Sleep / Wake Disorders

Question 1

What are the neurotransmitters involved in sleep disorders

Answer 1

• dopamine
• histamine
• norepi/epi/cortisol
• serotonin
• acetylcholine
• adenosine
• GABA

Question 2

What is the control center for sleep and wake

Answer 2

hypothalamus

Off = sleep; regulated by GABA

On = awake; regulated by histamine

Question 3

Explain the stages of sleep

Answer 3

Stage 1: NREM “drowsy period”

Stage 2: NREM increase sleep spindles

Stage 3: REM moderate to deep sleep (delta waves)

Stage 4: REM deepest level of sleep (slow wave sleep)

Stage 5: REM sleep (vivid generally dreaming occurs)

Question 4

What are the medications that help with sleep disorders

Answer 4

Non Benzodiazepines:

• zolpidem (Ambien); short acting or long acting
• Zaleplon (Sonata)
• Eszopiclone (Lunesta)

Benzos:

• Lorazepam 1-2mg
• Clonazepam 0.5-1mg
• Diazepam 5mg
• Alprazolam (Xanax) 0.25-0.5mg
• Triazolam* 0.125-0.25

Question 5

what are the over the counter drugs used for sleep

Answer 5

• antihistamines (benadryl)
• 5HTP
• melatonin
• tryptophan
• Valerian

Question 6

What are nursing interventions to teach the patient to promote sleep

Answer 6

• routine
• comfort items
• reduce stimuli
• deep breathing with relaxation
• reduce or eliminate racing repetitive thoughts, catastrophizing
• warm milk, avoid caffeine, spicy foods, computer use, TV