OBJECTIVE: To observe the effects of Tiaoshu Anshen (regulating the hinge and calming the mind) acupuncture on sleep quality and serum levels of 5-hydroxytryptamine (5-HT) and dopamine (DA) in patients with chronic insomnia. METHODS: A total of 58 patients with chronic insomnia were randomly divided into an acupuncture group and a medication group, 29 cases in each group. Tiaoshu Anshen acupuncture was applied at Baihui (GV20) and bilateral Shenmen (HT7), Sanyinjiao (SP6), Benshen (GB13) in the acupuncture group, once a day, 1-day interval was taken after 6 consecutive days of treatment. Estazolam tablet was given orally before bed in the medication group, 1 mg each time. The 4-week treatment was required in both groups. Before and after treatment, the sleep quality was assessed by Pittsburgh sleep quality index (PSQI) and polysomnography (PSG), the serum levels of 5-HT and DA were detected by ELISA. RESULTS: After treatment, the item scores and total scores of PSQI were decreased compared with those before treatment in the two groups (P<0.05); in the acupuncture group, the scores of sleep quality, sleep latency, sleep time, sleep efficiency, sleep disorders and total score of PSQI were lower than those in the medication group (P<0.05). After treatment, the total sleep time (TST) was prolonged (P<0.05), the sleep latency (SL) and wake after sleep onset (WASO) were shortened (P<0.05), the sleep efficiency (SE%), percentage of non-rapid eye movement stage 3 (N3%), percentage of rapid eye movement stage (REM%) and serum levels of 5-HT were increased (P<0.05) compared with those before treatment; the percentage of non-rapid eye movement stage 1 (N1%), percentage of non-rapid eye movement stage 2 (N2%) and serum levels of DA were decreased (P<0.05) compared with those before treatment in the two groups. After treatment, in the acupuncture group, TST was longer, while SL and WASO were shorter than those in the medication group (P<0.05), SE%, N3%, REM% and serum level of 5-HT were higher, while N1%, N2% and serum level of DA were lower than those in the medication group (P<0.05). CONCLUSION Tiaoshu Anshen acupuncture may improve the sleep quality by regulating the serum neurotransmitter levels i.e. 5-HT and DA in patients with chronic insomnia.
Humans ; Sleep Initiation and Maintenance Disorders/physiopathology* ; Male ; Acupuncture Therapy ; Female ; Middle Aged ; Adult ; Serotonin/blood* ; Sleep Quality ; Acupuncture Points ; Dopamine/blood* ; Aged ; Neurotransmitter Agents/blood* ; Young Adult

Objective To evaluate the clinical efficacy of a novel sleep-aid decoction in treating elderly insomnia patients with different traditional Chinese medicine (TCM) constitutional types, and its effects on neurotransmitter and inflammatory factor levels. Methods A total of 200 patients with four different TCM constitutions-peaceful, Qi-deficient, Yin-deficient, and Yang-deficient-were recruited. Peripheral blood neurotransmitter and inflammatory factor levels were measured for variations among insomnia patients across different constitutions. These patients were treated using the novel sleep-aid decoction, the effects of which were evaluated based on changes in neurotransmitters and inflammatory factors. Results Compared to the peaceful constitution group, insomnia patients with Qi-deficient, Yin-deficient, and Yang-deficient constitutions exhibited significantly elevated baseline levels of neurotransmitters (5-HT, GABA) and inflammatory factors (IL-6, TNF-α, IL-1β, CRP). Following the treatment, the Qi-deficient and Yin-deficient groups showed a marked increase in 5-HT levels, restored balance of Glu, GABA, and melatonin, and significant reductions in IL-6 and TNF-α levels. The overall effective rate was 83.5%, with optimal efficacy observed in the Qi-deficient (97.72%) and Yin-deficient (95.34%) groups. Conclusion The novel sleep-aid decoction is effective in treating insomnia in elderly patients, with the best results observed in the Qi-deficient and Yin-deficient constitution groups.
Humans ; Sleep Initiation and Maintenance Disorders/blood* ; Aged ; Male ; Female ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Middle Aged ; Tumor Necrosis Factor-alpha/blood* ; Sleep Aids, Pharmaceutical/therapeutic use* ; Anti-Inflammatory Agents/therapeutic use* ; Interleukin-6/blood* ; Interleukin-1beta/blood* ; Neurotransmitter Agents/blood* ; Aged, 80 and over ; C-Reactive Protein/metabolism*

