Insomnia Flashcards
What is insomnia?
It is a symptom but it is also a disorder in its own right. You should always explore more about mental health associations with someone’s insomnia (There is commonly and underlying mental health condition)
What are some ways in which people can struggle with their sleep?
Struggle to get off to sleep
Early morning wakening (feature of depression)
Dissatisfaction with sleep
Decreased daytime function due to fatigue
Lack of concentration
Which type of sleep disorder is most helped by sleeping tablets?
Sleeping tablets only really effective in people who are struggling to get to sleep - not early morning waking as they only last for 4 hours so will have worn off by the time they wake up
How long does the insomnia have to be going on for to be classes as chronic insomnia?
It has to have been happening 3 times a week for at least 3 months
How should we manage acute insomnia?
We often don’t need to - it is usually due to an acute reaction to stress and it will be self-limiting
What are some risk factors for developing insomnia?
Female Age Lower educational attainment Unemployment Economic inactivity Widowed, divorced or separated Alcohol or substance misuse Chronic pain Poor sleep hygiene
What advice can you give people about sleep hygiene?
Try and go to bed at the same time every evening (say 10pm)
Try and wake up at the same time
Do not take naps throughout the day
Avoid large meals just before going to bed (in hour before)
Avoid using screens (computers or phones) in the hour leading up to bed
Other than sleep hygiene what other advice can be given to people struggling with insomnia?
Keep a sleep diary
Medications should only really be used in the most extreme of circumstances
What medications can be offered in patients with insomnia?
BZDs can be useful
ZOPICLONE (7.5mg OD for up to 4 weeks)
Melatonin (2mg OD for up to 13 weeks)
Chloral hydrate (one tablet then two tablets on alternate days)
