Sleep disorders

Question 1

what are the different types of sleep disorders?

Answer 1

-transient
-short term
-chronic

Question 2

what is transient insomnia? and treatment

Answer 2

-due to external factors e.g. noise, shift work, jet lag
-rapidly eliminated hypnotic should be chosen only given 1 or 2 doses, should ideally start with OTC

Question 3

what is short term insomnia? and treatment?

Answer 3

-emotional problems or serious medical illnesses
-hypnotic can be useful but should not be given for more than 3 weeks (preferably 1 week as they can become dependant)

Question 4

what is chronic insomina?

Answer 4

normally has a cause like anxiety, depression, alcohol/drugs
-the underlying psychiatric complaint should be treated

Question 5

what are the 2 types of benzodiazepines?

Answer 5

-long and short acting

Question 6

what are long acting benzodiazepines?their use

Answer 6

-nitrazepam, diazepam and flurazepam
-used for sleep maintenance will keep them sedated over night
-higher hangover effect on the following day

Question 7

what are short acting benzodiazepines? their use?

Answer 7

-loprazolam, lormetazepam and temazepam
-used for sleep onset
-little to no hangover effect
-higher chance of withdrawal symptoms

Question 8

what are Z-hypnotics? their use?

Answer 8

examples zolpidem and zopiclone
-increases GABA leading to CNS depression
-dependency can occur so only use for 3-14 days
-should be taken intermittently
-should be used for 4 weeks max

Question 9

what are some side effects of Z-hypnotics?

Answer 9

benzos+ Z-drugs: avoid in elderly due to risk of falls and injury
-paradoxical side effects
-drowsiness
-dependance

Question 10

what other drugs can cause falls in the elderly?

Answer 10

-diuretics
-anti-hypertensives