A diagnosis of chronic insomnia occurs when the patient has symptoms at least
3 times per week for at least 3 months
Which medications can be used if a patient needs help falling asleep
eszopiclone, zolpidem, ramelteon, zaleplon
Which medications can be used if a patient needs help staying asleep
eszopiclone, zolpidem, doxepin, suvorexant
Which medications can be used if a patient needs help falling and staying asleep
eszopiclone, zolpidem
Drugs that can worsen insomnia
donepezil, alcohol, antiretrovirals, aripiprazole, atomoxetine, bupropion, caffeine, decongestants, diuretics, fluoxetine, steroids, stimulants, varenicline
Brand name eszopiclone
Lunesta
Brand name for zolpidem
Ambien
Brand name for sublingual zolpidem
Edluar
Brand name for zaleplon
Sonata
MOA of orexin receptor antagonist
block the orexin neuropeptide signaling system, resulting in drowsiness
Drugs that are orexin receptor antagonist
Quviviq, DayVigo, Belsomra
Brand name for daridorexant
Quviviq
Brand name for lemborexant
DayVigo
Brand name for suvorexant
Belsomra
MOA of melatonin receptor agonists
agonist at the melatonin receptors, MT1 and MT2. this promotes sleepiness and regulates the circadian rhythm to coordinate the sleep-wake cycle
Which medications are melatonin receptor agonists
ramelteon, tasimelteon
Brand name for ramelteon
Rozerem
Brand name for tasimelteon
Hetlioz
Which TCA is approved for insomnia
doxepin
Brand name for doxepin
Silenor
What is restless legs syndrome (RLS)
an urge to move the lower legs
RLS is thought to be due to a
dysfunction of dopamine in the brain's basal ganglia circuits
Brand name of doxylamine
Unisom SleepTabs
Primary treatment of RLS
dopamine agonists and the anticonvulsant gabapentin
Brand name for gabapentin ER approved for RLS
Horizant
When should gabapentin be taken for RLS
at 5pm daily
What is narcolepsy
excessive daytime sleepiness with cataplexy (sudden loss of muscle tone) and sleep paralysis
Stimulants for wakefulness
modafinil, armodafinil
Brand name for modafinil
Provigil
Brand name for armodafinil
Nuvigil
R-isomer of modafinil
armodafinil
Brand name of sodium oxybate
Xyrem