How to Manage Insomnia with and without medications

Size: px
Start display at page:

Download "How to Manage Insomnia with and without medications"

Transcription

1 How to Manage Insomnia with and without medications Tatyana Gurvich, Pharm.D. USC School of Pharmacy UC Irvine SeniorHealth Center

2 Insomnia: How common is it? 26-50% of adult population complain of insomnia 50% of elderly patients living at home complain of insomnia 66% of institutionalized elderly complain of insomnia

3 Diagnostic criteria for insomnia: Difficulty initiating sleep Difficulty maintaining sleep Complaint of non-restorative sleep Associated daytime fatigue which leads to impairment of daily functioning

4 Diagnostic criteria for insomnia: cont Problems sleeping 3-7 times a week Waking up 3 or more times at night Taking 30min or more to fall asleep Feeling moderately or severely unrefreshed Complaint lasting at least one month

5 How much sleep does each person need every night? Does everyone need 8 hours of sleep per night? Do older adults need less sleep than an average younger adult? Everyone requires a different amount of sleep to function well during the day: 4-9 hrs.

6 Normal Stages of Sleep Stage I: Mental relaxation/eyes closing; 5-30min Stage II Disconnect from the outside world; can t hear noise; 50% of total sleep time Stage III-IV: Deep sleep: 15-20% III 20-50% delta waves/iv all delta waves REM sleep: dreaming

7 Stages of Sleep and Ageing Stage I: takes longer to fall asleep Stage II: Impaired. Easily awakened Stage III and IV: Shorter in older pts REM: Shorter in older pts.

8 Sleep and ageing Increased sleep latency More frequent awakenings Medical conditions which contribute to insomnia Pain Restless Leg Syndrome Sleep apnea Depression/Anxiety

9 NON-Drug Therapy is Effective Meta-analysis of 23 randomized trials of sleep hygiene education Increased sleep efficiency Improved sleep quality Decreased sleep latency Decreased wake up times

10 Principles of Good Sleep Hygiene Stick to a regular sleep schedule Exercise regularly EARLY during the day Schedule regular outdoor time Go to bed only when sleepy

11 Principles of Good Sleep Hygiene Put your worries away when you go to bed Do something relaxing Make sure your bedroom is quiet and comfortable

12 More Principles of Good Sleep Hygiene Avoid large meals before bedtime Eat a snack high in L-tryptophan or Melatonin before going to bed Foods rich in L-tryptophan Milk Turkey

13 Food Rich in Melatonin Oats Rice Sweet corn Cherries Banana Ginger Tomatoes Barley

14 Principles of Good sleep Hygiene No reading in bed No watching TV in bed Use the bedroom for sleep and sex only

15 Principles of Good Sleep Hygiene Don t toss and turn. If you can t fall asleep, get up and do something else. Return to bed only when sleepy. Remove clock from eyesight. Do not take long naps: Very disruptive to your circadian rhythm.

16 More about Good Sleep Hygiene Avoid alcohol, caffeine Review medications Anticonvulsants Diuretics Asthma medications Antidepressants Thyroid replacement Oral contraceptives Herbal supplements Antipsychotics Dementia medications Steroids Decongestants Appetite suppressants ADHD medications

17 Alcohol and Sleep Can be disruptive to sleep Having a night cap can help with falling asleep, but daily use will lead to disruptive, unpleasant sleep

18 Caffeine and Sleep Avoid caffeine containing foods Coffee Tea Soda Chocolate Energy drinks Vitamins Herbal products

19 Caffeine Content in Certain Products Coffee, brewed 8 oz. 133mg (range: mg) (16 oz. = 266 mg) Starbucks Brewed Coffee (Grande) 16 oz.320 mg Tea, brewed 8 oz.53mg (range: ) Starbucks Chai Tea Latte (Grande) 16 oz.100 mg Snapple, Lemon (and diet version) 16 oz.42 mg Diet Coke 12 oz.47mg (20 oz. 78mg) Pepsi 12 oz.38 mg (20 oz. 63 mg) Mountain Dew, regular or diet 12 oz.54 mg (20 oz. = 90 mg) Ben & Jerry's Coffee Heath Bar Crunch 8 oz. 84 mg Hot Cocoa 8 oz.9 mg (range: 3-13)

20 Beers Criteria Update on sedative-hypnotics AVOID anithistamines due to anticholinergic effects. Strength of recommendation: STRONG BZD: AVOID for treatment of insomnia, agitation or delirium. Strength of recommendation: STRONG NonBZD hypnotics: AVOID chronic use >90days

21 Over the Counter Medicines for Insomnia Diphenhydramine (Benadryl, Nytol, Sominex, Tylenol/Advil PM) Dose: mg Onset of effect: minutes Half life hrs Side effects: Dry mouth, Constipation, confusion, urinary retention, grogginess in the a.m. NOT RECOMMENDED IN THE ELDERLY

22 Over the Counter Medicines Doxylamine (Unisom) Dose 25 mg Onset of effect: 30 min minutes Half life 10 hrs Side effects: Dry mouth, Constipation, confusion, urinary retention, grogginess in the a.m. NOT RECOMMENDED IN THE ELDERLY

23 Herbal supplements used for insomnia Melatonin: Dose 2-5 mg. May be used for jetlag. Chamomile: Dose variable. Relaxing. Potential allergies. Valerian root: Dose variable. Similar in mechanism of action to BZD s

24 Prescription Medicines for Sleep Not a long term solution for insomnia Provide symptomatic relief only Can be effective long term only if NOT used every night Should only be used as a last resort

25 A meta analysis of risks and Benefits of insomnia medications 8 studies of 601 pts increase in sleep time was 25.2 min 8 studies of 524pts BZD vs placebo, increase in sleep time was 34.2 min 6 studies of 441 pts mean # of awakenings decreased by studies of 296 pts BZD vs placebo mean # of awakenings decreased by 0.60

