TY  - CHAP
M1  - Book, Section
TI  - Sleep Disorders
A1  - Dopp, John M.
A1  - Phillips, Bradley G.
A2  - DiPiro, Joseph T.
A2  - Yee, Gary C.
A2  - Michael Posey, L.
A2  - Haines, Stuart T.
A2  - Nolin, Thomas D.
A2  - Ellingrod, Vicki L.
PY  - 2021
T2  - DiPiro: Pharmacotherapy A Pathophysiologic Approach, 12e
AB  - KEY  CONCEPTSCommon  causes  of  insomnia  include  concomitant  mental  illness,  significant  psychosocial  stressors,  alcohol  use,  caffeine  intake,  and  nicotine  use.Good  sleep  hygiene,  including  relaxing  before  bedtime,  exercising  regularly,  establishing  a  regular  bedtime  and  wake-up  time,  and  discontinuing  alcohol,  caffeine,  and  nicotine,  alone  and  in  combination  with  pharmacotherapy,  should  be  part  of  patient  education  and  treatments  for  insomnia.Long-acting  benzodiazepines  should  be  avoided  in  older  individuals.Benzodiazepine  receptor  agonist  tolerance  and  physical  dependence  are  avoided  by  using  low-dose  therapy  for  the  shortest  possible  duration.Obstructive  sleep  apnea  may  be  an  independent  risk  factor  for  the  development  of  hypertension.  When  hypertension  is  present,  it  is  often  refractory  to  pharmacotherapy  until  sleep-disordered  breathing  is  alleviated.Nasal  continuous  positive  airway  pressure  is  the  first-line  therapy  for  obstructive  sleep  apnea,  and  weight  loss  should  be  encouraged  in  all  obese  patients.Pharmacologic  management  of  narcolepsy  is  focused  on  two  primary  areas:  treatment  of  excessive  daytime  sleepiness  and  rapid  eye  movement  (REM)  sleep  abnormalities.Short-acting  benzodiazepine  receptor  agonists,  ramelteon,  or  melatonin  taken  at  appropriate  target  bedtimes  for  east  or  west  travel  reduce  jet  lag  and  shorten  sleep  latency.The  alpha-2-delta  ligands,  gabapentin,  gabapentin  enacarbil,  and  pregabalin,  are  standard  therapy  for  chronic  restless  legs  syndrome  and  have  not  caused  symptom  augmentation  during  chronic  therapy.  
SN  - 
PB  - McGraw Hill
CY  - New York, NY
Y2  - 2022/07/04
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1188913795
ER  -