Week 5 - Insomnia, Drowsiness, Fatigue

Question 1

What are the 4 common causes of insomnia?

Answer 1

1. Pain
2. Frequent urination
3. Heartburn
4. Difficulty breathing

Question 2

What are 6 common medications that can produce insomnia?

Answer 2

1. Alcohol
2. Amphetamines
3. Anti-depressants
4. Caffeine
5. Corticosteroids
6. Nicotine

Question 3

What are 5 common medications that can produce withdrawal insomnia?

Answer 3

1. Alcohol
2. Antihistamines (1st generation)
3. Benzodiazepines
4. Opiates
5. Valerian

Question 4

Name 2 other types of medications that commonly cause insomnia

Answer 4

1. Stimulants
2. Sedatives when abruptly withdrawn

Question 5

What is the appropriate dose for diphenhydramine?

Answer 5

25-50mg 30 minutes before bedtime

Question 6

What is the appropriate dose for melatonin?

Answer 6

2-5mg two to three hours before bedtime for up to 8 weeks

Question 7

What is the appropriate dose for caffeine?

Answer 7

100-200mg every three to four hours as needed

Question 8

Common adverse effects of diphenhydramine

Answer 8

Daytime sedation, anticholinergic toxicity

Question 9

Common adverse effects of melatonin

Answer 9

Headache, dizziness, nausea, drowsiness

Question 10

Common adverse effects of valerian

Answer 10

Diarrhea, withdrawal effect if stopped abruptly

Question 11

Common adverse effects of caffeine

Answer 11

Interferes with sleep, causes transient increase in heart rate and blood pressure, high doses may cause agitation

Question 12

Contraindications of melatonin

Answer 12

Pregnancy, breast feeding mothers, women trying to get pregnant

Question 13

Contraindications of valerian

Answer 13

Pregnancy and lactation (insufficient evidence)

Question 14

Contraindications of caffeine

Answer 14

Monoamine oxidase inhibitor use, coronary artery disease, uncontrolled hypertension, preexisting arrythmias