Week 9 Discussion 1: Sleep Disorders
Done:Make forum posts: 1
Value: 100 points
Due: Create your initial post Day 4 and reply to at least one of your peers by Day 7.
Grading Category: Discussions
Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the following prompts.
In a Word document, respond to each of the following statements succinctly, but with detail.
- Sleep disorders only come in two diagnostic categories, one related to sleep apnea and the other related to the failure to stay awake due to stress.
- The use of over-the-counter sleep aids should be encouraged over prescription drugs because OTC aids are safer and not habit-forming.
- Menopause has no impact on insomnia.
- As a backup to over-the-counter sleep aids, benzodiazepines are the most useful.
- What is the best practice for an insomnia assessment?
Use the appropriate APA formatting as listed in the syllabus.
Reply to at least one of your peers. In your reply post, pick one prompt to address and respond with scholarly discourse and an evidence-based framework. Your assertions should be backed by evidence that references at least two scholarly sources.
Please refer to the Grading Rubric for details on how this activity will be graded.
The described expectations meet the passing level of 80%. You are directed to review the Discussion Grading Rubric for criteria which exceed expectations.
This is my peer’s post
1. Sleep disorders only come in two diagnostic categories, one related to sleep apnea and the other related to the failure to stay awake due to stress.
There are many different types of sleep disorders. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), there are ten different sleep-wake disorders or disorder groups (American Psychiatric Association, 2013). Sleep disorders do not only come in two diagnostic categories as there are many different diagnostic categories specific to each sleep-wake diagnosis. Sleep disorders can be divided by presentation of symptoms into three categories called insomnia, hypersomnia, and parasomnias (Wilson & Nutt, 2013). There are also non-mental health related sleep disorders such as obstructive sleep apnea and chronic obstructive pulmonary disease (COPD) (CDC, 2022). For example, obstructive sleep apnea focuses on the person’s inability to receive effective sleep due to a medical condition where their upper airway becomes blocked repeatedly while they sleep, decreasing or completely obstructing their flow of air (Gottlieb & Punjabi, 2020). Other sleep disorders focus broadly on how a person falls or stays asleep like insomnia disorder or non-REM sleep arousal disorders (Reynolds, 2018).
2. The use of over-the-counter sleep aids should be encouraged over prescription drugs because OTC aids are safer and not habit-forming.
Cognitive behavioral therapy (CBT) is the gold standard of treatment for insomnia (Xie et al., 2017). If CBT does not help, non-habit forming over-the-counter (OTC) sleep aids should be used over prescription sleep aids. Many sleep aids can become habit-forming and can cause a toxic situation for a patient who utilizes sleep aids for long-term treatment for sleep (Almond et al., 2021).There are some OTC sleep aids that can be habit-forming also so it is important to educate patients on which OTC sleep aids are non-habit forming such as melatonin (Xie et al., 2017).
3. Menopause has no impact on insomnia.
According to Proserpio et al. (2020), menopause can cause an increase in sleep disturbances. Some predisposing factors such as having a history of insomnia can increase the likelihood that a woman experiencing menopause will experience insomnia. Sometimes insomnia occurs in these patients due to the symptoms that come with menopause such as hormone changes, night sweats, labile moods, and hot flashes (Proserpio et al., 2020).
4. As a backup to over-the-counter sleep aids, benzodiazepines are the most useful.
Benzodiazepines and drugs known as ”Z drugs” including zopiclone, zolpidem, and zaleplon all increase the effects of GABA by decreasing the concentration of GABA needed to open up the GABA-A channel (Wilson & Nutt, 2013). Benzodiazepines are highly addictive and can cause serious long-term side effects such as memory loss and can worsen sleep breathing such as in patients with obstructive sleep apnea and chronic obstructive pulmonary disease (COPD) (Wilson & Nutt, 2013). Benzodiazepines can cause physical and psychological dependence because the patient realizes treatment with these medications do work to stop sleep disturbances; making it difficult for patients to stop utilizing it (Wilson & Nutt, 2013). Due to its high dependence potential, I would support that providers use benzodiazepines only as a last resort for a backup to other treatments for sleep.
5. What is the best practice for an insomnia assessment.
The best practice for an insomnia assessment is to obtain a sleep history from your patient. Ways to obtain a sleep history is by having the patient keep a daily sleep log or diary, noting their bedtimes, how many hours of sleep they received, wake times, and the quality of their sleep (Wilson & Nutt, 2013). Providers can also provide their patients with sleep questionnaires to assess how their patient is sleeping (Wilson & Nutt, 2013).
Almond, S. M., Warren, M. J., Shealy, K. M., Threatt, T. B., & Ward, E. D. (2021). A Systematic Review of the Efficacy and Safety of Over-the-Counter Medications Used in Older
People for the Treatment of Primary insomnia. The Senior care pharmacist, 36(2), 83â€“92. https://doi.org/10.4140/TCP.n.2021.83
American Psychiatric Association. (2013).â€¯Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing, Inc.
Centers for Disease Control and Prevention (CDC). (2022). Sleep and Sleep Disorders. https://www.cdc.gov/sleep/for-clinicians.html
Gottlieb, D. J., & Punjabi, N. M. (2020). Diagnosis and Management of Obstructive Sleep Apnea: A Review. JAMA, 323(14), 1389â€“1400. https://doi.org/10.1001/jama.2020.3514
Proserpio, P., Marra, S., Campana, C., Agostoni, E. C., Palagini, L., Nobili, L., & Nappi, R. E. (2020). Insomnia and menopause: a narrative review on mechanisms and treatments.
Climacteric : the journal of the International Menopause Society, 23(6), 539â€“ 549. https://doi.org/10.1080/13697137.2020.1799973
Reynolds C. F., 3rd (2018). Biomarkers in DSM-5 Sleep-Wake Disorders: A Useful Paradigm for Psychiatry?. Focus (American Psychiatric Publishing), 16(2), 173â€“176.
Wilson, S. & Nutt, N. (2013). Sleep Disorders: Vol. Second edition. OUP Oxford.
Xie, Z., Chen, F., Li, W. A., Geng, X., Li, C., Meng, X., Feng, Y., Liu, W., & Yu, F. (2017). A review of sleep disorders and melatonin. Neurological research, 39(6), 559â€“565.