insomnia

Question 1

short term insomnia v long term

Answer 1

• short term occurring for less than 3 months
• long term occurring on at least 3 nights per week for 3 months

more common in females 2 times higher

Question 2

causes for insomnia

Answer 2

• short term = stressful events

long term

psychiatric disorders

medical disorders - such as COPD, heart failure,

substance abuse

Question 3

management

Answer 3

• sleep hygiene advise = CBT refer through a GP
• pharmacological treatments - benzodiazepines, melatonin, antidepressants, antipsychotics, sedating antihistamines (all POM)
  promethazine, diphenhydramine (prescription medications but can be bought OTC)

Question 4

what is some sleep hygiene advise

Answer 4

• limit caffeine
• avoid alcohol and cigarettes at night
• avoid napping during the day
  regular daily exercise
• getting up from bed same time each day
• avoid heavy meals before bed

Question 5

promethazine - OTC

Answer 5

• for short term use only
• do not sell to asthmatics or patients with epilepsy, serious liver, heart or kidney problems
• should not be used for more than 7 days without information doctor

Question 6

diphenhydramine - OTC

Answer 6

• an antihistamine with sedative properties

should not be given to
- patients with asthma, bronchitis, or COPD
- narrow angle glaucoma
- enlarged prostate or urinary retention
- moderate to severe kidney disease

do not take for more than 2 weeks without consulting your doctor

Question 7

cautions with insomnia

Answer 7

• children - use of hypnotics in children is nit normally justified
• otc medication - short term use only, long term use can lead to tolerance
• driving - hypnotics impair judgement and increase reaction time
• the elderly - are most at risk of developing ataxia becoming confused or falling due to treatment
• hypnotic drugs are associated with tolerance, dependency and withdrawal symptoms and rebound insomnia

Question 8

melatonin

Answer 8

• a hormone synthesised by the pineal gland - used for short term use treatment of insomnia for age 55 and over

Question 9

sleepio

Answer 9

not available on the nhs
it is a cognitive behaviour therapy for insomnia

Question 10

complications of insomnia

Answer 10

• quality of life impaired
• hypertension

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