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Journal of Chinese Integrative Medicine ›› 2012, Vol. 10 ›› Issue (6): 655-662.doi: 10.3736/jcim20120609

• Original Clinical Research • Previous Articles     Next Articles

Case-control study on the association between qi-stagnation and insomnia

Xiao-ling Jiang1(), Ying Zhang1, Ying Lei1, Gui-fang Hu1, Zheng-gang Zhang2, Zhong-ju Xiao2()   

  1. 1. Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, Guangdong Province, China
    2. Department of Physiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, Guangdong Province, China
  • Received:2012-01-05 Accepted:2012-03-01 Online:2012-06-20 Published:2018-06-15
  • Contact: Xiao-ling Jiang,Zhong-ju Xiao E-mail:jxlxl@fimmu.com;xiaozj@fimmu.com

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Objective: To investigate the relationship between insomnia and qi-stagnation by using the international standardized measurement of sleep quality and the Traditional Chinese Medicine (TCM) Constitution Scales.
Methods: A survey by means of the TCM Constitution Scales, the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and the Deep Sleep Scale (DSS) in 169 participants aged between 16 and 80 years old was conducted. Comparison was made to examine the sleep quality and insomnia symptoms in the qi-stagnation group and other-constitution group.
Results: Univariate analysis found that the qi-stagnation group had a significantly increased risk of difficulty in falling asleep (OR=3.012, and 95% CI 1.310 to 6.923 for PSQI; OR=3.016, and 95% CI 1.358 to 6.709 for DSS) and early waking (OR=3.545, and 95% CI 1.229 to 10.232 for PSQI; OR=2.742, and 95% CI 1.072 to 7.014 for DSS), while the other-constitution group had a significant risk of dreaminess (OR=2.419, and 95% CI 1.154 to 5.072 for PSQI; OR=2.561, and 95% CI 1.116 to 5.880 for DSS). A dose-effect relationship existed between insomnia symptoms and qi-stagnation. Qi-stagnation significantly increased the risk of difficulty in falling asleep and early waking.
Conclusion: This case-control study revealed that there is a statistically significant association between qi-stagnation and insomnia. Based on this study, we recommend that further research should be conducted for the rehabilitative care and cure of insomnia from the perspective of TCM constitution.

Key words: sleep initiation and maintenance disorders, physical constitution theory, qi-stagnation, insomnia, scales, case-control studies

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Index Normal group
(n=60)		 Other-constitution
group (n=63)		 Qi-stagnation
group (n=46)		 χ2 value P value
Age 3.138 0.791
<25 32 36 28
25 to 39 14 16 12
40 to 59 9 5 3
≥60 2 3 3
Gender 2.210 0.331
Male 26 21 14
Female 34 42 32
Education 4.633 0.592
Senior school or below 10 6 10
Junior college 4 1 5
Undergraduate 36 33 43
Graduate or above 9 6 4
Occupation 2.384 0.304
Student 37 40 35
Non-student 22 22 11

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Group n Sleep variable
PSQI ESS
Normal 60 54.64 63.34
Other-constitution 63 90.65** 90.15**
Qi-stagnation 46 99.00** 104.49**

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Insomnia subtype r value
Difficulty in falling asleep Wake-up during the night Early morning awakening Nightmare
Difficulty in falling asleep 1 – – –
Wake-up during the night 0.295△△ 1 – –
Early morning awakening 0.324△△ 0.383△△ 1 –
Nightmare 0.217△△ 0.260△△ 0.108△△ 1

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Group n Difficulty in falling asleep Wake-up during the night Early morning awakening Nightmare
– + – + – + – +
Normal 60 46 14 47 11 54 6 31 29
Other-constitution 63 45 17 42 21 50 13 19* 43*
Qi-stagnation 46 24** 22** 30 16 33* 13* 17 28

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Variable r value
Sleep latency Night awakening time Early awakening time Profuse dreaming
Sleep latency 1 – – –
Night awakening time 0.285△△ 1 – –
Early awakening time 0.227△△ 0.295△△ 1 –
Profuse dreaming 0.216△△ 0.271△△ 0.179△△ 1

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Group n Sleep latency Night awakening time Early awakening time Profuse dreaming
– + – + – + – +
Normal 60 37 23 40 20 51 9 49 11
Other-constitution 63 36 27 34 29 49 14 40* 23*
Qi-stagnation 46 16** 30** 25 21 31* 15* 30 16

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Group Difficulty in falling asleep Early morning awakening Sleep latency Early awakening time
– + OR – + OR – + OR – + OR
Normal 46 16 – 54 6 – 46 16 – 54 6 –
Qi-stagnation 24 22 – 33 13 – 16 30 – 31 15 –
40 to 54 20 11 1.807 26 5 1.731 12 19 2.547 24 7 1.653
55 to 69 4* 6* 4.929 5** 5** 9.000 4 6 2.413 5* 5* 5.667
70 to 95 0** 5** – 2** 3** 13.500 0* 5* – 2* 3* 8.500
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