수면장애와 동반된 임상증상에 따른 심박변이도와 수면 관련 설문간의 상관성 연구 = The Relation of HRV, PSQI and IQ with Symptoms of Insomnia Patients

다국어 초록 (Multilingual Abstract)

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 P1(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 NN50, 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(frequecy 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 stoo)l 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 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.

참고문헌 (Reference)

1 전국한의과대학 신경정신과 교과서편찬위원회, "한의신경정신과학" 집문당 77-78, 2007

2 대한한방신경정신과학회, "한방신경정신의학" 집문당 632-, 2005

3 전국한의과대학 병리학교실, "한방병리학" 일중사 443-, 2001

4 문성길, "최신정신의학" 일조각 434-450, 1995

5 김옥수, "청？중년층의 피로, 우울, 수면에 관한 연구" 한국간호과학회 33 (33): 618-624, 2003

6 방규만, "주요 정신장애자들에서 수면의 질과 건강관련 삶의 질" 대한생물치료정신의학회 11 (11): 138-149, 2005

7 정기삼, "심박변동 신호에 의한 자율신경 기능해석 시스템의 설계" 연세대학교 대학원 1997

8 이유미, "수면의 질과 구강 안면 통증의 관계" 대한안면통증∙구강내과학회 31 (31): 91-100, 2006

9 김원식, "수면단계 자동분류를 위한 심박동변이도 분석" 한국감성과학회 6 (6): 9-14, 2003

10 서만욱, "수면과 두통" 6 (6): 106-109, 1999

11 이선옥, "성인여성의 피로와 수면장애에 관한 연구" 여성건강간호학회 11 (11): 163-168, 2005

12 변영순, "성격유형과 우울정도에 따른 수면양상에 관한 연구" 11 (11): 43-55, 1999

13 한성희, "변비형 여성 과민성 장증후군 환자에서 불안, 우울 및 수면장애에 대한 환자-대조군 연구" 대한소화관운동학회 11 (11): 66-71, 2005

14 김은정, "배뇨장애 환자에 대한 전침치료가 심박 변이도에 미치는 영향" 대한침구학회 23 (23): 155-163, 2006

15 송예헌, "발반사마사지가 노인의 수면,우울및 생리적 지수에 미치는 영향" 한국간호과학회 36 (36): 15-24, 2006

16 전상복, "무기력 및 피로에 관한 문헌적 고찰(동서의학적 비교고찰, 치료를 중심으로)" 12 (12): 31-44, 1991

17 함병주, "만성 불면증 환자의 성격특성" 37 : 234-242, 1998

18 정인태, "만성 두통 환자에 대한 침치료가 심박변이도에 미치는 영향" 대한침���학회 22 (22): 105-112, 2005

19 김현우, "두통. 월간의약정보" 약업신문사 10-, 1990

20 심영숙, "두통 환자들의 MMPI 특성" 9 (9): 155-168, 1990

21 허준, "동의보감" 법인문화사 746-, 1999

22 謝觀, "東醫醫學大事典" 高文社 584-, 1975

23 Zhong X, "sympathetic and deceased parasympathetic cardiovasculr modulation in normal humans with acute sleep deprivation" 98 (98): 2024-2032, 2005

24 Cameron J, "Thermoregulation in normal sleep and insomnia; the role of peripheral heat loss and new applications for digital thermal infrared imahing(DITI)" 29 : 457-461, 2004

25 Floyd JA, "The use of across-method triangulation in the study of sleep concerns in healthy older adults" 16 (16): 70-80, 1993

26 Dexter JD, "The relationship of nocturnal headaches to sleep stage patterns" 20 : 513-518, 1970

27 Moss RA, "The influence of sleep duration on headache pain and frontalis EMG" 14 : 331-335, 1987

28 Kirsti M, "The impact of somatic health problems on insomnia in meddle age" 4 : 201-206, 2003

29 Zhong X Xiao Y, "The effects of overnight sleep deprivation on cardiovascular autonomic modulation" 44 (44): 577-580, 2005

30 Inbe H, "The Relationship Between R-R Interval Fluctuation Indices and Sleep Stage in Normal human Sleep" P-120-, 1994

31 McCraty R, "The Effects of Emotions on Short-Term Power Spectrum Analysis of Heart Rate Variability" 76 : 1089-1093, 1995

