred that the features of anxiety symptoms were much the same in our country, but female showed more various symptoms and higher level of anxiety than males. Male students attending in pharmacy showed higher level of anxiety scores (P<0.01). There was a strong tendency toward higher anxiety scores in the students who were dissatisfied with their home atmosphere, colleges, department and familiarity of parents, and those who had pessimistic views of self image in the past, present, or future, in both groups (P<0.001).
Anxiety* ; Atmosphere ; Dizziness ; Female ; Humans ; Male ; Parents ; Pharmacy ; Psychology ; Psychomotor Agitation ; Recognition (Psychology) ; Sleep Initiation and Maintenance Disorders ; Sweat ; Sweating ; Tremor

PURPOSE: This study was to compare and analyze sleep patterns, satisfaction of sleep, and sleep enhancement behaviors between hospitalized and non-hospitalized elderly. METHODS: Subjects were 201 older adults, who were hospitalized patients or living in U-city, Gyung-gi province. Data was collected from June 10 to August 25, 2007, and was analyzed by the SAS program. RESULTS: 1) Non-hospitalized elderly had better sleep patterns than hospitalized elderly patients. 2) There was a strong positive correlation between sleep patterns and satisfaction of sleep in both groups. 3) In hospitalized elderly, there were significant differences in sleep patterns and satisfaction of sleep by month. 4) In non-hospitalized elderly, there was a significant difference in sleep patterns by presence or absence of spouses. There was a significant difference in satisfaction of sleep by those living with others. There were significant differences in sleep enhancement behaviors by age, religion, length of time, and sponsors. CONCLUSION: To relieve sleep disturbances of elderly, comprehension of sleep of the aged by nursing care givers should be obtained. Also, improving environments and elder's selfesteem with religious consideration and preparation of financial conditions are needed to promote the sleep of hospitalized and non-hospitalized elderly.
Aged ; Aged, 80 and over ; *Behavior ; Data Interpretation, Statistical ; Female ; Humans ; Inpatients/*psychology ; Interviews as Topic ; Male ; Outpatients/*psychology ; Patient Satisfaction ; *Sleep ; Sleep Initiation and Maintenance Disorders/*psychology

The purpose of this study was to investigate the prevalence, primary causes, and management of insomnia newly admitted patients in a university hospital. Subjects consisted of 168 adult patients (95 men and 73 women, 88 medical and 94 surgical patients) newly admitted to Gyeongsang National University Hospital from September 7 through September 27, 1996. Sleep patterns of all subjects in the usual nights before admission(UN), the previous night to admission(PN), the night on admission(ON), and the 5th night after admission(5N) were investigated using the Korean version of the St. Mary's Hospital Sleep Questionaire. In addition, all insomnia patients and their doctors and nurses in charge were interviewed by psychiatric residents. Additionally, their medical records were reviewed. Prevalence of insomnia were 22.6% in the UN, 42.9% in PN, 51.8% in ON, and 43.5% in 5N. The prevalence of insomnia was significantly increased immediately before and after admission. There were no significant differences in the prevalence of insomnia by age and sex. The most ammon primary causes of insomnia were somatic symptoms and psychological factors in PN, somatic syptoms and noise in ON and 5n. Only 17 (10.1%) of insomnia patients took medicstions for insomnia control(analgesics in 15, hypnotics in 2). These results shorred that the prevalence of insomnia was significantly increased on hospitalization due to somatic symptoms, environmental factors, and psychological factors, but nearly none were adequately managed.
Adult ; Female ; Hospitalization ; Humans ; Hypnotics and Sedatives ; Male ; Medical Records ; Noise ; Prevalence* ; Psychology ; Sleep Initiation and Maintenance Disorders* ; United Nations

PURPOSE: This study is to study sleep disorder, sleep pattern, and depression in adult women, and to offer basic data for a program of the improvement of women's health and nursing intervention. METHOD: A structured questionnaire was carried out from September 1, 2001 to October 30, 2001 on the subject of 441 females, who are above 18 years old and lived in Seoul. This research tool measured insomnia with APA's insomnia scale(1994), sleep pattern and sleep disorder factors scale(Shin et al(1999)'s), and depression with Radloff's CES-D scale (1977). The data were analyzed with a SPSS program for descriptive statistics, x2-test, and t-test. RESULT: The result were as follows; 1) 35.1% of all participants have insomnia. 2) Sleep disorder group appeared shorter(50.98+/-29.41min.) than normal group(73.03+/-38.7min.) in daytime sleepiness(p=0.001). 3) Factors of sleep disorder were stress(76.6%), worry(55.6%), without reason(39.6%), and noise outside(37.4%). 4) In relation between sleep disorder and depression, group with sleep disorder(20.20+/-11.06) marked higher depression score than normal group(14.25+/-8.81)(p<0.0001). CONCLUSION: Based upon these finding, sleep disorder in adult women was influenced by psychological factors, group with sleep disorder showed a higher depression score than normal group, and which indicated correlation with sleep disorder and depression. This study shows that nursing intervention on women's sleep disorder and depression is needed and further research be done to verify the results.
Adolescent ; Adult* ; Depression* ; Female ; Humans ; Noise ; Nursing ; Psychology ; Seoul ; Sleep Initiation and Maintenance Disorders ; Women's Health ; Surveys and Questionnaires