26 A meta analysis of risks and Benefits of BZD s and BZD-like drugs NNT to show improvement in sleep quality was 13 (1,072pts) NNT to cause harm was 6 (2,200pts) Drowsiness, fatigue, headache, nightmares, nausea, loss of balance, dizziness, falling, MVA, broken bones, mental alertness in the am

27 Bezodiazepines (BZD) Effective after a single dose Can be habit forming Tolerance develops with chronic use Can be used for other indications: Anxiety Muscle relaxation Seizures

28 BZD s effect on Sleep architecture Decrease sleep latency Increase Stage II sleep Decrease Delta wave sleep Decrease REM sleep

29 Benzodiazepines Restoril (temazepam) Dose: mg Onset of effect: minutes T1/ hrs Duration of action 6-10 hrs Habit forming. Tolerance develops. Risk of falls, confusion.

30 Benzodiazepines Ativan (lorazepam) Dose: mg Onset of effect: minutes Half life 18hrs Habit forming. Tolerance develops. Risk of falls, confusion.

31 Benzodiazepines Halcion (tirazolam) Dose: mg Onset of effect: minutes Half life 1.5-5hrs Duration of action 2-5hrs Habit forming. Tolerance develops. Risk of falls, confusion.

32 Benzodiazepines Dalmane (flurazepam) Dose: mg Onset of effect: minutes Half life > 100 hrs Duration of action hrs Habit forming. Tolerance develops. Risk of falls, confusion, grogginess. Hangover effect DO NOT USE IN THE ELDERLY

33 Benzodiazepine-like medications May be habit forming Tolerance can still develop if used nightly Shorter duration of action More expensive Effective for sleep only

34 Benzodiazepine-like medications Ambien/Ambien CR (zolpidem) Dose: 5-10mg regular/sublingual tab 6.25/12.5 CR formulation 1.75/3.5mg sublingual low dose Lunesta (eszopiclone) Dose: 1-3 mg Sonata (zalepon) Dose: 5-20 mg

35 Benzodiazepine-like medications Half life in hrs hrs for zolpidem; hrs for Intermezzo 6hrs for Lunesta 1hr for Sonata

36 Benzodiazepine-like medications Duration of action: About 8hrs for most EXCEPT Intermezzo SL low dose: 4hrs Sonata 4hrs

37 FDA Zolpidem Safety communication 1/2013 Recommendation to lower dose Women 5mg/6.25mg Men consider prescribing lower doses Morning after impairment/difficulty driving/lack of mental alertness

38 Miscellaneous Agents Desyrel (Trazodone) Also used for depression May cause dizziness, priapism Dose may need to be increased to effect Not habit forming/no tolerance to dose Dose mg Onset of effect: minutes Duration of action 5-9hrs

39 Miscellaneous Agents Rozerem (Ramelteon) Not addicting Works like Melatonin Dose 8 mg Onset of effect 30 min Half life 1-2.6hr/2-5hrs metabolite Duration of action 8hrs

40 Miscellaneous Agents Remeron (Mirtazapine) Dose mg Onset of effect: unknown Half life20-40hrs Increases risk of RLS Used for depression induced insomnia

41 Miscellaneous Agents Doxepin (Silenor) Dose 3-6mg Half life 15hr/31hr for metabolite Duration of action 7-8hrs Does not improve sleep latency Sleep maintenance Increased by 52 min in week one and 63 min by week 4

42 What is the best way to handle insomnia? Limit daily caffeine Stay active Use some sleep hygiene techniques Medications should be used as a last resort! Remember, medications only work well if they are NOT used daily!

43 Wishing you a Good Night s Sleep

Insomnia treatment. Sleep hygiene education sleep hygiene teaches good sleeping habits. This includes:

Insomnia treatment. Sleep hygiene education sleep hygiene teaches good sleeping habits. This includes: Insomnia treatment INSOMNIA OVERVIEW insomnia is defined as difficulty falling asleep, difficulty staying asleep, or waking up early in the morning and not being able to return to sleep. In general, people

More information

Managing Insomnia Disorder A Review of the Research for Adults

Managing Insomnia Disorder A Review of the Research for Adults Managing Insomnia Disorder A Review of the Research for Adults e Is This Information Right for Me? This information is right for you if: Your health care professional said you have insomnia disorder (said

More information

Sleep and Parkinson's Disease

Sleep and Parkinson's Disease Parkinson s Disease Clinic and Research Center University of California, San Francisco 505 Parnassus Ave., Rm. 795-M, Box 0114 San Francisco, CA 94143-0114 (415) 476-9276 http://pdcenter.neurology.ucsf.edu

More information

Contents. Page. Can t sleep 3. Insomnia 4. Sleep 5. How long should we sleep? 8. Sleep problems 9. Getting a better night s sleep 11

Contents. Page. Can t sleep 3. Insomnia 4. Sleep 5. How long should we sleep? 8. Sleep problems 9. Getting a better night s sleep 11 I Cannot Sleep Contents Page Can t sleep 3 Insomnia 4 Sleep 5 How long should we sleep? 8 Sleep problems 9 Getting a better night s sleep 11 Treatment for insomnia 15 For more information 19 2 Can t sleep

More information

Sleeping Pills and Natural Sleep Aids

Sleeping Pills and Natural Sleep Aids Sleeping Pills and Natural Sleep Aids Prescription and Over-the-Counter Products It s the middle of the night, and you re staring at the ceiling, thinking about work, or bills, or the kids. Sleep just

More information

Insomnia % of adults suffer from chronic and severe insomnia (Complaints of insomnia with daytime consequences)

Insomnia % of adults suffer from chronic and severe insomnia (Complaints of insomnia with daytime consequences) 10-15% of adults suffer from chronic and severe insomnia (Complaints of insomnia with daytime consequences) 30 40% of adults complain of insomnia symptoms only 95% experience insomnia at some time in their