OBJECTIVE: To explore the therapeutic effects and underlying mechanisms of Dendrobium officinale (Tiepi Shihu) extract (DOE) on insomnia. METHODS: Forty-two male Sprague-Dawley rats were randomly divided into 6 groups (n=7 per group): normal control, model control, melatonin (MT, 40 mg/kg), and 3-dose DOE (0.25, 0.50, and 1.00 g/kg) groups. Rats were raised in a strong-light (10,000 LUX) and -noise (>80 db) environment (12 h/d) for 16 weeks to induce insomnia, and from week 10 to week 16, MT and DOE were correspondingly administered to rats. The behavior tests including sodium pentobarbital-induced sleep experiment, sucrose preference test, and autonomous activity test were used to evaluate changes in sleep and emotions of rats. The metabolic-related indicators such as blood pressure, blood viscosity, blood glucose, and uric acid in rats were measured. The pathological changes in the cornu ammonis 1 (CA1) region of rat brain were evaluated using hematoxylin and eosin staining and Nissl staining. Additionally, the sleep-related factors gamma-aminobutyric acid (GABA), glutamate (GA), 5-hydroxytryptamine (5-HT), and interleukin-6 (IL-6) were measured using enzyme linked immunosorbent assay. Finally, we screened potential sleep-improving receptors of DOE using polymerase chain reaction (PCR) array and validated the results with quantitative PCR and immunohistochemistry. RESULTS: DOE significantly improved rats' sleep and mood, increased the sodium pentobarbital-induced sleep time and sucrose preference index, and reduced autonomic activity times (P<0.05 or P<0.01). DOE also had a good effect on metabolic abnormalities, significantly reducing triglyceride, blood glucose, blood pressure, and blood viscosity indicators (P<0.05 or P<0.01). DOE significantly increased the GABA content in hippocampus and reduced the GA/GABA ratio and IL-6 level (P<0.05 or P<0.01). In addition, DOE improved the pathological changes such as the disorder of cell arrangement in the hippocampus and the decrease of Nissel bodies. Seven differential genes were screened by PCR array, and the GABA_A receptors (Gabra5, Gabra6, Gabrq) were selected for verification. The results showed that DOE could up-regulate their expressions (P<0.05 or P<0.01). CONCLUSION DOE demonstrated remarkable potential for improving insomnia, which may be through regulating GABA_A receptors expressions and GA/GABA ratio.
Animals ; Dendrobium/chemistry* ; Rats, Sprague-Dawley ; Male ; Sleep Initiation and Maintenance Disorders/blood* ; Plant Extracts/therapeutic use* ; Receptors, GABA-A/metabolism* ; Noise/adverse effects* ; Light/adverse effects* ; gamma-Aminobutyric Acid/metabolism* ; Sleep/drug effects* ; Rats ; Receptors, GABA/metabolism*

OBJECTIVETo compare the clinical efficacy differences between acupuncture at back- points of five , Geshu (BL 17), Shenmen (HT 7) and regular medication for the treatment of menopausal insomnia.

METHODSA total of 128 female patients of menopausal insomnia were randomly divided into an observation group and a control group, 64 cases in each one. Four patients in the observation group and 2 patients in the control group dropped out during the treatment. The patients in the observation group were treated with acupuncture at Feishu (BL 13), Xinshu (BL 15), Pishu (BL 20), Ganshu (BL 18), Shenshu (BL 23), Geshu (BL 17) and Shenmen (HT 7), once a day, and there was an interval of 2 days between every 5 days of treatment. The patients in the control group were treated with oral administration of alprazolam (0.4 mg or 0.8 mg) before sleep. Three-week treatment was taken as one course, and totally three courses were given in the two groups. Pittsburgh sleep quality index (PSQI), levels of estradiol (E), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were observed before treatment and 30 days after treatment; the efficacy was evaluated 30 days after treatment.

