Management of insomnia

Question 1

management of insomnia

<3 months / >3 months

Answer 1

<3 months
sleep hygine
short 3-7 course of Z drug
CBT

>3 months
sleep hygine
short course 14 days hypnotic
CBT 
specialist referral to sleep clinic

Question 2

sleep disorders

Answer 2

hypersomnia- too much sleep
insomnia- too little sleep
parasomnia- sleep walking/sleep driving/sleep eating

Question 3

what meds used

Answer 3

zopiclone 3.75-7.5mg

zolpiden 5-10mg

promethazine 10-50mg

melatonin MR 2mg in people aged 55 or over

less (and bad side effects)
: temazepam 10mg
nitrazepam 5mg

Question 4

melatonin

Answer 4

binds to melatonin 1 and 2 receptors as an agonist

reduced time to sleep onset

indication
sleep onset insomnia
delayed sleep phase syndrome
sleep disorder in young people
jet lag or other sleep related disorders

Question 5

promethazine

Answer 5

sedative antihistamine

antidepressants such asmitrazapine, trazadone

antipsychotics such as quetiapine

Question 6

side effect of benzodiazepines

Answer 6

sedation during the day
sleepwalking
sleep violence
sleep related eating disorder
hang over effect
nightmares
dependence
tolerance