Sleep Flashcards
Which gender is more likely to develop insomnia?
Females
Prevalence of chronic insomnia
10%
Medical conditions that can cause, contribute, or exacerbate insomnia
psychiatric conditions pain thyroid abnormalities asthma reflux
Medications that can cause, contribute, or exacerbate insomnia
SSRIs
Steroids
Stimulants
Beta-agonists
Characteristics of Insomnia
Difficulty falling asleep
Frequent nocturnal awakenings
early-morning awakenings
may result in daytime impairments in concentration and school or work performance
Transient insomnia
lasts only a few days
Short-term insomnia
lasts less than 3 weeks
Chronic insomnia
lasts longer than 1 month
How to improve sleep hygiene
keep a regular sleep schedule
exercise frequently, but not less than 2 hours before bed
Avoid alcohol and stimulants in the late afternoon and evening
Maintain a comfortable sleeping environment that is dark, quiet, and free of intrusions
Avoid consuming large quantities of food or liquids immediately before bedtime
1st line treatment for insomnia
BDZs
BDZ adverse effects
residual sedation in waking hours
grogginess
psychomotor impairment
antidepressants used in insomnia treatment
trazodone amitriptyline mirtazapine nefaxadone doxepin Appealing because it can treat underlying depression as well (2 birds 1 stone)
Why are antidepressants unappealing in treating insomnia?
side effects!! (carry over sedation, grogginess, anticholinergic effects (drys up) and weight gain)
Ramelteon Mechanism
melatonin receptor agonist
Ramelteon adverse effects
fatigue, nausea, dizziness, drowsiness (wanted)