RESULTSEach item score and total score of PSQI 30 days after treatment were lower than those before treatment in the two groups (all <0.05), the scores in the observation group were lower than those in the control group (all <0.05). The levels of E 30 days after treatment were higher than those before treatment in the two groups (both <0.05), but the level of FSH and LH 30 days after treatment were lower than those before treatment in the two groups; the level in the observation group was superior to that in the control group (all <0.05). The total effective rate was 98.3% (59/60) in the observation group, which was better than 95.2% (59/62) in the control group (<0.05).

CONCLUSIONAcupuncture at Feishu (BL 13), Xinshu (BL 15), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), Geshu (BL 17), and Shenmen (HT 7) has better efficacy for menopausal insomnia than alprazolam.

Acupuncture Points ; Acupuncture Therapy ; Alprazolam ; therapeutic use ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Menopause ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

PURPOSE: The purpose of this study was to evaluate the effectiveness of a sleep improvement program combined with an aroma-necklace on sleep, depression, anxiety, and blood pressure in elderly women living at home. METHODS: A program consisting of a four-week (one hour per week) sleep improvement intervention plus use of an aroma-necklace, was developed based on Cox's Interaction Model of Client Health Behavior. 70 elderly women were assigned to the experimental (n=35) or control group with no intervention (n=35). Data from 62 participants (32 in the experimental and 30 in the control) were analyzed using the SPSS 21.0 program. Women in the experimental group were instructed to constantly wear the aroma necklace filled with marjoram and orange oil until the program was completed. Sleep quality, sleep duration, sleep satisfaction, depression, anxiety, and blood pressure were measured to identify the effectiveness of the program. RESULTS: Significant group differences were found in sleep quality (t=-5.10, p<.001), sleep duration (z=-3.10, p=.002), sleep satisfaction (z=-4.13, p=<.001), depression (t=2.53, p=.015), and anxiety (z=-2.47, p=.014). No differences were found in the systolic or diastolic blood pressure. CONCLUSION: The results indicate that a sleep improvement program combined with an aroma-necklace was effective in improving sleep disturbances in elderly women living at home. Nurses may contribute to improving sleep among elderly women by applying this program to aged women living in various environments.
Aged* ; Anxiety* ; Blood Pressure* ; Citrus sinensis ; Depression* ; Female ; Health Behavior ; Humans ; Origanum ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: Gamma-aminobutyric acid (GABA) has potential benefits in counteracting the sleep disruption and potential therapeutic effects on blood pressure, stress, cancer, and inflammatory diseases. Recently, High-dose GABA can be extracted from fermented rice germ using lactic acid bacteria. This study aimed to evaluate the effects of GABA natural extracts from fermented rice-germ on sleep latency, subjective sleep quality and insomnia symptoms. METHODS: This was a prospective randomized double-blind placebo-controlled trial performed at Kyung-Hee University hospital at Gangdong from June 2013 to October 2013. Adult (age≥30) patients who was diagnosed of insomnia according to DSM-IV criteria was enrolled. They were randomized into three groups: high dose treatment group 300 mg; low-dose treatment group, 100 mg; and placebo group. Questionnaires including Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), WHO-5 Well-Being Index were performed, and 1-week actigraphy was recorded before and 1 week after the treatment. RESULTS: Total of 114 patients were randomized into 3 groups: high-dose treatment (n=37), low-dose treatment (n=38), and placebo treatment group (n=39). At 1 week after the treatment, PSQI total score and C2 (sleep latency) score significantly decreased in low-dose and high-dose treatment group than the placebo groups [Repeated measures analysis of variance (ANOVA), p=0.017, 0.004 respectively]. ISI score also decreased in the two groups in dose-dependent manner (Repeated measures ANOVA, p=0.037). There were five (4.4%) patients who reported medication adverse events. CONCLUSIONS: This study suggests that treatment of low and high-dose GABA from unpolished rice-germ decreases sleep latency and improve insomnia severity without severe adverse events.
Actigraphy ; Adult ; Bacteria ; Blood Pressure ; Diagnostic and Statistical Manual of Mental Disorders ; gamma-Aminobutyric Acid* ; Humans ; Lactic Acid ; Prospective Studies ; Sleep Initiation and Maintenance Disorders ; Therapeutic Uses

