만성 불면증 치료법 (1차 불면 증 과 2차 불면 증 페이지 정보 전성수 0 짧은주소 × 짧은 글주소 복사 Note! 위 주소를 클릭 후, 복사(Ctrl+C)하여 사용하세요. 이전글다음글 목록 본문 <TABLE class=tbl2> <TBODY> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD class=tbl2-title> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: red; FONT-SIZE: 18pt">만성 불면증 치료법<SPAN> (1</SPAN>차 불면 증 과<SPAN> 2</SPAN>차 불면 증<SPAN>)</SPAN></SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: red; FONT-SIZE: 18pt"></SPAN></B><B><SPAN style="COLOR: red; FONT-SIZE: 18pt"></SPAN></B> </P></TD></TR> <TR style="HEIGHT: 35.15pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes"> <TD class=tbl2-contents> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">한 달 이상 고생하는 불면증을 만성 불면증이라 한다<SPAN> </SPAN></SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">만성 불면증은 <SPAN>1</SPAN>차성 불면 증 과<SPAN> 2</SPAN>차성 불면증이 있으며</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">그 치료 법을 달리 해야 한다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">이는 미국 로체스터 의대<SPAN> Mayo Clinic </SPAN>연구 팀이</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">일반 개업의를 대상으로 하여<SPAN> </SPAN></SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">의학 최고의 전문지<SPAN> (NEJM)</SPAN>를 통해 발표한 내이다</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P></TD></TR> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD class=tbl2-subtitle> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: #000099; FONT-SIZE: 18pt">1</SPAN></B><B><SPAN style="COLOR: #000099; FONT-SIZE: 18pt">차성 불면증이란 <SPAN>?</SPAN></SPAN></B><B><SPAN style="COLOR: #000099; FONT-SIZE: 18pt"></SPAN></B></P></TD></TR> <TR style="HEIGHT: 35.15pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes"> <TD class=tbl2-contents> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" align=left> </P> <TABLE style="BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; BORDER-COLLAPSE: collapse; BORDER-TOP: medium none; BORDER-RIGHT: medium none; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt" border=1 cellSpacing=0 cellPadding=0> <TBODY> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="FONT-SIZE: 14pt">특성</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">유아<SPAN>, </SPAN>소아적 부터 시작 되었으며<SPAN> </SPAN></SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">간헐적으로 나타나지만 지속적인 불면증이다 </SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="FONT-SIZE: 14pt">과거의 스트레스</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">과거에 어떤 스트레스로 인해 잠시 불면증을 겪었던 자가 스트레스에 대한 적응 방식이 잘못된 이유로 체내 생리상태가 비정상화되어 </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">스트레스 요인은 사라졌음에도 불구하고 </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면 중 생리적으로 자극을 받는 상태이다 </SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">뇌파적 특징 </SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">뇌파 검사 등 객관적으로 불면 증 상태가 아님에도 불구하고</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt"> </SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">환자 자신은 잠을 못 잤다고 호소하는 불면증이다</SPAN></B></P></TD></TR> <TR style="mso-yfti-irow: 3; mso-yfti-lastrow: yes"> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">환자 발견 법</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">자다가 잘 깨는 불면증이 많다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="TEXT-INDENT: -14pt; MARGIN: 0cm 0cm 0pt 14pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">깨어날 때<SPAN> PET </SPAN>뇌 촬영을 해 보면 포도당 대사가 매우 활발하다.</SPAN></B></P> <P style="TEXT-INDENT: -14pt; MARGIN: 0cm 0cm 0pt 14pt" align=left> </P> <P style="TEXT-INDENT: -14pt; MARGIN: 0cm 0cm 0pt 14pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면 도중 뇌파 촬영을 해 보면 베타 파는 증가하고 <SPAN>Theta </SPAN>파 와<SPAN> Delta </SPAN>파는 감소해 있다.</SPAN></B></P> <P style="TEXT-INDENT: -14pt; MARGIN: 0cm 0cm 0pt 14pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">일중<SPAN> 24 </SPAN>시간 동안의 신진 대사율이 증가해 있다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-ACTH </SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">호르몬과 부신피질 호르몬 분비가 </SPAN></B></P> <P style="TEXT-INDENT: 14pt; MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">매우 증가해 있다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P></TD></TR></TBODY></TABLE> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" align=left> </P></TD></TR> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD class=tbl2-subtitle> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: #000099; FONT-SIZE: 18pt">2</SPAN></B><B><SPAN style="COLOR: #000099; FONT-SIZE: 18pt">차성 불면증이란<SPAN> ?