insomnia Flashcards
what percentage of the pop is affected by insomnia
30%
dyssomnia
sleep disorder characterized by problems in timing, quality or amount of sleep
parasomnia
sleep disorder characterized by abnormalities in the physiology of sleep or behavior associated with sleep, such as abnormal movements
insomnia
complaint of dissatisfaction with quantity or quality of sleep with at least one of the following: difficulty initiating, maintaining sleep. early awakening with the inability to go back to sleep. it must cause distress or impairment.
how many nights per week and time length for diagnosis of insomnia
3 nights per week, for 3 months.
does prevalence of insomnia increase with age?
yes
what percentage do women report over men>
50%
describe substance abuse links to insomnia
a majority of alcoholics report sleep disturbances before addiction.
first step in management
proper diagnosis
second step in management
behavioral counseling: sleep hygiene and stimulus control. need to reestablish circadian rhythm
management 3
sleep restriction therapy, cognitive therapy, thinking through, imagery, daily logs, progressive relaxation, self-hyponosis.
management 4
step-wise psychopharma
first step in the pharmacology of sleep?
OTC: melatonin, antihistamines
second step in sleep pharm
Rx, non habit forming: antihistamines, melatonin 1+2 therapy. ramelteon and transmelteon.
step 3 in sleep pharma.
Rx agents that are mild-habit forming. benzodiazepines, Orexin antagonists