Zolpidem (Stilnox®, Handok, Seoul, Korea) is a hypnotic imidazopyridine that is often used to treat insomnia because it has less abuse and addiction potential than benzodiazepines. Its side effects include headache, dizziness, and nausea, but these are mild. Zolpidem intoxication rarely has severe complications. Here, we report a case of acute kidney injury due to rhabdomyolysis related to zolpidem. A 51-year-old man was admitted with drowsy mentality after taking an overdose of zolpidem in a suicide attempt. Laboratory findings showed a blood urea nitrogen of 59.9 mg/dL, serum creatinine of 5.8 mg/dL, and creatine phosphokinase of 16,210 IU/L. Acute kidney injury associated with rhabdomyolysis complicating zolpidem intoxication was diagnosed. The patient was managed with hemodialysis and recovered completely in terms of renal function and muscle enzyme levels.
Acute Kidney Injury* ; Benzodiazepines ; Blood Urea Nitrogen ; Creatine Kinase ; Creatinine ; Dizziness ; Headache ; Humans ; Middle Aged ; Nausea ; Renal Dialysis ; Rhabdomyolysis ; Seoul ; Sleep Initiation and Maintenance Disorders ; Suicide

OBJECTIVETo compare the clinical efficacy on post-stroke insomnia between the low-frequency electric stimulation at the acupoints and the conventional western medication in the patients so as to explore the effect mechanism.

METHODSOne hundred and twenty patients of post-stroke insomnia were randomized into a low-frequency electric stimulation group, a medication group and a placebo group, 40 cases in each one. In the low-frequency electric stimulation group, the low-frequency pulse electric apparatus was applied to stimulate Dazhui (GV 14) and Shenshu (BL 23), once every day. The treatment for 15 days made one session and 2 sessions were required. In the medication group, estazolam was taken orally, 1 mg each time; and in the placebo group, the starch capsules were taken, one capsule each time; in the two groups the treatment was adopted before sleep every night, continuously for 15 days as one session, and 2 sessions were required. The levels of plasma 5-hydroxytryptamine (5-HT) and norepinephrine (NE) were compared before and after treatment in the patients of the three groups and: the efficacy was compared.

RESULTSIn the placebo group, 1 case was dropped out. The total effective rate was 95. 0% (38/40), 92. 5% (37/40) and 17. 9% (7/39) in the low-frequency electric stimulation group, the medication group and the placebo group respectively. The effects in the low-frequency electric stimulation group and the medication group were better apparently than that in the placebo group (both P<0. 01). The effect was not different significantly between the low-frequency electric stimulation group and the medication group (P>0. 05). The levels of plasma 5-HT and NE were not different significantly between before and after treatment in the placebo group. The level of plasma 5-HT was increased (both P<0. 05) and thelevel of NE was decreased (both P<0. 05) as compared with that before treatment in the low-frequency electric stimulation group and the medication group. But the differences were not significant between the two groups (P>0. 05).

CONCLUSIONThe low-frequency electric stimlaton a the acupoints is safe and effective in the treatment of post-stroke insomnia, which is similar to oral medication of estazolam. The outcome of the increase of plasma 5-HT level and the decrease of plasma NE level is probably one of the effect mechanisms.