More information

Pharmacological Help for a Good Night s s Sleep. Thomas Owens, MD

Pharmacological Help for a Good Night s s Sleep. Thomas Owens, MD Pharmacological Help for a Good Night s s Sleep Thomas Owens, MD Objectives 1. Define insomnia and characterize the symptoms and array of causes. 2. Describe traditional and new pharmacologic approaches

More information

Available Strengths Limits. 200 mg tablets PA. 50 mg, 150 mg, 200 mg, 250 mg tablets. 500 mg/ml solution PA

Available Strengths Limits. 200 mg tablets PA. 50 mg, 150 mg, 200 mg, 250 mg tablets. 500 mg/ml solution PA MEDICATION COVERAGE POLICY PHARMACY AND THERAPEUTICS ADVISORY COMMITTEE POLICY Sleeping Disorders P&T DATE: 12/14/2016 THERAPEUTIC CLASS Psychiatric Disorders REVIEW HISTORY: 2/16, 5/15, 2/12 LOB AFFECTED

More information

Ambien vs Rozerem There are people out there who have trouble falling asleep at night. Â Often, this would be considered as a disease that

Ambien vs Rozerem There are people out there who have trouble falling asleep at night. Â Often, this would be considered as a disease that 22-10-2013 Ambien vs Rozerem There are people out there who have trouble falling asleep at night. Â Often, this would be considered as a disease that can be treated with Ambien vs Rozerem. Ambien:. Ramelteon

More information

AGING CHANGES IN SLEEP

AGING CHANGES IN SLEEP OBJECTIVES: Understand the common age-related changes in sleep Discuss the evaluation of the older person with sleep complaints Identify sleep apnea, PLMS, RLS, and REM sleep disorders and their treatments

More information

Sleep Science: better sleep for you and your patients CHUNBAI ZHANG, MD MPH UW MEDICINE VALLEY MEDICAL CENTER

Sleep Science: better sleep for you and your patients CHUNBAI ZHANG, MD MPH UW MEDICINE VALLEY MEDICAL CENTER Sleep Science: better sleep for you and your patients CHUNBAI ZHANG, MD MPH UW MEDICINE VALLEY MEDICAL CENTER Disclosure: Financial - none Non-Financial - none Selected Topics Sleep epidemiology Sleep

More information

The most common problem in young people with insomnia is difficulty falling asleep (sleep-onset insomnia). An insomniac may also experience:

The most common problem in young people with insomnia is difficulty falling asleep (sleep-onset insomnia). An insomniac may also experience: Insomnia Introduction Insomnia is a difficulty getting to sleep or staying asleep for long enough for long enough to feel satisfied and refreshed the next day. It is reckoned that one in three people suffer

More information

Insomnia. F r e q u e n t l y A s k e d Q u e s t i o n s

Insomnia. F r e q u e n t l y A s k e d Q u e s t i o n s Insomnia Q: What is insomnia? A: Insomnia is a common sleep disorder. If you have insomnia, you may: Lie awake for a long time and have trouble falling asleep Wake up a lot and have trouble returning to

More information

Sleep This factsheet is available in a downloadable PDF here. Table of Contents Introduction Insomnia How Long does Insomnia Last? How much Sleep should You get? Symptoms of Insomnia Causes of Insomnia

More information

Dr Alex Bartle. Sleep Well Clinic

Dr Alex Bartle. Sleep Well Clinic Dr Alex Bartle Sleep Well Clinic Overview of Sleep Disorders Sleep: Why bother. Effect of Poor Quality or reduced Quantity of Sleep Common Sleep Disorders Management of Insomnia Medication vs CBTi Conclusion

More information

Sleep and Ageing. Siobhan Banks PhD. Body and Brain at Work, Centre for Sleep Research University of South Australia

Sleep and Ageing. Siobhan Banks PhD. Body and Brain at Work, Centre for Sleep Research University of South Australia Sleep and Ageing Siobhan Banks PhD Body and Brain at Work, Centre for Sleep Research University of South Australia Health and Active Ageing, 22 nd September 2015 Sleep and Aging How does sleep change as

More information

CPT David Shaha, MC US Army

CPT David Shaha, MC US Army CPT David Shaha, MC US Army None Thoughts and comments are my own and do not represent the official policy of the Department of the Army, Department of Defense, or United States Government. Clinical Case

More information

TEST BANK FOR GERONTOLOGICAL NURSING 3RD EDITION BY TABLOSKI Chapter 08

TEST BANK FOR GERONTOLOGICAL NURSING 3RD EDITION BY TABLOSKI Chapter 08 Link full download: http://testbankair.com/download/test-bank-forgerontological-nursing-3rd-edition-by-tabloski/ TEST BANK FOR GERONTOLOGICAL NURSING 3RD EDITION BY TABLOSKI Chapter 08 View Sample Question

More information

INSOMNIA IN THE GERIATRIC POPULATION. Shannon Bush, MS4

INSOMNIA IN THE GERIATRIC POPULATION. Shannon Bush, MS4 INSOMNIA IN THE GERIATRIC POPULATION Shannon Bush, MS4 CHANGES IN SLEEP ARCHITECTURE 2 Reduction in slow wave sleep (stage 3 and 4) Increase in lighter stages of sleep (stage 1 and 2) Decrease in REM sleep

More information

Insomnia: Updates in Medical Management. Michael Newnam M.D.

