Insomnia Flashcards
Types of sleep disturbances include:
sleep onset disorder, nocturnal awakenings, early am awakenings, global sleep disturbance
Dyssomnias include: ___, ___, and ___ ___ sleep disorders.
intrinsic, extrinsic, circadian rhythm
Intrinsic sleep disturbances originate ___ the body or from causes that develop within the body. This includes: ___ insomnia, ___ ___ misperception, ___, and ___ insomnia.
psychophysiologic, sleep state, RLS, idiopathic
Hypersomnia includes: central ___ ___, obstructive ___ ___, and ___ hypersomnia.
sleep apnea, sleep apnea, posttraumatic
Extrinsic sleep disorders arise from ___ the body and affect sleep. These include: inadequate sleep ___, ____ sleep disorder, ___ insomnia, ___ sleep syndrome, nocturnal ___/___ syndrome, ___ dependent sleep syndrome, and ___ dependent sleep syndrome.
outside, hygiene, environmental, altitude, insufficient, eating/drinking, hypnotic, alcohol
Circadian rhythm sleep disorders include: ___ ___ change, ___ ___ sleep disorder, irregular ___-___ pattern, delayed ___ ___ syndrome, and ___-___ hr sleep-wake syndrome.
time zone, shift work, sleep-wake, sleep phase, non-24
Parasomnia’s are the ___ ___ phenomena that occur primarily during sleep and include: ___, sleep ___, sleep ___, and ___ arousal.
undesirable physical, arousal, walking, terrors, confusional
Parasomnia’s ass. w/REM sleep include: ___, sleep ___, impaired sleep-related ___ ___, REM sleep related ___ ___, REM sleep ___ disorder.
nightmares, paralysis, penile erections, sinus arrest, behavior
Medical/psychiatric sleep disorders are ___ and ___ disorders that may include: depression, anxiety, schizo, seizure disorders, etc.
mental, neurologic
____ tx is the best tx for insomnia when possible.
Nonpharmacologic
Nonpharmacologic tx includes: setting ___ time for sleep, having a ___ and ___ environment, omitting ___ and ___ late in the date, reserving the BR for ___ and ___ only, avoiding ___ and ___ late in the day, using ___ techniques like meditation, and considering ___ (which are affective as benzo’s).
regular, comfortable, safe, ETOH, caffeine, sleep, sex, meals, exercise, relaxation, psychotherapy
OTC sleep aids include ___ like diphenhydramine, ___ like lavendar and chamomile, ___ which has a metabolic precursor to ___, and ___ which is a normal body hormone.
antihistamines, herbs, tryptophan, melatonin
Barbiturates include: ___. Downfalls include: have a ___ margin of safety, ___ potential for abuse, ___ interactions, suppression of ___ sleep, ___ rebound.
pentobarbital (Nembutal), secobarbital (Seconal), amobarbital (Ambal), narrow, high, drug, REM, REM
Nonbarbiturates/Nonbenzo’s include: methaqualone (Qualude) which may cause ___ arousal, glutethianide (Doriden) which can be used to get a ___-like high from codeine, and ___ ___ which may cross-react w/___ and can cause the person to act like they are ___.
sexual, heroine, chloral hydrate, ETOH, drunk
___ are the DOC for sleeping aids.
Benzodiazepines
Benzo’s end in either ___ or ___.
Z, lam, pam
Benzo’s include:
flurazepam (Dalmane), triazolam (I lalcion), temazepam (Restoril), estazolam (ProSam), and quazepam (Doral)
Benzo’s have the potential adverse effects of: drug ___ insomnia, ___ insomnia, ___ rebound, withdrawal ___. All can be treatable by gradual ___ of dose.
withdrawal, rebound, REM, seizures, tapering
Nonbenzo’s are not ___ prone to tolerance w/long-term use, do not change sleep ___, and ___ is less common.
as, stages, withdrawal
Non-benzo’s include all the ___ names and include:
zolpidem (Ambien), zalaplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem)
Zolpidem interacts w/___ receptors and has a half-life of ___ hrs.
GABA, 2.5
Zalaplon is similar to ___ but has half-life of ___ hr and may be taken again if time of arousal more than ___ hrs away.
zolpidem, 1, 4
eszoplicone interacts w/___ receptors with a half-life of ___ hrs.
GABA, 6
Common s/e of Z drugs include:
bitter taste, h/a, dry mouth, daytime drowziness, dysmenorrhea, aggressive behavior, visual hallucinations, amnesia
The newest non-benzo is ___ and acts essentially like ___ b/c it is a potent agonist for its receptors.
ramelteon, melatonin
Important not to use sleeping aids in these pts:
sleep apnea, pregnancy, substance abuse, suicidal pts
The Z drugs (zolpidem, zalelpon, and eszopiclone have no ___ syndrome like many of the other sleeping aids.
withdrawal
___ are DOC for insomnia and include all the “___”. ___ is the actual DOC.
Benzo’s, “pams”, temazepam/Restoril
___ has half-life of 1hr, so can be taken if arousal occurs more than 4 hrs from need to awake.
Zalaplon/Sonata
