MEDI7212 Lecture Notes - Lecture 51: Clonazepam, Estazolam, Zolpidem
Document Summary
Issues persist for at least 1 month: primary insomnia, unknown pathogenesis; possible state of hyperarousal (pet scan & measure adrenal hormones, 2-4% prevalence in adult population. Intrinsic sleep disorders: osa or central sleep apnoea, restless leg syndrome/ periodic limb movement disorder, extrinsic sleep disorders, psychophysiologic insomnia (due to conditioned arousal when in bedroom) Sleep: difficulty initiating sleep and/or staying asleep, early awakening, non restorative sleep, daytime consequences (daytime fatigue or sleepiness) Sleep wake schedule: precipitating events, progression, aggravating or alleviating factors, cognitive attitudes towards sleep, medical illness with nocturnal symptoms, psychiatric disorder, substance misuse or medication, treatment. Sleep hygiene/ stimulus control therapy refers to actions that tend to improve & maintain good sleep (behavioural treatment for insomnia) Sleep restriction therapy: decrease amount of time spent in bed to increase amount of time spent sleeping, keep waking time constant and bedtime later, with progressively earlier bedtimes as improvements show.
