As a nurse, you will encounter patients with all kinds of issues. Learning about the different conditions and how to treat them is essential to improving care delivery. Because you are the healthcare professional who interacts the most with patients and their families, educating them about their health conditions is imperative. The more patients and caretakers know, the better the health outcomes can be. One of the problems your patients may complain of is insomnia.
Insomnia is a common sleep disorder affecting many adults. It involves problems with sleeping, staying asleep, or waking up too early and being unable to sleep again. Insomnia can be short-term, often due to stress or a significant life event, or long-term, lasting for months or even years.
Understanding insomnia is crucial as it affects a large portion of the adult population. According to reports, approximately 30% of adults have symptoms of insomnia, and 10% experience problems in daily activities due to the severity of their symptoms. This disorder can lead to daytime fatigue, mood disturbances, and reduced ability to function at work or in social settings.
In this Fast CE For Less Guide, we will explore important facts about insomnia and medications used to treat it.
Causes of Insomnia
Insomnia is a term used to describe the inability to sleep. Insomnia in adults can occur from several reasons. The treatment for insomnia varies and is reliant on the underlying cause. Understanding the causes can help nurses educate their patients on how to manage insomnia effectively.
- Medical Conditions: Chronic illnesses such as asthma, arthritis, or heart disease can disrupt sleep. Pain or discomfort from these conditions can make it hard to stay asleep or get restful sleep.
- Psychological Factors: Stress, anxiety, and depression are common psychological causes of insomnia. Worries or emotional distress can make it hard to relax and fall asleep.
- Lifestyle Factors: Poor sleep habits, such as improper sleep schedules, using screens before going to bed, or consuming caffeine or alcohol late in the day can interfere with sleep.
- Environmental Factors: An uncomfortable sleep environment, such as a noisy or bright room, can also contribute to insomnia. Even small disturbances like a partner’s snoring or an uncomfortable mattress can affect sleep quality.
Non-Pharmacological Treatments
While the sleeping medications can help deal with insomnia, sometimes they are unnecessary. There are methods to manage insomnia that nurses should recommend before discussing the possibility of medication. If these work for a patient, it can be a far better way to improve sleep than through prescription medicines.
Lifestyle Changes
Improving sleep habits and creating a better sleep environment are effective ways to treat insomnia. This includes maintaining a consistent sleep schedule by going to bed and waking up at the same time every day, even on weekends.
It is also important to make the bedroom a comfortable place for sleep. This means keeping it dark, quiet, and cool. Avoiding screens, caffeine, and heavy meals before bedtime can also help. Relaxation techniques, such as deep breathing exercises, meditation, or listening to calming music can promote better sleep.
Cognitive Behavioral Therapy for Insomnia (CBT-I)
Cognitive Behavioral Therapy for Insomnia, or CBT-I, is a structured program that helps people change behaviors and thoughts that affect their sleep. Unlike sleeping pills, which work quickly but only temporarily, CBT-I addresses the root causes of insomnia.
Cognitive Behavioral Therapy for Insomnia includes techniques like cognitive restructuring, where patients learn to challenge and change unhelpful thoughts about sleep, and sleep restriction, where time spent in bed is limited to increase sleep drive. Studies have shown that CBT-I is very effective and can lead to long-lasting improvements in sleep.
By focusing on non-drug treatments, patients can achieve better sleep without relying on medication, which can come with side effects and risks.
Sleep Medications
When non-pharmacological methods fail to get positive results, healthcare professionals may recommend and prescribe various medicines to help patients manage insomnia.
Benzodiazepines
Benzodiazepines are a class of drugs that help with sleep by slowing down the brain’s activity. They include medications like Temazepam and Diazepam. These drugs are usually effective in treating short-term insomnia because they promote relaxation and help people fall asleep quickly. However, they can be addictive if used for long periods. Therefore, they are typically prescribed for short-term use only. Patients should follow their healthcare provider’s instructions closely to avoid dependency and other side effects.
Non-Benzodiazepine Sedative Hypnotics (Z-Drugs)
Non-benzodiazepine sedative hypnotics, commonly known as Z-drugs, include medications such as Zolpidem and Eszopiclone. These drugs work similarly to benzodiazepines but are often preferred because they have a lower risk of dependence and fewer side effects. Z-drugs are usually taken right before bedtime and can help patients fall asleep faster and stay asleep longer. However, some people may experience next-day drowsiness or memory problems.
