Insomnia Flashcards
(41 cards)
When should caffeine, EtOH, heavy, spicy, or sugary foods be avoided prior to bed?
4 to 6 hrs
When should you avoid exercise prior to bed?
2 hrs
What are good pre-bed snacks?
Warm mild or bananas (tryptophan)
What is the max time you should allow yourself to fall asleep?
30 minutes
How long should you lay in bed if you wake up?
20 minutes
Who is most likely to succeed at suicide?
White males
Who is most likely to attempt suicide?
What females
Characteristics of an elderly person who might commit suicide?
Widows/widower Live alone Poor health perception Poor sleep Lack a confidante Stressful life event
What percent of patients see a PCP before suicide?
75%
What are not risk factors for suicide?
Ethnic minority
Poverty
SIG E CAPs
Need 5+ for 2 weeks
Sleep Interest Guilt Energy Concentration Appetite Psychomotor retardation Suicide ideation
When does bereavement become MDD?
2+ months is typical Red flags - Guilt - Thoughts of death - Feeling worthless - Functional impairment - Hallucinations
Risk factors for late life depression?
Female Isolation Widowed, divorced, or separated Low SES Poor health Pain Insomnia Functional impairment Cognitive impairment
How bad is depression on the elderly?
Increases disabilities by 70% in about 6 years
SAD PERSONS
Sex: Male
Age: 45
Depression
Previous Attempt EtOH or other substance Rational thinking: Impaired Social support: Lacking Organized plan No significant other Sickness
When is SAD PERSONS treated outpatient?
4 to 6
7+ = inpatient treatment
Does the USPSTF recommend depression screening for all adults?
Yes, especially people who are sick
Which tool is faster and more sensitive when screening for dementia?
Minicog (99% & 93%)
Most common SE of SSRI or SNRI?
Headache
Sleep disturbances
GI upset
Other SE of SSRI of SNRI?
SIADH -> Low Na+
Serotonin syndrome
GI bleeds
Special risk of SSRI or SNRI in elderly?
Falls
Lower bone density
What two SSRIs may prolong QT?
Citalopram and Escitalopram
How might a hispanic patient present with depression?
Somatic complaints > mood symptoms
Who has the lower rate of depression US born or immigrant hispanics?
Immigrants
