NSG 322 TOPIC 14 SLEEP DISORDERS
• insomnia 3 P's
Answer:
Predisposing factors
Precipitating factors
Perpetuating factors
• insomnia 3 P's: predisposing
Answer: individual factors that create a vulnerability toinsomnia.
• insomnia 3 P's: precipitating
Answer:
-external events that trigger insomnia
-Personal and vocational difficulties, medical and psychiatric disorders, grief, andchanges in
role or identity (as seen with retirement) are examples.
• insomnia 3 P's: perpetuating
Answer: -sleep practices and attributes that maintain thesleep complaint, such as excessive
caffeine or alcohol use, spending excessive amounts of time in bed or napping, and worrying
about the consequences of insomnia.
• Insomnia
Answer:
-Perception of insufficient amount of sleep
-Perception of a sufficient amount of sleep without feeling rested
-Occurs 3 nights per week for at least three months
• what are non-pharmacological interventions for insomnia?
Answer:
-Improvingsleep hygiene
-Shutting off electronics
-Timing of exercise and meals (not immediately prior to sleep)
-Relaxation techniques
-Cognitive behavioral therapy
-CBT-I specialized for insomnia
• What are drugs for insomnia?
Answer:
zolpidemeszopiclone
zaleplon
ramelteon (melatonin agonist)
melatonin
, • Suvorexant
Answer:
-for insomnia
-contraindicated in narcolepsy due to causing narcolepsy like symptoms
• Zolpidem (Ambien): onset
Answer: 30 minduration: short
• eszopiclone: onset
Answer: 60 minduration: intermediate
• zaleplon: onset: 15-30duration
Answer: ultra short
• ramelteon: onset: 30 minduration
Answer: short
• hypersomnolence
Answer:
-chronic (3+ months)
-begins in young adulthood
-excessive daytime sleepiness
• clinical manifestations of hypersomnolence
Answer:
-recurrent periods of sleep orunintended lapses into sleep
-frequent napping
-sleep period of greater than 9 hours
-unrefreshing nonrestorative sleep regardless of amount of time slept
-difficulty with full alertness during the wake period
-impacting the person's ability to participate in and enjoy relationships and functionin the
workplace
-Cognitive impairment is common, as is an increased risk for accident or injuryassociated
with the sleepiness.
• treatment for hypersomnolence
Answer:
-focuses on maintaining a regularsleep-wake schedule with an ample sleep opportunity
-allow for an extended sleep opportunity of 10 or more hours. -long-acting am- phetamine-
based stimulants such as methylphenidate and nonamphetamine-basedstimulants such as
modafinil (Provigil) are helpful.
• slide 18
• insomnia 3 P's
Answer:
Predisposing factors
Precipitating factors
Perpetuating factors
• insomnia 3 P's: predisposing
Answer: individual factors that create a vulnerability toinsomnia.
• insomnia 3 P's: precipitating
Answer:
-external events that trigger insomnia
-Personal and vocational difficulties, medical and psychiatric disorders, grief, andchanges in
role or identity (as seen with retirement) are examples.
• insomnia 3 P's: perpetuating
Answer: -sleep practices and attributes that maintain thesleep complaint, such as excessive
caffeine or alcohol use, spending excessive amounts of time in bed or napping, and worrying
about the consequences of insomnia.
• Insomnia
Answer:
-Perception of insufficient amount of sleep
-Perception of a sufficient amount of sleep without feeling rested
-Occurs 3 nights per week for at least three months
• what are non-pharmacological interventions for insomnia?
Answer:
-Improvingsleep hygiene
-Shutting off electronics
-Timing of exercise and meals (not immediately prior to sleep)
-Relaxation techniques
-Cognitive behavioral therapy
-CBT-I specialized for insomnia
• What are drugs for insomnia?
Answer:
zolpidemeszopiclone
zaleplon
ramelteon (melatonin agonist)
melatonin
, • Suvorexant
Answer:
-for insomnia
-contraindicated in narcolepsy due to causing narcolepsy like symptoms
• Zolpidem (Ambien): onset
Answer: 30 minduration: short
• eszopiclone: onset
Answer: 60 minduration: intermediate
• zaleplon: onset: 15-30duration
Answer: ultra short
• ramelteon: onset: 30 minduration
Answer: short
• hypersomnolence
Answer:
-chronic (3+ months)
-begins in young adulthood
-excessive daytime sleepiness
• clinical manifestations of hypersomnolence
Answer:
-recurrent periods of sleep orunintended lapses into sleep
-frequent napping
-sleep period of greater than 9 hours
-unrefreshing nonrestorative sleep regardless of amount of time slept
-difficulty with full alertness during the wake period
-impacting the person's ability to participate in and enjoy relationships and functionin the
workplace
-Cognitive impairment is common, as is an increased risk for accident or injuryassociated
with the sleepiness.
• treatment for hypersomnolence
Answer:
-focuses on maintaining a regularsleep-wake schedule with an ample sleep opportunity
-allow for an extended sleep opportunity of 10 or more hours. -long-acting am- phetamine-
based stimulants such as methylphenidate and nonamphetamine-basedstimulants such as
modafinil (Provigil) are helpful.
• slide 18
