Sleep Disturbance Flashcards
Insomnia definition
Problems in falling to sleep, quality of sleep, early wakening or maintaining sleep.
Short V long term insomnia
Short = less than 4 weeks of symptoms
Long = persistent, greater than 4 weeks.
(at least 3 days a week)
Primary insomnia
No comorbidity. Occurs for greater than 1 month
Secondary/Comorbid insomnia
Poor sleep occurs as a symptom of, or is associated with, other conditions. e.g. Sleep apnoea, restless leg syndrome, narcolepsy, depression, mania.
Drugs which can cause insomnia
alcohol, caffeine, nicotine, beta-blockers, CCB, SSRI, NSAIDs, thyroid hormone, lamotrigine, phenytoin.
Investigations for insomnia
Sleep diary, video recording of sleep, actigraphy, polysomnography
Treatment of insomnia
Education on sleep hygiene and regular exercise.
Physiological intervention e.g. IAPT CBT.
Not long term drug treatment!
Pharmacological treatment
Only for acute exacerbation! Hypnotic agents e.g Benzodiazepines. Melatonin if old patient.
Narcolepsy
Inability for normal sleep wake cycle resulting in excessive sleepiness, sleep paralysis, hallucinations and cataplexy (partial or total loss of muscle control)
