thera final sleep disorders

minimum of 1 month in duration

several nights as a result of acute stressors

symptoms < 3 wks

symptoms > 1 month

• reducing the latency to sleep onset
• increases total sleep time

• sleep apnea
• history or IV substance abuse
• pregnancy (X)

• temazepam - restoril     15-30mg
• triazolam - halcion         0.125 - 0.25mg

restoril

halcion

• next day sedation
• psychomotor incoordination
• anterograde amnesia
• rebound insomnia

• triazolam - halcion
• estazolam - prosom

• quazepam - doral 
• flurazepam - dalmane

triazolam - halcion

• reduce time to fall asleep
• reduce nocturnal awakenings
• increase total sleep time

• 30 minutes
• duration 6-8 hrs

• sleep disorders
•   eating
•   walking
•   sexual activity

• women and elderly 5mg
• men 10 mg

• women and elderly 6.25
• men 12.5 mg

zolpidem sublingual tablets

• zolpidem sublingual
• FDA approval for middle of the night awakenings

sonata

decrease time to sleep onset

zaleplon - sonata

• elderly 5 mg
• nonelderly 10 mg

eszopiclone - lunesta

lunesta

• reduce time to sleep onset
• reduce number of nocturnal awakenings
• increases total sleep time
• increases total sleep quality

fluvoxamine = increased ramelteon levels

cessation of airflow to the nose and mouth lasting at least 10 seconds

obstructive & central

repeated episodes of apnea caused by temporary loss of respiratory effort during somnolence

CPAP and oxygen

• PAP - positive airway pressure
• weight loss
• surgery to open the upper airway
• avoidance of CNS depressants

• excessive daytime sleepiness
• cataplexy
• hypnagogic hallucinations
• sleep paralysis

episode of sudden bilateral loss of muscle tone

episodic loss of voluntary muscle tone that occurs when the individual is falling asleep or awakening

narcolepsy

excessive daytime sleepiness with sleep attacks that may last up to 30 minutes

• ropinirole - requip 0.25 mg
• pramipexole - Mirapex 0.125 mg

rotigotine patch - neupro