Insomnia

Question 1

What is insomnia?

Answer 1

• Insomnia 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)

Question 2

What are some ways in which people can struggle with their sleep?(5)

Answer 2

FEATURES OF INSOMNIA

• Struggle to get off to sleep
• Early morning wakening (feature of depression)
• Dissatisfaction with sleep
• Decreased daytime function due to fatigue
• Lack of concentration

Question 3

Which type of sleep disorder is most helped by sleeping tablets?

Answer 3

-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)

Question 4

How long does the insomnia have to be going on for to be classes as chronic insomnia?

Answer 4

Insomnia is defined as trouble sleeping for 3 times a week for at least 3 months

Question 5

How should we manage acute insomnia?

Answer 5

We often don’t need to - it is usually due to an acute reaction to stress and it will be self-limiting

Question 6

What are some risk factors for developing insomnia? (8)

Answer 6

Female 
Age 
Lower educational attainment 
Unemployment 
Economic inactivity 
Widowed, divorced or separated
Alcohol or substance misuse 
Chronic pain 
Poor sleep hygiene

Question 7

What advice can you give people about sleep hygiene?

Answer 7

• 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
• Avoid caffeine in afternoon

Question 8

Management on insomnia? (3)

Answer 8

MANAGMENT FOR INSOMNIA

• Keep a sleep diary
• Educate about sleep hygiene
• Medications should only really be used in the most extreme of circumstances

Question 9

What medications can be offered in patients with insomnia?

Answer 9

INSOMNIA MEDICATIONS

• 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)