Sleep-Wake Disorders

MODULE 6: Sleep-Wake Disorders

Introduction

Don't use plagiarized sources. Get Your Custom Essay on
Sleep-Wake Disorders
Get a plagiarism free paper Just from $13/Page
Order Essay

We will focus on the treatment of insomnia, hypersomnolence/narcolepsy, and restless legs syndrome (RLS) due to the lack of pharmacological treatment options for the other disorders in this chapter.

Insomnia is a frequently heard complaint throughout all areas of healthcare. The loss of sleep can significantly affect occupational, social, personal outcomes and overall quality of life. Before treating, however, a thorough evaluation is warranted as many factors can affect quality of sleep. Insomnia is frequently a symptom or manifestation of an underlying physical or psychological disorder. (Pharmacotherapy Principles and Practice, pg 734) Many medications, psychosocial stressors, and common behaviors can induce sleep disturbances as well. Ensuring that any underlying causes are being appropriately treated and encouraging nonpharmacological treatments should occur prior to starting pharmacological treatment for insomnia. Hypnotics are extremely effective in providing quick relief of insomnia but these medications should be used at the lowest required doses to reduce the risk of adverse effects and daytime impairments, as well as minimizing the risk of rebound insomnia and withdrawal symptoms when tapering off. (Gabbard pg 607)

RLS is another condition where a thorough evaluation is warranted. Symptoms consistent with RLS can be caused by many physical comorbidities and can be an adverse effect from common psychiatric medications, especially antipsychotics. Any comorbidities should be addressed and any potential offending medications should be discontinued or decreased prior to initiating treatment. Dopaminergic agents can induce or exacerbate psychotic symptoms, making the evaluation for physical or pharmacological explanations all the more important.

Narcolepsy, on the other hand, is an incurable neurological disorder that typically requires long term management. (Gabbard pg 616) Nonpharmacological interventions, like behavioral modifications, should be encouraged as they can enhance medication effectiveness. Although effective, stimulants should be used with caution in patients with comorbid psychiatric disorders as they can potentially exacerbate these illnesses.

Objectives

By the end of this module the student should be able to:

  • Identify secondary causes of insomnia or RLS in a given case.
  • Choose an appropriate first line pharmacological treatment for insomnia, narcolepsy, or RLS based on patient specific factors.
  • Choose an appropriate modification to therapy in the event of nonadherence, partial response, nonresponse, or intolerability.

Read It

Required

Stahl’s Essential Psychopharmacology

  • Chapter 11

Gabbard’s Treatments of Psychiatric Disorders

  • Part VII: Sleep-Wake Disorders
    • Chapter 36: Sleep-Wake Disorders; pg 603 – 619, 630 – 635

DynaMed summaries

This will provide a more detailed summary of pharmacological treatment guidelines and important information about medications (adverse effects, interactions, monitoring, etc.)

  • Insomnia in Adults
  • Narcolepsy
  • Restless Legs Syndrome (RLS)

Highly Recommended

Pharmacotherapy Principles and Practice

  • Chapter 41: Sleep Disorders
    • This chapter is a nice introductory reading to the pharmacology and the treatment of the sleep disorders of focus in this module

Discuss It 

Module 6 Discussions
Discussion Group 1: KL is a 79 yo man requesting assistance for “something to help with sleep”. His past medical history is significant for coronary artery disease and s/p CABG, hyperlipidemia, hypertension, major depressive disorder, and benign prostatic hypertrophy. He is taking the following medications: Aspirin 81 mg daily, Lisinopril 20 mg daily, Metoprolol succinate 100 mg daily, Simvastatin 20 mg daily, fluoxetine 40 mg hs, and doxazosin 4 mg hs. He admits to drinking 2 alcoholic drinks/night and denies smoking. Include in your discussion:

The differences in initial, middle, and terminal insomnia and how would you best choose pharmacologic treatment for each one of these based on the half-lives of each hypnotic?

Identify any secondary causes for insomnia.