Insomnia: Updates in Medical Management. Michael Newnam M.D. Insomnia: Updates in Medical Management Michael Newnam M.D. Sleep Neurobiology Delicate balance of excitatory and inhibitory neurotransmitters that control the switch between wakefulness and sleep Circadian

More information

Question #1. Disclosures. CAPA 2015 Annual Conference. All of the following occur as we get older EXCEPT: Evaluating Patients with Insomnia

Question #1. Disclosures. CAPA 2015 Annual Conference. All of the following occur as we get older EXCEPT: Evaluating Patients with Insomnia Evaluating Patients with Roger D. Seheult, M.D. Pulmonary Critical Care Physician - Beaver Medical Group, Redlands California Assistant Clinical Professor of Medicine - Loma Linda University School of

More information

Facts about Sleep. Circadian rhythms are important in determining human sleep patterns/ sleep-waking cycle

Facts about Sleep. Circadian rhythms are important in determining human sleep patterns/ sleep-waking cycle Sleep Sleep is described as a state of unconsciousness or partial consciousness from which a person can be roused by stimulation Period of rest and recovery People spend about a third of their lives sleeping

More information

Comparison of Insomnia Treatments

Comparison of Insomnia Treatments PL Detail-Document #280504 This PL Detail-Document gives subscribers additional insight related to the Recommendations published in PHARMACIST S LETTER / PRESCRIBER S LETTER May 2012 Comparison of Insomnia

More information

Healthy Habits for Sleeping

Healthy Habits for Sleeping Healthy Habits for Sleeping Depression often causes a disruption in sleep patterns. Poor sleep contributes to daytime fatigue, low energy, irritability, decreased concentration and increased depression.

More information

Insomnia Agents (Sherwood Employer Group)

Insomnia Agents (Sherwood Employer Group) Insomnia Agents (Sherwood Employer Group) BCBSKS will review Prior Authorization requests Prior Authorization Form: https://www.bcbsks.com/customerservice/forms/pdf/priorauth-6058ks-st-ippi.pdf Link to

More information

RECIPES FOR A GOOD NIGHT S SLEEP

RECIPES FOR A GOOD NIGHT S SLEEP RECIPES FOR A GOOD NIGHT S SLEEP Maribeth Gallagher, PMHNP-BC, MS Hospice of the Valley Objectives: Describe the most common changes in sleep that occur in older adults. Discuss the possible negative effects

More information

The Medical Letter. on Drugs and Therapeutics. Usual Adult Hypnotic Dose 1,2 Some Adverse Effects Comments Cost 3

The Medical Letter. on Drugs and Therapeutics. Usual Adult Hypnotic Dose 1,2 Some Adverse Effects Comments Cost 3 The Medical Letter publications are protected by US and international copyright laws. Forwarding, copying or any other distribution of this material is strictly prohibited. For further information call:

More information

WHY CAN T I SLEEP? Deepti Chandran, MD

WHY CAN T I SLEEP? Deepti Chandran, MD WHY CAN T I SLEEP? Deepti Chandran, MD Sleep and Aging How does sleep change as we age? Do we need less sleep as we get older? Can a person expect to experience more sleep problems or have a sleep disorder

More information

Insomnia treatment in primary care

Insomnia treatment in primary care Insomnia treatment in primary care Daniel J. Buysse, MD UPMC Professor of Sleep Medicine Professor of Psychiatry and Clinical and Translational Science University of Pittsburgh School of Medicine buyssedj@upmc.edu

More information

Sleep and Traumatic Brain Injury (TBI)

Sleep and Traumatic Brain Injury (TBI) Sleep and Traumatic Brain Injury (TBI) A resource for individuals with traumatic brain injury and their supporters This presentation is based on TBI Model Systems research and was developed with support

More information

A Good Night s Sleep Participant s Guide

A Good Night s Sleep Participant s Guide FCD 08-002 September 2007 A Good Night s Sleep Participant s Guide "Sleep is better than medicine." --- English Proverb "The beginning of health is sleep." --- Irish Proverb "Disease and sleep keep far

More information

YOU REALLY NEED TO SLEEP: Several methods to improve your sleep

YOU REALLY NEED TO SLEEP: Several methods to improve your sleep YOU REALLY NEED TO SLEEP: Several methods to improve your sleep Sleep is essential to our well-being. When humans fail to get good sleep over a period of time, numerous problems can occur. CAN T SLEEP!!

More information

DRUGS THAT ACT IN THE CNS

DRUGS THAT ACT IN THE CNS DRUGS THAT ACT IN THE CNS Anxiolytic and Hypnotic Drugs Dr Karamallah S. Mahmood PhD Clinical Pharmacology 1 OTHER ANXIOLYTIC AGENTS/ A. Antidepressants Many antidepressants are effective in the treatment

More information

Many people with physical

Many people with physical FACTSHEET How to Sleep Better Many people with physical disabilities suffer from sleep disturbances, and sleep tends to become more disrupted as we get older. Not sleeping well can negatively impact your

More information

Beyond Sleep Hygiene: Behavioral Approaches to Insomnia

Beyond Sleep Hygiene: Behavioral Approaches to Insomnia Beyond Sleep Hygiene: Behavioral Approaches to Insomnia Rocky Garrison, PhD, CBSM Damon Michael Williams, RN, PMHNP-BC In House Counseling Laughing Heart LLC 10201 SE Main St. 12 SE 14 th Ave. Suite 10

More information

Addressing the Multiple Causes and Lifestyle Impacts of Insomnia: A Guide for Patient Counseling

Addressing the Multiple Causes and Lifestyle Impacts of Insomnia: A Guide for Patient Counseling Addressing the Multiple Causes and Lifestyle Impacts of Insomnia: A Guide for Patient Counseling Educational Objectives: At the completion of this knowledge-based activity, participants will be able to:

More information

HEALTH 3--DEPRESSION, SLEEP, AND HEALTH GOALS FOR LEADERS. To educate participants regarding the sleep wake cycle.

