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Sleep DisordersPsychiatric Nursing: Contemporary Practice

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What are some changes in eating habits that can aid sleep?
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Avoid spicy foods, alcohol, and caffeine. Warm milk can help induce sleep.
Why does warm milk help induce sleep?
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It has L-tryptophan in it which is a precursor of serotonin which helps with sleep. It shouldn't be combined with a snack.
How do benzodiazepines aid with sleep?
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They potentiate GABA, an inhibitory neuron.
What are the risks associated with prescribing benzodiazepines for sleep?
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The potential for dependence, risk of residual sedation and pronounced withdrawal if abruptly stopped.
__________ is a melatonin receptor agonist with a low abuse potential that is used to promote sleep.
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Ramelteon/Rozerem
________ is an antidepressant used off label to promote sleep.
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Trazodone/Desyrel
Doxylamine/Unisom is an OTC drug used to induce sleep. How does it work?
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It is a histamine-1 antagonist that effects the CNS inducing sedation, diminished alertness and slowed reaction times.
What are common side effects of OTC medications used to induce sleep?
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Dry mouth, tachycardia, urinary retention, dilated pupils, extended drowsiness.
What is rebound insomnia?
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Insomnia that develops after abruptly discontinuing a drug for sleep. It typically lasts one night. Can be prevented by using the lowest effective dose and tapering.
What medications commonly interact with medications used to induce sleep?
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Oral contraceptives, isoniazid, fluvoxamine, and verapamil.
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What class of medications can be impacted by concurrent use of carbamazepine, reducing their effectiveness?
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Benzodiazepines
What class of medications can be impacted by concurrent use of cimetidine, increasing their effectiveness, therefore requiring a lower dose?
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Benzodiazepines
What beverage should be avoided when taking medications to induce sleep?
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Grapefruit juice
What medication shouldn't be taken concurrently with Ramelteon?
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Fluvoxamine
Which sleep medication is the only one that can be used within 5 hours of bedtime?
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Sonata/zaleplon (all others require 8 hours)
How long prior to bedtime should a patient take ramelteon?
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30 minutes. Benzodiazepines are taken at bedtime.
_________ is a technique used when the bedroom environment no longer provides cues for sleep but has become the cue for wakefulness.
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Stimulus control
_________ is a sleep medication that shouldn't be taken after a high fat meal.
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Ramelteon/Rozerem
Cigarette smoking should be avoided at least ________ before bedtime.
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One hour
Caffeine should be avoided at least ________ before bedtime.
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Six hours
What are the diagnostic characteristics of primary hypersomnia?
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Excessive sleepiness for at least a month, sleepiness on almost a daily basis, without a diagnosis of narcoplepsy or obstructive sleep apnea.
  
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