Insomnia Flashcards

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1
Q

diagnosis criteria for chronic insomnia

A

Chronic insomnia may be diagnosed after three months, if a person has trouble falling asleep or staying asleep at least three nights per week

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2
Q

DSM-V insomnia definition

A

insomnia is defined as difficulty initiating or maintaining sleep, or early-morning awakening that leads to dissatisfaction with sleep quantity or quality. This is despite adequate time and opportunity for sleep and results in impaired daytime functioning.

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3
Q

Insomnia clinical features

A
  • decreased daytime functioning,
  • decreased periods of sleep (delayed sleep onset or awakening in the night)
  • or increased accidents due to poor concentration
  • . Often the partner’s rest will also suffer. It is important to identify the aetiology of the insomnia, as management can differ.
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4
Q

diagnostic factors and risk factors in insomnia

A

The following features are associated with insomnia:
* Female gender
* Increased age
* Lower educational attainment
* Unemployment
* Economic inactivity
* Widowed, divorced, or separated status

Other risk factors include:
* Alcohol and substance abuse
* Stimulant usage
* Medications such as corticosteroids
* Poor sleep hygiene
* Chronic pain
* Chronic illness: patients with illnesses such as diabetes, CAD, hypertension, heart failure, BPH and COPD have a higher prevalence of insomnia than the general population.
* Psychiatric illness: anxiety and depression are highly correlated with insomnia. People with manic episodes or PTSD will also complain of extended periods of sleeplessness.

Less common diagnostic factors may include:
* Daytime napping
* Enlarged tonsils or tongue
* Micrognathia (small jaw) and retrognathia
* Lateral narrowing of oropharynx

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5
Q

Investigations in insomnia

A
  • Diagnosis is primarily made through patient interview, looking for the presence of risk factors.
  • Sleep diaries and actigraphy may aid diagnosis. Actigraphy is a non-invasive method for monitoring motor activity.
  • Polysomnography is not routinely indicated. It may be considered in patients with suspected obstructive sleep apnoea or periodic limb movement disorder, or when insomnia is poorly responsive to conventional treatment.
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6
Q

Short term management of insomnia and advice on drug management

A
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