What treatment plan do you recommend for KL’s insomnia? (Be specific with your recommendations-which hypnotic and why)

Group 2: Discuss the neurobiology of narcolepsy and then discuss the different pharmacological treatments including the MOA, efficacy, side effects and patient education that should be completed.

Group 3: Discuss Restless Leg syndrome and Periodic Limb Syndrome. Include etiology and neurobiologic principles. Discuss treatments with emphasis on pharmacologic treatments. Don’t forget to include why and how these medications work to reduce symptoms by including the MOA, evidence for its use, and side effects along with patient education.

Group 1: KL is a 79 yo man requesting assistance for “something to help with sleep”. His past medical history is significant for coronary artery disease and s/p CABG, hyperlipidemia, hypertension, major depressive disorder, and benign prostatic hypertrophy. He is taking the following medications: Aspirin 81 mg daily, Lisinopril 20 mg daily, Metoprolol succinate 100 mg daily, Simvastatin 20 mg daily, fluoxetine 40 mg hs, and doxazosin 4 mg hs. He admits to drinking 2 alcoholic drinks/night and denies smoking. Include in your discussion:

The differences in initial, middle, and terminal insomnia and how would you best choose pharmacologic treatment for each one of these based on the half-lives of each hypnotic?

Identify any secondary causes for insomnia.

What treatment plan do you recommend for KL’s insomnia? (Be specific with your recommendations-which hypnotic and why)

Group 2: Discuss the neurobiology of narcolepsy and then discuss the different pharmacological treatments including the MOA, efficacy, side effects and patient education that should be completed.

Group 3: Discuss Restless Leg syndrome and Periodic Limb Syndrome. Include etiology and neurobiologic principles. Discuss treatments with emphasis on pharmacologic treatments. Don’t forget to include why and how these medications work to reduce symptoms by including the MOA, evidence for its use, and side effects along with patient education.

 

Responses must be a minimum of 275 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to the Grading Rubric for Online Discussion in the Course Resource section.

 

Master Homework
Order Now And Get A 20% Discount!
Pages (550 words)
Approximate price: -

Advantages of using our writing services

Custom Writing From Scratch

All our custom papers are written by qualified writers according to your instructions, thus evading any case of plagiarism. Our team consists of native writers from the USA, Canada, and the Uk, making it convenient for us to find the best to handle your order.

Unlimited Free Revisions

If you feel your paper didn't meet all your requirements, we won't stop till it's perfect. You're entitled to request a free revision within 7 days after we submit your paper.

Quality Writing In Any Format

If you have issues with citing sources and referencing, you need not worry. Our writers are highly knowledgeable in referencing, including APA/MLA/Havard/Chicago/Turabian and all other formatting styles.

Fast Delivery And Adherence To The Deadline

All our custom papers are delivered on time, even the most urgent. If we need more time to perfect your paper, we may contact you via email or phone regarding the deadline extension.

Originality & Security

At Master Homework, your security and privacy is our greatest concern. For this reason, we never share your personal information with third parties. We use several writing tools to ensure your paper is original and free from plagiarism.

24/7 Customer Support

Our agents are online 24 hours a day, 7 days a week, and are always ready to serve you. Feel free to contact us through email or talk to our live agents whenever you need assistance with your order.

Try it now!

Calculate the price of your order

We'll send you the first draft for approval by at
Total price:
$0.00

How it works?

Follow these simple steps to get your paper done

Place your order

Fill in the order form and provide all details of your assignment.

Proceed with the payment

Choose the payment system that suits you most.

Receive the final file

Once your paper is ready, we will email it to you.

Our Services

We work nonstop to see the best client experience.

Pricing

Flexible Pricing

We offer pocket-friendly prices that coincide with the preferred client's deadline.

Communication

Admission help & Client-Writer Contact

Our support team is always ready to ensure vital interaction between you and the writer whenever you need to elaborate on something.

Deadlines

Paper Submission

We deliver our papers early within the stipulated deadlines. We are glad to help you if there should be an occurrence of any alterations required.

Reviews

Customer Feedback

Your review, positive or negative, is of great concern to us and we take it very seriously. We are, consequently adjusting our policies to ensure the best customer/writer experience.