Insomnia Pharmaceutical Care

Question 1

What is insomnia?

Answer 1

Incapacity to sleep/ remain asleep for a reasonable period
Sleep must be disturbed at least 3x a week for 1 month

Question 2

What are the risk factors for insomnia?

Answer 2

Stress
Anxiety
Lifestyle
Nicotine
Alcohol
Weight
Diet
Non-relaxing environment

Question 3

What is diazepam?

Answer 3

Benzodiazepine
= GABAergic drug
= sedation

Question 4

What are the high risk patients taking diazepam?

Answer 4

Drives
Uses machinery
Elderly

Question 5

How should a benzodiazepine be prescribed for insomnia?

Answer 5

NOT 1st line
Short course = 3-7 days
NO repeated prescription = addiction
Lowest effective dose for shortest period

Question 6

What are some OTC for insomnia?

Answer 6

Promethazine hydrochloride = anti-histamines (1st generation) = sedation
Diphenhydramine
BUT 7 days MAX

Question 7

Who can take melatonin?

Answer 7

Over 50s

Question 8

What is sleep hygiene?

Answer 8

How you fall asleep
= temperature, noise level, clutter + brightness
= caffeine, nicotine + alcohol
= Tv, laptop
= avoid napping
= relaxation before bed

Question 9

Can nicotine patches cause sleep disturbances?

Answer 9

24hr patches can cause disturbances + nightmares

Question 10

What is the treatment for insomnia?
<3 months

Answer 10

Short course of non-benzodiazepine hypnotic drug
= lowest effective dose for shortest period possible
Sleep hygiene
CBT

Question 11

What is the treatment for insomnia?
>3 months

Answer 11

Referral to sleep clinic
Address any triggers or factors
Short course of hypnotic drug