HEALTH 3--DEPRESSION, SLEEP, AND HEALTH GOALS FOR LEADERS. To educate participants regarding the sleep wake cycle. HEALTH 3--DEPRESSION, SLEEP, AND HEALTH GOALS FOR LEADERS Talk about the relationship between depression, sleep, and health problems. To educate participants regarding the sleep wake cycle. To provide

More information

Earl J. Soileau, MD, FSAHM Asst Professor, Family Medicine LSU HSC Medical School New Orleans at Lake Charles

Earl J. Soileau, MD, FSAHM Asst Professor, Family Medicine LSU HSC Medical School New Orleans at Lake Charles Earl J. Soileau, MD, FSAHM Asst Professor, Family Medicine LSU HSC Medical School New Orleans at Lake Charles Sleep Disorders Restless Legs Syndrome (RLS) and Periodic Limb Movement Disorder (PLMD) Sleep

More information

Insomnia. Dr Terri Henderson MBChB FCPsych

Insomnia. Dr Terri Henderson MBChB FCPsych Insomnia Dr Terri Henderson MBChB FCPsych Plan Basics of insomnia Pharmacology Medication CBT Details of insomnia Unsatisfactory sleep that impairs daytime well-being Starts with specific problem or change

More information

Healthy Sleep Tips Along the Way!

Healthy Sleep Tips Along the Way! Women and Sleep What You Will Learn The Benefits and Importance of Sleep States and Stages of the Sleep Cycle Unique Physiology of Women s Sleep Common Disorders in Women that Affect Sleep Women s Role

More information

Guideline for Adult Insomnia

Guideline for Adult Insomnia Guideline for Adult Insomnia Exclusions This guideline does not apply to: Children under the age of 18 Pregnant and lactating women Geriatric patients: While the general principles of the diagnosis and

More information

A good night s sleep

A good night s sleep A good night s sleep Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit www.uhb.nhs.uk/patient-information-leaflets.htm A good night

More information

TOP 10 LIST OF SLEEP QUESTIONS. Kenneth C. Sassower, MD Sleep Disorders Unit Massachusetts General Hospital for Children

TOP 10 LIST OF SLEEP QUESTIONS. Kenneth C. Sassower, MD Sleep Disorders Unit Massachusetts General Hospital for Children TOP 10 LIST OF SLEEP QUESTIONS Kenneth C. Sassower, MD Sleep Disorders Unit Massachusetts General Hospital for Children QUESTION #1: ARE SLEEP ISSUES IN CHILDREN THE SAME AS IN ADULTS? Distinctive Features

More information

Insomnia. Learning Objectives. Disclosure 6/7/11. Research funding: NIH, Respironics, Embla Consulting: Elsevier

Insomnia. Learning Objectives. Disclosure 6/7/11. Research funding: NIH, Respironics, Embla Consulting: Elsevier Insomnia Teofilo Lee-Chiong MD Professor of Medicine National Jewish Health University of Colorado Denver School of Medicine Learning Objectives Learn about the causes of transient and chronic Learn how

More information

Module 04: Sleep. Module 04:

Module 04: Sleep. Module 04: Module 04: Sleep Module 04: Sleep Module 04: SLEEP This module includes the following sections: Key Messages Common Sleep Challenges Medications and Sleep Tips from Families for Getting a Good Night s

More information

HealthyLife. SleepWell. For a Good Night s Sleep and Daytime Energy. Do Not Reproduce

HealthyLife. SleepWell. For a Good Night s Sleep and Daytime Energy. Do Not Reproduce HealthyLife SleepWell For a Good Night s Sleep and Daytime Energy Do Not Reproduce Why You Need Sleep Getting enough sleep and good quality sleep helps you maintain good health and function your best during

More information

Sleep & Relaxation. Session 1 Understanding Insomnia Sleep improvement techniques Try a new technique

Sleep & Relaxation. Session 1 Understanding Insomnia Sleep improvement techniques Try a new technique Sleep & Relaxation Sleep & Relaxation Session 1 Understanding Insomnia Sleep improvement techniques Try a new technique Session 2 Dealing with unhelpful thoughts Putting these techniques together for better

More information

HOW TO DEAL WITH SLEEP PROBLEMS

HOW TO DEAL WITH SLEEP PROBLEMS The Handbook on Successful Ageing HOW TO DEAL WITH SLEEP PROBLEMS Up to 50% of the elderly complain of insomnia, but although such complaints are prevalent and are often accompanied by higher rates of

More information

Sleep History Questionnaire

Sleep History Questionnaire Location South Loop Katy Steeplechase Fort Bend NAME ADDRESS PHONE SEX DOB AGE HEIGHT WEIGHT NECK COLLAR SIZE (inches) Do you have difficulty falling asleep? Is your sleep restless or disturbed? Do you

More information

3/24/2016 DISCLOSURE STATEMENT PHARMACIST OBJECTIVES OVERVIEW TECHNICIAN OBJECTIVES PREVALENCE OF INSOMNIA THE WRONG SIDE OF THE BED: CHRONIC INSOMNIA

3/24/2016 DISCLOSURE STATEMENT PHARMACIST OBJECTIVES OVERVIEW TECHNICIAN OBJECTIVES PREVALENCE OF INSOMNIA THE WRONG SIDE OF THE BED: CHRONIC INSOMNIA DISCLOSURE STATEMENT I do not have any actual or potential conflict of interest in relation to this presentation THE WRONG SIDE OF THE BED: CHRONIC INSOMNIA DANIELLE ROWAN, PHARMD, MBA PGY1 PHARMACY PRACTICE

More information

The Reasons for Insomnia and the Ways to Fight It

The Reasons for Insomnia and the Ways to Fight It The Reasons for Insomnia and the Ways to Fight It Insomnia is a relatively common sleep disorder, which is indicated by insufficient duration or unsatisfactory quality of sleep over an extended period.

