종합병원 입원 환자에서의 불면증의 임상적 특징

The Clinical Characteristics of Insomnia in General Hospital Inpatients

The purpose of this study is to investigate the clinical characteristics of insomnia in 300 new inpatients of general hospital with semistructured interview and questionaires. Among 4 clinical groups-129 noninsomniacs, 171 insomniacs (100 insomniacs with past insomnia history and 71 without past history)-, we compared the following variables ； age, sex, associated significant diseases, usual life habits, environmental variables influencing sleep pattern, types of insomnia, causes of insomnia, coping methods with insomnia, and usage of hypnotics. In insomniacs we also compared the changes of types and causes of insomnia, coping methods with insomnia after admission. The prevalence of insomnia was significantly increased after admission, and was higher in female patients but not significantly different in age. The frequencies of associated significant disease(angina, arrhythmia, asthma, duodenal ulcer etc.), naps, smoking, alcohol and coffee drinking showed no difference between insomniacs and noninsomniacs. Among environmental variables, “apprehension about illness”，“noise”，“nurse’ s visit”，and “bed discomfort” were significantly more frequent in insomniacs. Presence or absence of past insomnia history gave no significant effect on the types, causes of insomnia and coping methods with insomnia. Difficulty in maintaining sleep(DMS) was significantly increased after admission but difficulty in falling asleep(DFA) was decreased. The causes of insomnia were physical illness, sleep environmental variables, and psychological variables in order •’ first two of these were significantly increased after admission. After admission as well as before admission, the most coping method with insomnia was “effort to forget problems” . Among the methods, “exercise or walking” was significantly increased after admission. Afterwards the study on the psychopathology and characteristics of personality which related with insomnia will be needed to broaden our understanding about insomnia and to establish proper management plan of insomnia.