Melatonin Receptor Agonist
Ramelteon is a melatonin receptor agonist that mimics the action of melatonin, a hormone that regulates the sleep-wake cycle. Unlike other sleeping pills, Ramelteon is not habit-forming and does not have significant withdrawal effects. It is usually prescribed for people who have trouble falling asleep. By enhancing the natural sleep process, Ramelteon can improve sleep quality without the risk of dependency.
Orexin Receptor Antagonists
Orexin receptor antagonists, such as Suvorexant, work by blocking the action of orexin, a chemical in the brain that keeps you awake. This helps to regulate the sleep-wake cycle and can be especially useful for people who wake up frequently during the night. Orexin receptor antagonists are relatively new and have been found to be effective with a lower risk of dependency compared to traditional sleeping pills.
Low Dose Antidepressants
Some low-dose antidepressants like Doxepin, are also used to treat insomnia. These drugs can be helpful for people who have difficulty staying asleep or have a history of depression. They work by altering neurotransmitters in the brain, which helps to promote sleep. Unlike higher doses used for depression, the low doses for insomnia generally have fewer side effects.
It is essential to educate patients on the importance of only taking medicine as prescribed. All medication has side effects that can have significant consequences when taken irresponsibly.
Sleeping Medication Side Effects
While effective, sleep medications can have side effects.
Common Side Effects
- Drowsiness: Feeling excessively sleepy during the day.
- Dizziness: Experiencing lightheadedness or a spinning sensation.
- Headache: Persistent head pain or discomfort.
Serious Side Effects
- Dependency: Risk of becoming dependent on the medication for sleep.
- Memory Problems: Difficulty remembering events or information.
- Complex Sleep Behaviors: Activities like sleepwalking, sleep driving, or preparing and eating food while not fully awake.
Prescription sleep medications should be used with caution, especially in elderly patients or those with a history of substance abuse, due to the increased risk of falls and dependency. When prescribing sleep medications, healthcare professionals should make special considerations to ensure they are safe for a patient.
Risks of Combining Medications with Alcohol
Combining medications with alcohol is very dangerous and should be avoided. Alcohol can enhance the sedative effects of sleeping pills, leading to severe drowsiness and impaired coordination. This can increase the risk of accidents and injuries.
More critically, mixing the two can cause severe respiratory depression, causing breathing to slow down or stop entirely, leading to life-threatening conditions. Patients should be advised to avoid alcohol when taking any medications for sleep to ensure their safety and well-being.
Over the Counter (OTC) Options for Insomnia
Diphenhydramine (Benadryl)
Diphenhydramine is an antihistamine that is commonly used as an OTC sleep aid. It works by blocking histamine receptors in the brain, which can cause drowsiness. This drug is available under brand names like Benadryl and is often used for short-term relief of mild insomnia. However, it is not recommended for long-term use because it can lead to tolerance, where the drug becomes less effective over time.
Potential Side Effects
- Dry mouth
- Constipation
- Dizziness
Doxylamine (Unisom)
Doxylamine is another antihistamine used as a sleep aid. It is available in products like Unisom. Like diphenhydramine, doxylamine causes drowsiness by blocking histamine receptors. It is effective for helping people fall asleep but can have side effects like dry mouth and dizziness. It is best used occasionally to avoid dependency.
Potential Side Effects
- Dry mouth
- Constipation
- Dizziness
Melatonin
Melatonin is a hormone that regulates sleep-wake cycles. As an OTC supplement, it helps people fall asleep by signaling to the body that it’s time to rest. Melatonin is useful for those who have improper sleep schedules or suffer from jet lag. It is generally considered safe for short-term use but should be taken according to package instructions to avoid potential side effects.
Potential Side Effects
- Headache
- Dizziness
- Nausea
Insomnia affects many adults and can significantly impact their daily lives. Nurses play a crucial role in helping patients manage this condition effectively. You can provide better care and education by understanding the various treatment options, including lifestyle changes, cognitive therapies, and medications.
Additionally, you should inform patients about the risks of long-term use of sleep aids and the dangers of combining these with alcohol. Emphasizing non-drug treatments can often lead to better, safer outcomes for patients.
If you have not completed your nursing continuing education requirements to renew your license, online nursing CEUs offered by Fast CE For Less can be of great help.
To access flexible and affordable nursing continuing education courses and state bundles, visit www.fastceforless.com.