Acupuncture Points ; Aged ; Aged, 80 and over ; Electric Stimulation ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Norepinephrine ; blood ; Serotonin ; blood ; Sleep ; Sleep Initiation and Maintenance Disorders ; blood ; etiology ; physiopathology ; therapy ; Stroke ; blood ; complications ; physiopathology ; Treatment Outcome

BACKGROUND: Donor granulocyte transfusion has been used as a salvage treatment for neutropenic patients with severe infection who did not respond to antibiotics. Here we investigated hematological parameters of granulocyte collection to evaluate its efficacy and safety. METHODS: The clinical data for 92 procedures of granulocyte collection performed on 82 healthy donors from April 2007 to July 2014 at National Cancer Center were reviewed retrospectively. Healthy donors were pre-medicated 12 hours before apheresis with subcutaneous injection of 600 microg of granulocyte-colony stimulating factor (G-CSF) with or without 8 mg of oral dexamethasone. Blood cell counts of donors at the time of pre- and post- granulocyte collection state of donors were investigated and any clinical symptoms and signs were monitored during the procedure. RESULTS: he median age was 29 years old (range, 18~52). The mean of collected granulocyte volume was 230 mL, and the granulocyte yield in apheresis products was 4.90x10(10) (1.46~7.86). Granulocyte yields showed significant correlation with volume of granulocyte collection, total processing volume, pre-WBC count, and pre-ANC. Granulocyte yields of dexamethasone and G-CSF administration were greater than with G-CSF administration alone. Pain (low back, hip, knee, and whole body), insomnia, fatigue, abdominal discomfort, and/or headache occurred in 21% of donors during mobilization. CONCLUSION: Granulocyte mobilization was safe and effective, and is well-tolerable in healthy donors because collection was possible in all donors without complications of G-CSF and dexamethasone administration and apheresis.
Anti-Bacterial Agents ; Blood Cell Count ; Blood Component Removal ; Dexamethasone ; Fatigue ; Granulocyte Colony-Stimulating Factor ; Granulocytes* ; Headache ; Hip ; Humans ; Injections, Subcutaneous ; Knee ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders ; Tissue Donors*

OBJECTIVETo observe the effect of Zaoren Anshen capsules in treating senile insomnia and changes in its hemorheology.

METHODA total of 120 patients with senile insomnia were randomly divided into the Zaoren Anshen capsules group (five capsules, n = 60) and the Alprazolam group (0.8 mg, n = 60) for treatment and control observation. Pittsburgh sleep quality index (PSQI) was used for evaluating clinical efficacy in the first and fourth week before and after treatment.

RESULTThe Zaoren Anshen capsules group had lower higher scores in PSQI (5.91 +/- 1.37) than that before treatment (13.49 +/- 3.87), with great statistical significant in difference (P < 0.01). The alprazolam group had lower higher scores in PSQI than that before treatment, with great statistical significant in difference (P < 0.01). apart from higher PSQI scores in the Zaoren Anshen capsules group than that of the Alprazolam group after treatment for one week (P < 0.05), the comparison between the Zaoren Anshen capsules group and the alprazolam group before and after treatment for four weeks showed no statistical significance. As for hemorheological parameters, the difference in the whole blood viscosity (including high-shear, middle-shear and low-shear) of patients in the Zaoren Anshen capsules showed great statistical significance before and after treatment (P < 0.01), and so did the plasma viscosity (P < 0.05). Zaoren Anshen capsules showed less adverse reactions than alprazolam.

CONCLUSIONZaoren Anshen capsules have similar effect in treating senile insomnia with alprazolam, with less adverse reactions. They are so suitable for patients with senile insomnia that they can improve hemorheological indicators of patients with senile insomnia and have good effect in promoting circulation and removing stasis.

Aged ; Aged, 80 and over ; Alprazolam ; administration & dosage ; Blood Viscosity ; drug effects ; Capsules ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Hemorheology ; drug effects ; Humans ; Hypnotics and Sedatives ; administration & dosage ; Male ; Middle Aged ; Sleep Initiation and Maintenance Disorders ; drug therapy ; Surveys and Questionnaires ; Treatment Outcome