32 Busek P, "Spectral analysis of the heart rate variability in sleep" 54 (54): 369-376, 2005

33 Vitiello MV, "Sleep, alcohol and alcohol abuse" 2 : 151-158, 1997

34 Hartmann E, "Sleep requirement" 14 : 95-103, 1973

35 Lindberg E, "Sleep disturbance in young adultpopulation:Can gender differences be explained by differences in psychological status?" 20 : 381-387, 1997

36 Pilowsky I, "Sleep disturbance in pain clicinc patients" 23 : 27-33, 1985

37 Clark AJ, "Sleep didsturbance in mid-life woman" 22 : 562-568, 1995

38 Sahota PK, "Sleep and headache syndrome:A clinical review" 30 : 80-84, 1990

39 Raymann RJ, "Skin temperature and sleep-onset latency: changes with age and insomnia" 90 (90): 257-266, 2007

40 Kim YH, "Relationship women's stress and intervention and sleeping disturbance" Young Nam University 2000

41 Maurice M. Ohayon, "Relationship between chronic painful physical condition and insomnia" 39 : 151-159, 2005

42 Mélanie L, "Psychological and health-related quality of life factors associated with insomnia in a population-based sample" 63 : 157-166, 2007

43 Montano N, "Power spectral analysis of heart rate variability to assess the changes in sympatho-vagal balince during graded orthostatic tilt" 90 (90): 1826-1831, 1994

44 Malliani A, "Power spectral analysis of geart rate variability a tool to explore neural regulatory mechanisms" 741 (741): 1-2, 1994

45 Ohayon MM, "Place of chronic insomnia in the course of depressive and anxiety disorders" 37 (37): 9-15, 2003

46 Menefee LA, "Perez-Schwartz L. Self-reported sleep quality and quality of life for individuals with chronic pain conditions" 16 (16): 290-297, 2000

47 Miller CA, "Nursing care of older adults:Theory and Practice" Little and Brown 1990

48 Cowan MJ, "Measurment of HRV" 17 (17): 2-48, 1995

49 Platisa MM, "Linear and non-linear heart rate vaiability measures in chronic and acute phase of anorexia nervosa" 26 (26): 54-60, 2006

50 Landolt HP, "Late-afternoon ethanol intake affects nocturnal sleep and the sleep EEG in middle-aged man" 16 : 428-436, 1996

51 Baker TL, "Introduction to sleep and sleep disorder" 69 : 1123-1153, 1985

52 Karacan I, "Insomniacs: unpredictable and idiosyncratic sleepers. In; Sleep:Physiology, biochemistry, psychology, pharmacology, clicical Implications: Proceeding of 1st European Congress on sleep Research" Karger 120-132, 1973

53 Drake CL, "Insomnia causes, Consequences, and therapeutics: An overview" 18 : 163-176, 2003

54 Morawetz D, "Insomnia and depression: Which comes first?" 5 : 77-81, 2003

55 Cagnacci A, "Hypohermic effect of melatonin and nocturnal core body temperature decline are reduced in aged women" 78 (78): 314-317, 1995

56 Gary GB, "Heart rate variability:stress and psychiatric condition"

57 Task force of The European Society of Cardiology and the North American Society of Pacing and Electrophysiology, "Heart rate variability standards of measurement, physiological interpretation, and clinical use" 93 : 1043-1065, 1996

58 Fuller J, "Health assessment: A Nursing Approach" Lippincott 2000

59 박정준, "HRV 測定으로 본 不眠症 患者에 對한 硏究" 13 (13): 39-45, 2004

60 Reyne A, "Gender-and age-related differences in sleep determined by home-recorded sleep logs and actimetry from 400 adults" 18 : 127-134, 1995

61 Verbrugge LM, "Female illness rates and illness behavior: testing hypothesis about sex differrences in health" 4 : 61-79, 1979

62 Hjortskov N, "Fallentin N, Lundberg U, Søgaard K. The effect of mental stress on heart rate variability and blood pressure during computer work" 92 (92): 84-89, 2004

63 Edinger JD, "Cognitive behavioral therapy for treatment of chronic primary insomnia" 285 (285): 1856-1864, 2001

64 Sforza E, "Cardiac variability and heart-rate increment as a marker of sleep fragmentation in patients with a sleep disorder: a preliminary study" 30 (30): 43-51, 2007

65 Schechtman KB, "Buchner DM, Ory MG & FICSIT group. Gender, self-reported depressive symptoms, and sleep disturbance among older community-dwelling persons" 43 (43): 513-527, 1997