Sleep Disorders

Question 1

short term insomnia

Answer 1

<3 months

Question 2

treatment of short term insomnia

Answer 2

• sleep hygiene
• z-hypnotic
• melatonin
• sedating antihistamines
• benzodiazepines

Question 3

chronic insomnia

Answer 3

> 3 months

Question 4

treatment of chronic insomnia

Answer 4

Treat underlying cause (e.g. anxiety)
- do not prescribe hypnotics unless very short course for acute exacerbations

Question 5

examples of Z-drugs (hypnotics)

Answer 5

zolpidem, zopiclone

Question 6

Up to how long should Z-drugs be prescribed for?

Answer 6

Up to 4 weeks
- avoids tolerance

Question 7

Adverse effects of Z-drugs

Answer 7

• daytime sleepiness
• rebound insomnia (occurring when stopped)
• neurological effects- headache, confusion, nightmares

Question 8

Adverse effect specific to zopiclone?

Answer 8

taste disturbances
- Metallic or bitter taste
- staying hydrated or using mouthwash before bed

Question 9

What can be bought OTC for insomnia?

Answer 9

Anti-histamine promethazine (Phenergan) or diphenhydramine (Nytol)