More information

continuing education for pharmacists

continuing education for pharmacists continuing education for pharmacists General Insomnia Disorder in Adults and Treatment Guidelines Amanda R. Kriesen, R.Ph., PharmD Volume XXXV, No. 9 Dr. Amanda Kriesen has no relevant financial relationships

More information

Modern Management of Sleep Disorders. If Only I Could Sleep Like I Did Before

Modern Management of Sleep Disorders. If Only I Could Sleep Like I Did Before Modern Management of Sleep Disorders Douglas C. Bauer, MD University of California, San Francisco No Disclosures If Only I Could Sleep Like I Did Before Sleep Case 52 yr. old WF with >4 yr. of poor sleep

More information

SLEEP DISORDERS. Kenneth C. Sassower, MD Division of Sleep Medicine; Department of Neurology Massachusetts General Hospital for Children

SLEEP DISORDERS. Kenneth C. Sassower, MD Division of Sleep Medicine; Department of Neurology Massachusetts General Hospital for Children SLEEP DISORDERS Kenneth C. Sassower, MD Division of Sleep Medicine; Department of Neurology Massachusetts General Hospital for Children Distinctive Features of Pediatric Sleep Daytime sleepiness uncommon

More information

Learning Objectives. Management of Insomnia. Impact of Chronic Insomnia. Insomnia: Definitions. Measurement of Goals. Goals of Therapy 9/29/2017

Learning Objectives. Management of Insomnia. Impact of Chronic Insomnia. Insomnia: Definitions. Measurement of Goals. Goals of Therapy 9/29/2017 Learning Objectives Characterize insomnia and its negative effects Management of Insomnia Discuss the goals of treatment Summarize guidelines of management of insomnia including non-pharmacologic and pharmacologic

More information

SLEEP QUESTIONNAIRE. Please briefly describe your sleep or sleep problem:

SLEEP QUESTIONNAIRE. Please briefly describe your sleep or sleep problem: SLEEP QUESTIONNAIRE Your answers to the following questions will help us to obtain a better understanding of your sleep problems. Please answer every question to the best of your ability. It is helpful

More information

CBT for Insomnia: Past, Present, and Future Directions

CBT for Insomnia: Past, Present, and Future Directions CBT for Insomnia: Past, Present, and Future Directions J. Todd Arnedt, Ph.D. Associate Professor of Psychiatry and Neurology Director, Behavioral Sleep Medicine Program Acting Director, Sleep and Circadian

More information

Sleep Healthy, Live Healthy By: Gary E. Foresman, MD

Sleep Healthy, Live Healthy By: Gary E. Foresman, MD Sleep Healthy, Live Healthy By: Gary E. Foresman, MD That dreaded statement, usually uttered at the end of the office visit with your doctor, I can t get to sleep at all said in half query and half acceptance.

More information

Self care information on insomnia

Self care information on insomnia Self care information on insomnia 2 What is insomnia? Insomnia means poor sleep. It is defined as: Difficulty in getting to sleep Difficulty staying asleep Waking up too early Not feeling refreshed after

More information

Insomnia: habits, help, and hazards

Insomnia: habits, help, and hazards Insomnia: habits, help, and hazards Balanced data about medications www.rxfacts.org Copyright 2010 by The Alosa Foundation www.rxfacts.org November 2010 2 www.rxfacts.org Author: Leslie Jackowski, B.Sc.,

More information

Improving Sleep: Promoting Sleep Hygiene Techniques

Improving Sleep: Promoting Sleep Hygiene Techniques University of Vermont ScholarWorks @ UVM Family Medicine Clerkship Student Projects College of Medicine 2018 Improving Sleep: Promoting Sleep Hygiene Techniques Katherine Clifford University of Vermont

More information

Sleep Issues for Adults with ADHD. Robert Myers, PhD Clinical Psychologist Associate Clinical Professor, Psychiatry & Human Behavior

Sleep Issues for Adults with ADHD. Robert Myers, PhD Clinical Psychologist Associate Clinical Professor, Psychiatry & Human Behavior Sleep Issues for Adults with ADHD Robert Myers, PhD Clinical Psychologist Associate Clinical Professor, Psychiatry & Human Behavior Sleep Disorders are Prevalent in ADHD 30% in children 60% to 80% in adults

More information

Insomnia Restoring Restful Sleep

Insomnia Restoring Restful Sleep Insomnia Restoring Restful Sleep written by Harvard Medical School www.patientedu.org Nearly everyone has spent at least one night lying in bed wishing for sleep. But for many people, it s a nightly struggle.

More information

6/3/2015. Insomnia An Integrative Approach. Objectives. Why An Integrative Approach? Integrative Model. Definition. Short-term Insomnia

6/3/2015. Insomnia An Integrative Approach. Objectives. Why An Integrative Approach? Integrative Model. Definition. Short-term Insomnia Insomnia An Integrative Approach Jeffrey S. Jump, M.D. Medical Director CHI Memorial Integrative Medicine Associates Objectives Understand the importance of sleep to health Identify patients with insomnia

More information

Temazepam 30 mg sleeping pills

Temazepam 30 mg sleeping pills Temazepam 30 mg sleeping pills The sedative effects of temazepam may last longer in older adults. Accidental falls are common in elderly patients who take benzodiazepines. Use caution to avoid falling

More information

Sleep History Questionnaire

Sleep History Questionnaire Sleep History Questionnaire Name: DOB: Phone: Date of Consultation: Consultation is requested by: Primary care provider: _ Preferred pharmacy: Chief complaint: Please tell us why you are here: How long

More information

Article printed from

Article printed from What Are Sleep Disorders? Sleep disorders are conditions that affect how much and how well you sleep. The causes range from poor habits that keep you awake to medical problems that disrupt your sleep cycle.

