thera final sleep disorders

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coal
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272869
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thera final sleep disorders
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2014-05-03 13:42:15
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thera final sleep disorders
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  1. criteria for diagnosis of a sleep disorder
    minimum of 1 month in duration
  2. transient insomnia
    several nights as a result of acute stressors
  3. short-term insomnia
    symptoms < 3 wks
  4. chronic insomnia
    symptoms > 1 month
  5. benzo's affect on insomnia
    • reducing the latency to sleep onset
    • increases total sleep time
  6. who should benzo not be prescribed for
    • sleep apnea
    • history or IV substance abuse
    • pregnancy (X)
  7. benzos for insomnia
    • temazepam - restoril     15-30mg
    • triazolam - halcion         0.125 - 0.25mg
  8. temazepam
    restoril
  9. triazolam
    halcion
  10. side effects of benzos
    • next day sedation
    • psychomotor incoordination
    • anterograde amnesia
    • rebound insomnia
  11. benzos CI with CYP 3A4 inhibitors
    • triazolam - halcion
    • estazolam - prosom
  12. benzos that have long half lives and increase next day sedation (avoid in elderly)
    • quazepam - doral 
    • flurazepam - dalmane
  13. benzo that higher rates of antegrade amnesia
    triazolam - halcion
  14. zolpidem's affects on insomnia
    • reduce time to fall asleep
    • reduce nocturnal awakenings
    • increase total sleep time
  15. zolpidem onset and duration
    • 30 minutes
    • duration 6-8 hrs
  16. zolpidem SE
    • sleep disorders
    •   eating
    •   walking
    •   sexual activity
  17. ambien dosing in women, elderly and men
    • women and elderly 5mg
    • men 10 mg
  18. ambien CR dosing
    • women and elderly 6.25
    • men 12.5 mg
  19. edluar
    zolpidem sublingual tablets
  20. intermezzo
    • zolpidem sublingual
    • FDA approval for middle of the night awakenings
  21. zaleplon
    sonata
  22. zaleplon affects on insomnia
    decrease time to sleep onset
  23. FDA approved drug for short term treatment of insomnia
    zaleplon - sonata
  24. zaleplon - sonata dosing
    • elderly 5 mg
    • nonelderly 10 mg
  25. FDA approved for long term treatment of insomina
    eszopiclone - lunesta
  26. eszopiclone
    lunesta
  27. eszopiclone - lunesta affects on insomnia
    • reduce time to sleep onset
    • reduce number of nocturnal awakenings
    • increases total sleep time
    • increases total sleep quality
  28. drug interaction with ramelteon
    fluvoxamine = increased ramelteon levels
  29. definition of sleep apnea
    cessation of airflow to the nose and mouth lasting at least 10 seconds

    obstructive & central
  30. definition of central sleep apnea
    repeated episodes of apnea caused by temporary loss of respiratory effort during somnolence
  31. Tx of central sleep apnea
    CPAP and oxygen
  32. Tx of obstructive sleep apnea
    • PAP - positive airway pressure
    • weight loss
    • surgery to open the upper airway
    • avoidance of CNS depressants
  33. narcolepsy tetrad
    • excessive daytime sleepiness
    • cataplexy
    • hypnagogic hallucinations
    • sleep paralysis
  34. definition of cataplexy
    episode of sudden bilateral loss of muscle tone
  35. definition of sleep paralysis
    episodic loss of voluntary muscle tone that occurs when the individual is falling asleep or awakening
  36. which sleep disorder do you recommend naps
    narcolepsy
  37. definition of narcolepsy
    excessive daytime sleepiness with sleep attacks that may last up to 30 minutes
  38. treatments for restless leg syndrome
    • ropinirole - requip 0.25 mg
    • pramipexole - Mirapex 0.125 mg
  39. alternative therapy for restless leg syndrome
    rotigotine patch - neupro

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