OTC - insomnia

Question 1

Symptoms?

Answer 1

• disturbed sleep
• difficulty initiating sleep
• difficulty maintaining sleep i.e. waking up at night
• early morning waking
• poor sleep quality = tiredness despite full sleep

Question 2

Referral criteria?

Answer 2

• chronic insomnia > 3 weeks (underlying medical condition?)
• suspected depression (early morning awakening is a classic symptom)
• under 16
• medication ADR (e.g. MAOIs, fluoxetine, phenytoin, corticosteroids and theophylline)

Question 3

OTC products?

Answer 3

ANTIHISTAMINE

• diphenhydramine 16+ (nytol)
• promethazine hcl 16+ (sominex, phenergan)

Take at bedtime

Question 4

Advice?

Answer 4

SLEEP HYGEINE

• do not use mobile, computers or watch tv before bed
• establish a regular sleep routine
• avoid napping during the day
• relax before bedtime; warm baths, listen to calm music
• avoid caffeine, alcohol, nicotine, exercise and heavy meals a few hours before bed