More information

Sleep hygiene. Turnberg Building Department of Respiratory Medicine University Teaching Trust

Sleep hygiene. Turnberg Building Department of Respiratory Medicine University Teaching Trust University Teaching Trust Sleep hygiene Turnberg Building Department of Respiratory Medicine 0161 206 3158 All Rights Reserved 2016. Document for issue as handout. Nothing is more frustrating than not

More information

Self-care information on insomnia

Self-care information on insomnia Self-care information on insomnia 2 What is insomnia? Insomnia means poor sleep. It is defined as: Difficulty in getting to sleep Difficulty staying asleep Waking up too early Not feeling refreshed after

More information

SLEEP-WAKE DISORDERS: INSOMNIA. Prof. Paz Gía-Portilla

SLEEP-WAKE DISORDERS: INSOMNIA. Prof. Paz Gía-Portilla SLEEP-WAKE DISORDERS: INSOMNIA Prof. Paz Gía-Portilla SLEEP-WAKE DISORDERS AND ICD-10 Chapter V: Mental and Behavioural Disorders F51. Non-organic sleep disorders Chapter VI: Nervous System Illnesses G47.

More information

Sedative/Hypnotic Agents. Sedative/Hypnotic Agents. Central Nervous System Depressants. Sedative/Hypnotic Agents(cont d) Sleep

Sedative/Hypnotic Agents. Sedative/Hypnotic Agents. Central Nervous System Depressants. Sedative/Hypnotic Agents(cont d) Sleep Central Nervous System Depressants Sedative Drugs that have an inhibitory effect on the CNS to the degree that they reduce: Nervousness, excitability, irritability Without causing sleep Hypnotics Calm

More information

Can you take ambien with doxepin

Can you take ambien with doxepin Can you take ambien with doxepin Any Bad Experiences with Taking Ambien and Doxepin : I have been taking these 2 meds along with a great deal of others. I am taking these meds for my 19-2-2018 Can you

More information

Dr Alex Bartle. Director Sleep Well Clinic

Dr Alex Bartle. Director Sleep Well Clinic Dr Alex Bartle Director Sleep Well Clinic 1 Fatigue in the Workforce The structure of sleep Fatigue and sleep Consequences of fatigue Management of Shiftwork Conclusion Sleep Architecture REM NREM Rapid

More information

Not Sleepy HO Q1 D2 Q3 Q4 ]5 D6 j7 Q8 Q9 Q10 Extremely Sleepy

Not Sleepy HO Q1 D2 Q3 Q4 ]5 D6 j7 Q8 Q9 Q10 Extremely Sleepy Health Benefits Employee Services HBE Preventive Health - Sleep Assessment Form Please bring your completed assessment form to your appointment. To schedule an appointment please call 505 844-HBES (4237).

More information

Pediatric Sleep History

Pediatric Sleep History Fax 423-431-2983 Pediatric Sleep History Patient/ Child s Name: Date of Birth: Parent Name: Last 4 of Social Security No: Gender: Male Female Height: Weight: Age: Race: Street Address: City: State: Zip:

More information

Sleep and Insomnia 2/8/2018. Presented by. Marie Rataj, MSN, APRN, ANP. Objectives. Everything you wanted to know

Sleep and Insomnia 2/8/2018. Presented by. Marie Rataj, MSN, APRN, ANP. Objectives. Everything you wanted to know Sleep and Insomnia Everything you wanted to know Presented by Marie Rataj, MSN, APRN, ANP Objectives Develop a basic knowledge of normal sleep and differentiate from abnormal sleep Develop basic understanding

More information

Treating Insomnia in Primary Care. Judith R. Davidson Ph.D., C. Psych. Kingston Family Health Team

Treating Insomnia in Primary Care. Judith R. Davidson Ph.D., C. Psych. Kingston Family Health Team Treating Insomnia in Primary Care Judith R. Davidson Ph.D., C. Psych. Kingston Family Health Team jdavidson@kfhn.net Disclosure statement Nothing to disclose A ruffled mind makes a restless pillow. ~ Charlotte

More information

The Wellbeing Plus Course

The Wellbeing Plus Course The Wellbeing Plus Course Resource: Good Sleep Guide The Wellbeing Plus Course was written by Professor Nick Titov and Dr Blake Dear The development of the Wellbeing Plus Course was funded by a research

More information

Session 5. Bedtime Relaxation Techniques and Lifestyle Practices for Improving Sleep

Session 5. Bedtime Relaxation Techniques and Lifestyle Practices for Improving Sleep Session 5 Bedtime Relaxation Techniques and Lifestyle Practices for Improving Sleep Lesson 1: Relaxation Techniques at Night and Lifestyle Practices That Improve Sleep Using Relaxation Techniques to Aid

More information

Karen s Ultimate Guide to a Solid Nights Sleep

Karen s Ultimate Guide to a Solid Nights Sleep Karen s Ultimate Guide to a Solid Nights Sleep Insomnia has reached epidemic proportions. It s estimated to be the #1 health-related problem in America. More than 1/3 of Americans have trouble sleeping

More information

Anxiolytic and Hypnotic drugs

Anxiolytic and Hypnotic drugs Anxiolytic and Hypnotic drugs Anxiolytic and Hypnotic drugs Anxiety is unpleasant state of tension and fear that seems to arise from unknown source. The symptoms of severe anxiety are similar to those

More information

Treatments for Alzheimer s Disease A Quick Guide for Patients and Caregivers

Treatments for Alzheimer s Disease A Quick Guide for Patients and Caregivers Treatments for Alzheimer s Disease A Quick Guide for Patients and Caregivers By Kelsey F. Lee, PharmD candidate 2011 Preceptor: Demetra Antimisiaris, PharmD University of Louisvlle Dept. Family Medicine

More information

MANAGING SLEEP IN OLDER ADULTS

MANAGING SLEEP IN OLDER ADULTS MANAGING SLEEP IN OLDER ADULTS INFORMATION FOR OLDER ADULTS, FAMILIES, AND CAREGIVERS READ THIS PAMPHLET TO LEARN: What Causes Sleeping Problems in Older Adults. About Types of Sleeping Problems and Disorders.

