Sleep Disorders

Question 1

What are the different types of sleeping disorders

Answer 1

1) Transient insomnia
External factors such as noise, shift work, and jet lag
Rapidly eliminated hypnotic should be chosen, only 1-2 doses should be given

2) short-term insomnia
Emotional problem or serious medical illness
Hypnotic can be useful but should not be given for more than 3 weeks (Preferably only one week)

3) chronic insomnia
Normally has a cause such as anxiety, depression and alcohol/drug use
The underlying psychiatric complaint should be treated

Question 2

What pharmacological intervention is used for insomnia

Answer 2

There are two types of benzodiazepines
Long acting and short acting

Long acting:
Nitrazepam, diazepam and flurazepam
Higher hangover effects on the following day
Used for sleep maintenance has a longer half life

Short acting:
Loprazolam, lormetazepam and temazepam
Little or no hangover effect
Used for sleep onset- just get you to sleep
Higher chance of withdrawal symptoms

Question 3

What is meant by Z-hypnotics

Answer 3

Zolpidem and zopiclone

Works by increasing GABA and causes CNS depression

Dependency occurs within 3-14 days of use

Should be taken intermittently

Should be used for 4 weeks max

Question 4

What are some of the counselling points of Z- hypnotics

Answer 4

Benzodiazepine and z-drugs: avoid in the elderly due to risk of falls and injury

Paradoxical side effects can cause people to stay awake rather than helping them to fall asleep
Drowsiness
Dependence