Insomnia, Drowsiness, & Fatigue Flashcards
Self-limited
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Transient Insomnia
Lasts < 1 wk
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Transient Insomnia
Last to 3 weeks
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Short Term Insomnia
Lasts > 3 weeks
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Chronic-Long Term Insomnia
From illness, psych, or substance abuse
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Chronic-Long Term Insomnia or Secondary Insomnia
At least 1 month
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Primary Insomnia
Rules out secondary causes
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Primary Insomnia
Classified by duration
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Transient, Short term, long term
Classified by identifiable cause
Primary + secondary
Avoid caffeine, alcohol or nicotine __ to __ hrs before bedtime
4 to 6
What OTC is approved for the management of transient and short term insomnia?
Diphenhydramine
Diphenhydramine is used for…?
Transient Insomnia Short Term Insomnia Chronic-Long Term Insomnia Primary Insomnia Secondary Insomnia
Transient + short term insomnia
What is the best recommendation for insomnia?
Diphenhydramine 50mg for 7-10 days
What are some complementary options for insomnia?
Melatonin, 5-HTP, valerian, kava
Exclusion of insomnia
Age?
<12 yrs and >64yrs old
What are the treatments for drowsiness/fatigue?
Sleep hygiene + caffeine
What are some complementary options for drowsiness/fatigue?
Ginseng, Cola nut, Guarana, Yerba mate
MOA of caffeine?
Nonselective adenosine antagonist at A1/A2 receptors
A1
A2
Which blockade causes arousal, vigilance, and attention?
A1
A1
A2
Which blockade causes increase in motor activity?
A2
What is the caffeine limit in pregnant women?
200mg
Doxylamine vs Diphenhydramine
Which should you recommend for sleep and why?
Diphenhydramine
FDA has not fully established the other as safe and effective, not enough studies