</SPAN></SPAN></B><B><SPAN style="COLOR: #0000cc; FONT-SIZE: 18pt"></SPAN></B></P></TD></TR> <TR style="HEIGHT: 35.15pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes"> <TD class=tbl2-contents> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" align=left><SPAN><FONT size=2></FONT></SPAN> </P> <TABLE style="BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; BORDER-COLLAPSE: collapse; BORDER-TOP: medium none; BORDER-RIGHT: medium none; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt" border=1 cellSpacing=0 cellPadding=0> <TBODY> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="FONT-SIZE: 14pt">현재의 스트레스</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">현재 겪고 있는 스트레스성 요인이 불면을 유발</SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">정신 질환성</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">불안 우울 등 정신 질환으로 인한 불면</SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면 환경성</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면 환경이나 습관적 행동 방식이 불면을 유발</SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">합병증성</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">만성 통증<SPAN>, </SPAN>야간 기침<SPAN>, </SPAN>호흡곤란<SPAN>, </SPAN>다리 저림 등 </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">질환이 유발 </SPAN></B></P></TD></TR> <TR style="mso-yfti-irow: 4; mso-yfti-lastrow: yes"> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.45pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=179> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">약물성</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 362.65pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #66ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=484> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">술<SPAN>, </SPAN>카페인 등 이 원인 인 경우</SPAN></B></P></TD></TR></TBODY></TABLE> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" align=left></P></TD></TR> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD class=tbl2-subtitle> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: blue; FONT-SIZE: 18pt">1</SPAN></B><B><SPAN style="COLOR: blue; FONT-SIZE: 18pt">차 불면증 치료 원리 </SPAN></B><B><SPAN style="COLOR: red; FONT-SIZE: 18pt"></SPAN></B></P></TD></TR> <TR style="HEIGHT: 35.15pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes"> <TD class=tbl2-contents> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">1</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">차 불면증은 약물 요법부터 시도해서는 안된다</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">인식 행동 교정 요법을 먼저 시도하면 효과를 볼 수 있다</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">약물 요법과 병행해서도 효과가 떨어진다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><SPAN><FONT size=2></FONT></SPAN> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">인식 행동 교정 요법이 실패하면 약물 여법을 시도 한다</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><SPAN><FONT size=2></FONT></SPAN> </P></TD></TR> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD class=tbl2-subtitle> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: blue; FONT-SIZE: 18pt">인식 행동 교정법이란 어떤 것<SPAN>?</SPAN></SPAN></B><B><SPAN style="COLOR: red; FONT-SIZE: 18pt"></SPAN></B></P></TD></TR> <TR style="HEIGHT: 35.15pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes"> <TD class=tbl2-contents> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">불면증 원인의 종류에 상관없이 시도할 수 있다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">일반 개업 의가 전문의로부터<SPAN> 3 </SPAN>시간 교육 받으면</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">환자에게 실시 할 수 있다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">환자 당<SPAN> 1</SPAN>회<SPAN> 20</SPAN>분<SPAN>-50</SPAN>분 정도<SPAN> 4-6</SPAN>회 실시한다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면 도입 시험에서도 </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Triazolam </SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">과 효과가 같거나 </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Zolpidem </SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">보다 효과가 우수한 것으로 발표되고 있다.</SPAN></B></P> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" align=left><SPAN><SPAN><FONT size=2> </FONT></SPAN></SPAN></P> <TABLE style="BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; MARGIN: auto auto auto 28.1pt; BORDER-COLLAPSE: collapse; BORDER-TOP: medium none; BORDER-RIGHT: medium none; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt" border=1 cellSpacing=0 cellPadding=0> <TBODY> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 469pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ccffff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid" width=625 colSpan=2> <P style="TEXT-ALIGN: center; MARGIN: 0cm 0cm 0pt" align=center><B><SPAN style="COLOR: blue; FONT-SIZE: 14pt">인식 행동 교정법</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt"> <SPAN>Cognitive Behavioral Therapy</SPAN></SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.7pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=180> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">자극 요소 통제법</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 334.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #99ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=446> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">잠이 올 때 침대에 높는다 .</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">침실은 오로지 침실용으로 만 사용한다<SPAN>.<BR>-15-20</SPAN>분 잠들지 못하면 </SPAN></B></P> <P style="TEXT-INDENT: 14pt; MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">즉시 다른<SPAN><SPAN> </SPAN></SPAN>방으로 가서 다른 일을 한다.</SPAN></B></P> <P style="TEXT-INDENT: 14pt; MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">잠잔 시간과 관계 없이 동일한 시간에 기상한다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">낮잠을 없앤다.</SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.7pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=180> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면제한법</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 334.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #99ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=446> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">잠 자는 시간을<SPAN> 5 </SPAN>시간으로 줄인 후 침대 누워있는 시간과 실제 수면 시간 비율이 </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">90%</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">에 도달하면 매주마다<SPAN> 15</SPAN>분씩 수면 시간을 연장해 나간다.</SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.7pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=180> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Relaxation </SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">법 </SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 334.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #99ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=446> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">근육 이완<SPAN> Biofeedback</SPAN></SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">명상 및 최면요법</SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.7pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=180> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">인식 요법</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 334.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #99ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=446> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-8</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">시간 이상 자야 한다는 고정 관념 타파</SPAN></B></P></TD></TR> <TR style="mso-yfti-irow: 5; mso-yfti-lastrow: yes"> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 134.7pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=180> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면 위생 환경</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 334.3pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #99ff66; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=446> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">-</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면 장애 환경 개선<SPAN>: </SPAN>애완동물<SPAN>, </SPAN></SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt 5.6pt; mso-para-margin-left: .56gd" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt"> </SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">코골이 동침자<SPAN>, </SPAN>실내온도 괘종 이용<SPAN>, </SPAN>알코올<SPAN>, </SPAN>담배<SPAN>, </SPAN>커피<SPAN>, </SPAN>운동 등</SPAN></B></P></TD></TR></TBODY></TABLE> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" align=left><SPAN><FONT size=2></FONT></SPAN> </P> <P style="LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt" align=left><SPAN><FONT size=2></FONT></SPAN> </P></TD></TR> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD class=tbl2-subtitle> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: blue; FONT-SIZE: 18pt">2</SPAN></B><B><SPAN style="COLOR: blue; FONT-SIZE: 18pt">차 불면증 치료 원리 </SPAN></B><B><SPAN style="COLOR: red; FONT-SIZE: 18pt"></SPAN></B></P></TD></TR> <TR style="HEIGHT: 35.15pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes"> <TD class=tbl2-contents> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">약물 요법부터 시도한다 약물 요법이 더 효과적이기 때문이다</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><SPAN><FONT size=2></FONT></SPAN> </P></TD></TR> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD class=tbl2-subtitle> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: blue; FONT-SIZE: 18pt">만성 불면증 약물 요법</SPAN></B></P></TD></TR> <TR style="HEIGHT: 35.15pt; mso-yfti-irow: 1; mso-yfti-lastrow: yes"> <TD class=tbl2-contents> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">불면증 치료 약물에는 </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">불면증 상태에 따라 약을 선택해야 한다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">잠 들기가 어려운 자에게는 </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Zolpidem </SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">같은 수면 도입제를 사용한다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt"><BR></SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">자다가 쉽게 깨어나는 자에게는</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Temazepam </SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">같은 숙면제를 사용한다.</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P> <TABLE style="BORDER-BOTTOM: medium none; BORDER-LEFT: medium none; MARGIN: auto auto auto 13.95pt; BORDER-COLLAPSE: collapse; BORDER-TOP: medium none; BORDER-RIGHT: medium none; mso-yfti-tbllook: 1184; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt" border=1 cellSpacing=0 cellPadding=0> <TBODY> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes"> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 92.15pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ccffff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid" width=123> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 163pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ccffff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid" width=217> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Benzodiazepine</SPAN></B><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">계</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 6cm; PADDING-RIGHT: 5.4pt; BACKGROUND: #ccffff; BORDER-TOP: windowtext 1pt solid; BORDER-RIGHT: windowtext 1pt solid" width=227> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Benzodiazepine-</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수용체 증강제</SPAN></B></P></TD></TR> <TR> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 92.15pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=123> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">수면 도입</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 163pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff66ff; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=217> <P style="TEXT-ALIGN: center; MARGIN: 0cm 0cm 0pt" align=center><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Triazolam</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 6cm; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff66ff; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=227> <P style="TEXT-ALIGN: center; MARGIN: 0cm 0cm 0pt" align=center><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Zolpidem</SPAN></B></P></TD></TR> <TR style="mso-yfti-irow: 2; mso-yfti-lastrow: yes"> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: windowtext 1pt solid; PADDING-LEFT: 5.4pt; WIDTH: 92.15pt; PADDING-RIGHT: 5.4pt; BACKGROUND: yellow; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=123> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">숙면 도입</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 163pt; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff66ff; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=217> <P style="TEXT-ALIGN: center; MARGIN: 0cm 0cm 0pt" align=center><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Temazepam</SPAN></B></P> <P style="TEXT-ALIGN: center; MARGIN: 0cm 0cm 0pt" align=center><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Estazolam</SPAN></B></P></TD> <TD style="BORDER-BOTTOM: windowtext 1pt solid; BORDER-LEFT: #ffffff; PADDING-LEFT: 5.4pt; WIDTH: 6cm; PADDING-RIGHT: 5.4pt; BACKGROUND: #ff66ff; BORDER-TOP: #ffffff; BORDER-RIGHT: windowtext 1pt solid" width=227> <P style="TEXT-ALIGN: center; MARGIN: 0cm 0cm 0pt" align=center><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Eszopiclone</SPAN></B></P> <P style="TEXT-ALIGN: center; MARGIN: 0cm 0cm 0pt" align=center><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Zaleplon</SPAN></B></P></TD></TR></TBODY></TABLE> <P style="MARGIN: 0cm 0cm 0pt" align=left></P></TD></TR></TBODY></TABLE> <TABLE class=tbl2> <TBODY> <TR style="mso-yfti-irow: 0; mso-yfti-firstrow: yes; mso-yfti-lastrow: yes"> <TD class=tbl2-ref1> <P style="MARGIN: 0cm 0cm 0pt"><B><SPAN style="FONT-SIZE: 14pt">근거</SPAN></B></P></TD> <TD class=tbl2-ref2> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">2005 August 25 New England Journal of Medicine; Vol 353, No 8</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">803-809; Clinical Practice Chronic Insomnia; Michael H, Silber </SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">The Sleep Disorders Center and the Department of Neurology</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left><B><SPAN style="COLOR: black; FONT-SIZE: 14pt">Mayo Clinic, College of Medicine Rochester</SPAN></B></P> <P style="MARGIN: 0cm 0cm 0pt" align=left> </P></TD></TR></TBODY></TABLE> <STYLE> .tbl2 { border-left: 1pt solid windowtext; border-bottom: 1pt solid windowtext; width: 790px; border-collapse: collapse; border-right-style: none; border-right-color: inherit; border-right-width: medium; border-top-style: none; border-top-color: inherit; border-top-width: medium; margin-right: 0px; } .tbl2-title { padding: 30px; border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; width: 790px; background: aqua; border-top: windowtext 1pt solid; border-right: windowtext 1pt solid; vertical-align: middle; } .tbl2-left { border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; width: 20px; background: #fabf8f; border-top: #ece9d8; border-right: windowtext 1pt solid; } .tbl2-contents { padding: 30px; border-bottom: windowtext 1pt solid; border-left: #ece9d8; width: 790px; background: #fde9d9; border-top: #ece9d8; border-right: windowtext 1pt solid; vertical-align: middle; } .tbl2-subtitle { padding: 30px; border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; background: aqua; border-top: #ece9d8; border-right: windowtext 1pt solid; vertical-align: middle; } .tbl2-ref1 { border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; width: 80px; background: #d9d9d9; border-top: windowtext 0pt solid; border-right: windowtext 1pt solid; vertical-align: middle; text-align: center; } .tbl2-ref2 { padding: 30px; border-bottom: windowtext 1pt solid; border-left: #ece9d8; background: #f2f2f2; border-top: windowtext 0pt solid; border-right: windowtext 1pt solid; vertical-align: middle; } </STYLE> 이전글다음글 목록