More information

SLEEP DISORDERS

SLEEP DISORDERS SLEEP DISORDERS 17.03.2013 Well this is a problem that is close to my heart, because for most of my life I have had problems sleeping. Many nights I have watched with envy as my husband goes to bed and

More information

OBJECTIVES. The psychiatric, medical, and neurologic causes of sleep problems. Office-based and objective methods of evaluating sleep

OBJECTIVES. The psychiatric, medical, and neurologic causes of sleep problems. Office-based and objective methods of evaluating sleep SLEEP ISSUES 1 OBJECTIVES 2 Know and understand: Age-related changes in sleep The psychiatric, medical, and neurologic causes of sleep problems Office-based and objective methods of evaluating sleep Appropriate

More information

Modern Management of Sleep Disorders

Modern Management of Sleep Disorders Modern Management of Sleep Disorders Douglas C. Bauer, MD University of California, San Francisco No Disclosures Case 68 yr. old WF with >15 yr. of poor sleep Difficulty with both initiation and maintenance

More information

Reduction in the Use of Night Sedation to Reduce the Risk of Falls

Reduction in the Use of Night Sedation to Reduce the Risk of Falls Reduction in the Use of Night Sedation to Reduce the Risk of Falls Ms Margaret Hargraves Hospital Pharmacist Prince of Wales Hospital South Eastern Sydney Illawarra Area Health Service Objectives Falls

More information

Achieving better sleep

Achieving better sleep Achieving better sleep A patient s guide 1 Sleep problems are common and affect a large proportion of people at some time in their lives. One question often asked is How much sleep do I need? for which

More information

Insomnia. St. Joseph s Annual Family Practice Refresher March 1, Robert J. Ostrander, M.D

Insomnia. St. Joseph s Annual Family Practice Refresher March 1, Robert J. Ostrander, M.D St. Joseph s Annual Family Practice Refresher March 1, 2018 Robert J. Ostrander, M.D If in bed I say, When shall I arise? then the night drags on; I am filled with restlessness until the dawn. Job 7:4

More information

INSOMNIA SELF-CARE GUIDE

INSOMNIA SELF-CARE GUIDE INSOMNIA SELF-CARE GUIE All of us have trouble sleeping from time to time. This is perfectly normal. Sleep problems (also known as insomnia) are often triggered by sudden life changes that lead to increased

More information

Sleep Symptoms & History

Sleep Symptoms & History Sleep Symptoms & History In your own words, please tell us what brings you to the sleep clinic today? How long have you been experiencing your sleep problems? yrs. mos. To give us a precise understanding

More information

Let s Sleep On It. Session Overview. Let s Sleep On It. Welcome and Introductions Presenter: Rita Piper, VP of Wellness

Let s Sleep On It. Session Overview. Let s Sleep On It. Welcome and Introductions Presenter: Rita Piper, VP of Wellness Let s Sleep On It Let s Sleep On It Welcome and Introductions Presenter: Rita Piper, VP of Wellness Session Overview Why Sleep is so Important Types of Sleep Common Sleep Disruptors Sleep Disorders Tips

More information

Sleep. Information booklet. RDaSH. Adult Mental Health Services

Sleep. Information booklet. RDaSH. Adult Mental Health Services Sleep Information booklet RDaSH Adult Mental Health Services Sleep problems are often referred to as insomnia. They are very common, particularly in women, children and people over 65, so it is quite normal

More information

Session 6. A good laugh and a long sleep are the best cures in the doctor's book. ~Irish Proverb

Session 6. A good laugh and a long sleep are the best cures in the doctor's book. ~Irish Proverb Session 6 Relaxation Response: Guided Imagery with an Inner Healer Check-in: 1. Share two items from your gratitude journal 2. Any changes in your diet since we have been talking about nutrition? Any results?

More information

Ten tips for a good night s sleep

Ten tips for a good night s sleep Ten tips for a good night s sleep This task set contains: Teacher instructions Reading text Learner response sheet Answer key Marking and feedback to learners When marking the learners' responses please

More information

Counter Control Instructions University of North Carolina Hospitals Sleep Disorders Center

Counter Control Instructions University of North Carolina Hospitals Sleep Disorders Center Counter Control Instructions 1. Stay in bed during the appropriated time period whether you are able to fall asleep or not. From to 2. Spend thirty minutes each day in the bed performing work, reading

More information

Patient Scheduled Letter Thunderbird Internal Medicine Sleep Center 5620 W. Thunderbird Rd., Suite C-1 Glendale, AZ (602)

Patient Scheduled Letter Thunderbird Internal Medicine Sleep Center 5620 W. Thunderbird Rd., Suite C-1 Glendale, AZ (602) Patient Scheduled Letter Thunderbird Internal Medicine Sleep Center 5620 W. Thunderbird Rd., Suite C-1 Glendale, AZ 85306 (602) 938 6960 Dear Patient, Your Doctor has requested you be scheduled for a sleep

More information

Insomnia Disorder A Journey to the Land of No Nod

Insomnia Disorder A Journey to the Land of No Nod Insomnia Disorder A Journey to the Land of No Nod JACQUELINE D. KLOSS, PH.D. P S Y C H O L O G I S T B R Y N M A W R P S Y C H O L O G I C A L A S S O C I A T E S B E H A V I O R A L S L E E P M E D I

More information

For: NEON Primary Healthcare Providers By: Michelle Romero, DO June 2013

For: NEON Primary Healthcare Providers By: Michelle Romero, DO June 2013 For: NEON Primary Healthcare Providers By: Michelle Romero, DO June 2013 This power point is only a guideline for recommendations in the treatment of psychiatric disorders. This is not comprehensive. Please

More information

Managing Sleep Problems after Cancer

Managing Sleep Problems after Cancer Managing Sleep Problems after Cancer For cancer survivors Read this resource to learn about: What a sleep problem is What causes it What you can do to improve your sleep When to talk to your doctor Please

More information