Sleep Flashcards
(32 cards)
What is chronic insomnia?
- Having symtpoms (difficulty falling asleep, reduced sleep, poor sleep quailty) 3x a week for 3 months
What are some of the non drug treatments for insomnia?
- Cognitive Behavioral Therapy
- Treating any medical conditions that worsen insomnia (Pain, SOB in HF, Anxiety, Bipolar, Depression)
- DC’ing any medication that worsen insomnia
What are the cognitive behavorial therapies that help with insomnia?
- Keeping room dark, comfortable, quiet
- Keeping regular sleep schedule
- avoiding naps or limit to 30 mins
- Turn the face of clock (avoids any anxiety)
- If unable to sleep, get up and do something
- Pre-bedtime ritual
- Avoid exercise right before bed
- DO NOT eat heavy meals
- DO NOT consume caffiene in afternoon
What are some medications that can worsen insomnia?
- Acetylcholineesterase Inhibitors (Donepezil)
- Alochol
- Aripiprazole
- Atomoxetine
- Bupropion
- Caffeine
- Decongestants (Pseudoephedrine)
- Diuretices (because of peeing at night)
- Fluoxtine (if taken late in the day)
- Nicotine
- INSTIs
- Steriods
- Stimulants (Methylphenidate, Phentermine)
- Verenicline
What are some natural products that can help with insomnia?
- melatonin 1 - 5 mg in the evening
- Chamomile tea can calm you down before bed
- Valerain or Kava should NOT be used due to increased risk of Hepatotoxicity
What are some of the drug classes that are used for insomnia?
- Hypontics
- Orexin Receptor Antagonist
- Melatonin Receptor Agonist
- TCAs
- Benzos
- Antihistamines
What is the MOA for the Hypnotics used for insomnia?
- Act on Benzo receptors increasing GABA?
What are the Hypnotics that are used for insmonia?
- Eszoplicline (lunesta)
- Zolpidem (Ambian)
C-IV
What are the Warnings for Hypotics used in insmonia?
- Increased risk for CNS Depression
- Needs ~8 hours of sleep to avoid next day impairment
- Potential for abuse
What are the side effects for hypnoitcs used in insmonia?
- Somnolence, Dizziness, Ataxia, headache
What are the additional notes for hypnotics used in insmonia?
- Preferred over benzos
What is the MOA for the Orexin Receptor Antagonist?
- Blocks orexin neuropeptide signaling system = drowsiness
What are the orexin receptors antagonists that are used for insomnia?
- Daridorexant (Quviviq)
- Lemborrexant (DayVigo)
- Suvorexant (Belsomra)
What are the side effects for orexin receptor antagonist used in insmonia?
- Somnolence, headache, dizziness, abnormal dreams
What are theMOA for the melatonin receptor agonist
- Agonist for the melatonin receptors to help promote sleepiness
What are the melatonin receptor agonist that are used for Insomnia
- Remelteon (Rozerem)
- Tasiemelteon (hetlioz)
What are the side effects for melatonin receptor agonist used in insmonia?
- Somnolence, Dizziness
What are the additional notes for melatonin receptor agonist used in insmonia?
- Not a controlled substance
what is the MOA for the tricycle antidepressants that are used for insomnia?
- Blocks serotonin and norepi reuptake BUT it also blocks acetylcholine and histamine reupatke causing the sleepiness
What are the Tricycle antidepressants that are used for insomnia?
- Doexpin (Slienor)
What are the contraindications for tricyclie antidepressants used in insmonia?
- used within 2 weeks of an MAOi
What are the side effects for tricyclic antidepressants used in insmonia?
- Seizures, somnolence, anticholinerigic effects (blurred vision, constipation, urinary retention, dry mouth)
What is the MOA for the benzodiazepines used for insomnia?
- Enhacnes GABA = CNS depression
What are the benzodiazepines that are used for insomnia?
- Temazepem (Restoril)
- Estazolam
- Quazepam (Doral)
- Flurazepem
- Triazolam (Halcian)
C-IV
