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16 Cards in this Set
- Front
- Back
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what does REM sleep help recovery? what does non rem sleep help recover? |
neuro things, memory, synaptic growth (when you are dreaming and paralyzed) physical recovery and well being |
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what 3 things are related to the cause of insomnia? |
increased metabolic rate during sleep, increased eeg during non REM sleep, elevated cortisol and adrenocorticotripic hormones
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what sleep latency/time awake time suggests insomnia? what early morning awakening suggest insomnia? what is nonrestorative sleep? |
more than 20-30 minutes waking up 30 minutes prior to scheduled time AND before total sleep time reaches 6.5 hours waking up and not feeling well rested |
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what is transient insomnia acute chronic? |
less than a week acute chronic |
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what sleep hygiene advice can you give? |
sleep schedule, excercise but not before bed, avoid alcohol and stimulants, maintain comfortable sleep environment, avoid consuming large quatitiies of food or liquids before bed |
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what stimulus control advice can you give to help with sleep? what relaxing training can you suggest? |
go to bed when sleepy, avoid naps, use bed for sleep and intamcy only not for tv watching, wake up at the sametime everyday reduce somatic arousal, reduce mental arousal, use biofeedback |
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what cognitive therapy can help with sleep? define the ideal hypnotic? |
alter beliefs, attitudes, and expectations about sleep effective at reducing sleep latency and increasing sleep time with no side effects |
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what should you do if your patient is resistant to insomnia medications? what are the common side effects of benzo receptor agonists? |
re-evaluate for secondary insomnia residual sedation, rebound effects upon discontinuation, building tolerance, cns depression, sleep related activities |
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how do you prevent residual sedation? how do you prevent rebound effects upon discontinuation? "" tolerance to the medication? |
match duration of action with patients sleep budget, use low doses use long duration drugs, low dose intermittent therapy with the lowest possible dose possible |
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what side effect of the benzo agonists warrants discontinuation? what antidepressants are used for sleep? |
if pateint does sleep related activities mirtazapine and doxepin |
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what over the counter products are used for sleep? when is ramelteon beneficial? |
diphenhydramine, valerian root, melatonin, ramelteon (melatonin receptor agonist) sleep onset and if patient has substance abuse |
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what are the first line drugs for insomnia? what is second line? |
z drugs, ramelteon, suvorexant sedating antidepressant, or that plus hypnotic |
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what drugs are definitely a no go in the elderly? what drugs are good to use in the elderly? |
doxepin, estazolam, flurazepam, quazepam, diphenhydramine, amitriptyline ramelteon, temazepam, mirtazapine, melatonin |
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what drug is good for both insomnia and depression? what drug is good for early morning awakening? what drug can cause hypotension and hangover effects? |
mirtazapine zolpidem cr trazodone |
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what drug approved for insomnia can be used for 6 months? is ramelteon a controlled substance? what drug is extremely short acting? |
eszopiclone non controlled triazolam |
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next |
done |
