Efficacious Treatments for Insomnia Essay

Pages: 4 (1362 words)  ·  Bibliography Sources: 4  ·  Level: Master's  ·  Topic: Health - Nursing

SAMPLE EXCERPT:

[. . .] g, for fatal familial insomnia or FFI); and (e) brain imaging (e.g., to assist in the diagnosis of FFI) (Chawla & Benbadis, 2016, para. 3). In addition, the 2008 American Academy of Sleep Medicine (AASM) guidelines recommend that insomnia sufferers should receive the following evaluations at a minimum:

• A general medical and psychiatric questionnaire to detect comorbid disorders;

• A sleepiness assessment, such as the Epworth Sleepiness Scale;

• A 2-week sleep log to define sleep-wake patterns and their variability;

• Transient or short-term insomnia: Recent situational stresses;

• Chronic insomnia: Past stresses or medical illnesses; and, • Use of tobacco, caffeinated products, alcohol, and illegal drugs (Chawla & Benbadis, 2016, para.3).

Likewise, clinicians should also review patients' medication history to identify agents that have been implicated in causing insomnia to rule out differential diagnoses, such as (a) beta blockers, (b) clonidine, (c) theophylline (acutely), (d) certain antidepressants (e.g., protriptyline, fluoxetine), (e) decongestants, (f) stimulants, and (g) over-the-counter and herbal remedies (Chawla & Benbadis, 2016, para.3). Finally, a physical examination of insomnia sufferers can provide clinicians with additional information concerning the potential causes for the disorder (Chawla & Benbadis, 2016).

Prognosis

Psychological and pharmacological interventions have both proven effective in treating insomnia but measuring their efficacy has been difficult because there remains a lack of consensus concerning how improvement should be measured (Milner & Belicki, 2010).

Potential complications

Left untreated, there are a number of potential complications associated with insomnia, including the following: (a) daytime fatigue; (b) greater use of medical services; (c) use of over-the-counter medication and alcohol; (d) functional impairment; (e) work absenteeism; (f) impaired concentration and memory; (g) decreased enjoyment of relationships; and (h) increased risk of medical illness, traffic accidents, and work accidents (Milner & Belicki, 2010, p. 237).

Parent and patient education, particularly sleep hygiene and the effects of different types of sleeping medications on sleep architecture

According to Bonnet et al. (2016b), nurse practitioners should educate all parents and insomniac patients concerning with the precipitating factors that can cause insomnia as well as provide behavioral counseling about stimulus control and sleep hygiene. For this purpose, the 2008 AASM guidelines outline two key treatment goals: (a) to improve sleep quality; and (b) to improve related daytime impairments. To achieve these treatment goals, the AASM guidelines also recommend incorporating at least one behavioral intervention such as cognitive-behavioral therapy (CBT) for initial treatment (Bonnet et al., 2016b). In addition, nurse practitioners should counsel parents and patients concerning the effects of medications on sleep architecture taking into account the following recommendations for the use of sedative-hypnotics:

• Start with a low dose, and maintain at the lowest effective dose;

• Avoid continued nightly use; encourage patients to use them only when truly necessary;

• Avoid using for more than 2-4 weeks if possible;

• Counsel patients to allow for at least 8 hours of sleep;

• Be aware that impairment can be present despite a feeling of being fully awake; and, • When the problem is falling asleep, prefer hypnotics with a rapid onset of action (e.g., zolpidem, zaleplon) (Bonnet et al., 2016b, para. 4).

Conclusion

The research showed that insomnia is generally defined as experiencing problems falling asleep, staying asleep and awakening earlier than intended without being able to go back to sleep. While most people experience an episode of insomnia at some point in their lives, the vast majority, a sizeable percentage report suffering from chronic insomnia. Finally, the research also showed that there are a number of interventions available, including psychological and pharmacological, that have proven efficacy in treating insomnia notwithstanding a lack of consensus among clinicians concerning how such effectiveness such be measured.

References

Bonnet, M. H., Arand, D. L., Benca, R. & Eichler, A. F. (2016a, October). Overview of insomnia. Wolters Kluwer. Retrieved from http://www.uptodate.com/contents/overview-of-insomnia.

Bonnet, M. H., Arand, D. L., Benca, R. & Eichler, A. F. (2016b, October). Treatment of insomnia. Wolters Kluwer. Retrieved from http://www.uptodate.com/contents/treatment-of-insomnia.

Chawla, J. & Benbadis, S. R. (2016, August 1). Insomnia. Medscape. Retrieved from http://emedicine.medscape.com/article/1187829-overview.

Milner, C. E. & Belicki,… [END OF PREVIEW]

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