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.
Sleep Diagnostic Categories
Sleep-wake disorders not only consist of breathing-related disorders and narcolepsy but other sleep-related disorders such as insomnia, hypersomnolence circadian rhythm sleep-wake, non-rapid movement, sleep arousal, nightmare, rapid eye movement (REM) sleep behavior, restless legs syndrome, and substance or medication inducted sleeping disorder (“Diagnostic and statistical manual,” 2022). Many individuals with a known diagnosis of these disorders often complain about their sleep-wake cycle and the amount of sleep they get within a twenty-four-hour period (“Diagnostic and statistical manual,” 2022). There are many risk factors to consider with alternation in sleep patterns, including acute stress, depression, anxiety, medications, obesity, family history, psychological changes with pregnancy, and comfort while sleeping (Rhoads & M., 2015).
Over-the-Counter Versus Prescription Medications
There are many sleep aids for treating sleep disorders. However, choosing the proper medication can be challenging based on the situation and overall well-being of the individual. Both prescriptions and over-the-counter medications (OTC) have benefits and side effects risks. OTCs are not recommended for chronic use but for occasional sleep disturbance. These medications should be cautiously used in the elderly population because of the increased risk of anticholinergic effects, decrease in the level of functioning, and compromising cognitive abilities many of these medications carry, leading to other complications (Albert et al., 2017). Melatonin has been known to improve sleep by aligning the circadian rhythm with the proper sleep-wake schedule and has fewer side effects (Boland et al., 2022). However, prescription sleep aids such as benzodiazepine have shown dependency, relapse, and withdrawal effects after stopping and are also recommended for short-term use (Wilson & Nutt, 2013). Z-drug is known to have less tolerance and dependence but can have some rebound insomnia like benzodiazepines (Wilson & Nutt, 2013). For safety reasons, individuals with sleeping disorders should consult their provider before considering using sleeping aids.
During menopause, many women have poor sleeping patterns associated with hot flashes, which affects their physical, mental, and overall well-being. Disturbance in sleep during this time has been known to increase the risk of diabetes, heart disease, obesity, and depression (Harris & Harrison, 2020). Therefore, examining and practicing good sleeping hygiene by modifying behavior changes and short-term medication management is essential (Rhoads, 2015).
Use of Benzodiazepines
At one time, Benzodiazepines were prescribed frequently for insomnia. However, other medications such as doxepin, ramelteon, and Zolpidem are now the first-line drug therapy for treating insomnia, secondary treatment to the use of over-the-counter medications. However, these medications should still be for short-term usage (Rhoads, 2015).
Proper assessment of insomnia is essential when diagnosing and determining treatment choices. During the evaluation, it is vital to inquire about sleep hygiene and medical history. The medical history should include whether the individual has had a sleep study with a known diagnosis of sleep apnea. They should be assessed for mood changes, length of sleep, difficulty falling asleep, staying asleep, and repeating awakening (Rhoads, 2015). Stress can interfere with sleep; therefore, it is essential to ask about new stressors. Medication history is also necessary, including newly prescribed medications and the use of OTC or herbal supplements (Rhoads, 2015). Assessing and obtaining the correct information is essential to diagnosing and determining the next step of treatment for the overall well-being and safety of these individuals.
Albert, S. M., Roth, T., Toscani, M., Vitiello, M. V., & Zee, P. (2017). Sleep Health and
Appropriate Use of OTC Sleep Aids in Older Adults-Recommendations of a
Gerontological Society of America Workgroup. The Gerontologist, 57(2), 163â€“170.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders
Boland, R. J., Verduin, M. L., Ruiz, P., Shah, A., & Sadock, B. J. (2022). Kaplan & Sadock’s Synopsis of Psychiatry. Wolters Kluwer.
Harris, A. L., & Harrison, A. (2020). Examining sleep disturbance during the menopausal period.
Nursing for Women’s Health, 24(2), 134â€“142. https://doi.org/10.1016/j.nwh.2020.01.008
Rhoads, J., & M., M. P. J. (2015). Clinical consult to psychiatric nursing for advanced practice.
Springer Publishing Company, LLC.
Wilson, S., & Nutt, D. (2013). Sleep disorders: (2nd ed.). Oxford University Press