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Glossary of Insomnia

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NREM
lowered physiological fxn
restore various physiological and ummunological fxns
REM
increased neuronal activity
similar or greater psysiological fsx as wakefulness
abstract dreaming
important for memory and learning
tx of insomnia
BZD
or
non-bzd hypnotic agents: antidepr, antihist, ethanol, chloral hydrate, warm milk and cookies
BZD
increases GABA tansmission
increase total sleep time
decreases REM and deep sleep
Sedating Antidepressants
tricyclic, trazodone, and mirtazapine
blocks reuptake of serotonin and NE
long t 1/2 results in next day sedation
may take 4-6 weeks
high potential for drug interaction
What are the SE of sedating antidepressants?
anticholinergic
orthostatic hypotension
hypothermia
seizures
cardiotoxicity
Antihistimines
OTC medication
Sleep eze, unisom, sominex, and nytol
anticholingeric side effects
residual drowsiness
Chloral Hydrate
rarely used
converste to trichloroethanol
hangover
ADE- GI, drug interactions
transfers to breast milk
melatonin
hormone secreted by pineal gland and synthesized from trytophan
ramelteon
highly selective MT1 and MT2 receptors
longer t1/2 than melatonin
no hangover effects
ADE- somnolence, dizziness and fatigue
Valerian
inhibits GABA reuptake
ADE- hA, excitability, and cardiac disturbances
associated with uterine contractions
cause of hepatitis and liver damage

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