Sleep therapy

Gillin J. C. (1983). The sleep therapies of depression. Prog. Neuropsychopharmacol Biol. 

Gillin JC Sleep studies in affective illness diagnostic, therapeutic and pathophysiological implications. Psychiatr Ann 13 367-384, 1983a Gilhn JC The sleep therapies of depression. Prog Neuropsychopharmacol Biol Psychiatry 7 351-364, 1983b... 

Under the effect of chlorpromazine, as 4560 RP was later to be named, patients did not lose consciousness but merely became sleepy and uninterested in everything going on around them and being done to them (Laborit et ti/.. 1952). Laborit and co-workers postulated that this strange central action suggested the use of chlorpromazine in psychiatry, e.g. in sleep therapy, where... 

Appropriate sleep hygiene techniques should always be considered and, when possible, used in lieu of pharmacotherapy. When medication is given, such nonpharmacological approaches may significantly decrease the amount and duration of drug exposure. Sleep therapies include the following ... 

Arendt J. In what circumstances is melatonin a useful sleep therapy Consensus statement, WFSRS focus group, Dresden, November 1999. J Sleep Res 2000 9 397-398. 

Like much mischief in medicine, the notion that we can infer disease from treatability was created by psychiatrists. Yet, a famous psychiatrist—Manfred Bleuler (1903—1994), the son of the famed psychiatrist Eugen Bleuler (1857—1939), aprofessor of psychiatry at the University of Zurich and director of the Burgholzli mental hospital— warned After the introduction of sleep therapy, and cardiazole-, insulin-, and electroshock therapies for schizophrenics, the argument was often raised that the discovery of a specific physical therapy indicated a specific physical disease. Subsequent experience effectively refuted such assumptions. The assumption is, a priori, fallacious. 

Sleep therapy and respiratory care represent an additional class of applications in healthcare. Respirators, ventilators, and positive-pressure devices to allow airways to function properly are specific examples and require biocompatibilty. Respiratory masks and valves require chemical resistance and impact performance. PC-based blends are commonly used in applications in this space. 

The short-acting clomethia2ole [533-45-9] (1), sometimes used as therapy for sleep disorders ia older patients, shares with barbiturates a risk of overdose and dependence. Antihistamines, such as hydroxy2iae [68-88-2] (2), are also sometimes used as mild sedatives (see HiSTAMlNES AND HISTAMINE antagonists). Antidepressants and antipsychotics which have sedative effects are used to treat insomnia when the sleep disorder is a symptom of some underlyiag psychiatric disorder. 

Low affinity use-dependent NMDA recqrtor antagonists meet the criteria for safe administration into patients. Drugs like amantadine and memantine have modest effects on Parkinson s disease and are used as initial therapy or as adjunct to l-DOPA. Their adverse effects include dizziness, lethargy and sleep disturbance. 

Estrogens and progestins are diminished in menopausal or ovarectomized women. In hormone replacement therapy (HRT), these hormones are substituted to alleviate hot flushes, mood changes, sleep disorders, and osteoporosis. 

TCAs Once-a-day dosing may be prescribed for maintenance therapy. When the nurse administers the total daily dosage at night, the sedative effects promote sleep, and the adverse reactions appear less troublesome Because protriptyline may produce a mild stimulation in some patients, it is usually not given as a single bedtime dose... 

Other potential adverse effects from P-blockers include fatigue, sleep disturbances, malaise, depression, and sexual dysfunction. Abrupt P-blocker withdrawal may increase the frequency and severity of angina, possibly because of increased receptor sensitivity to catecholamines after longterm P-blockade. If the decision is made to stop P-blocker therapy, the dose should be tapered over several days to weeks to avoid exacerbating angina. 

Unfortunately, antidepressants do not produce a clinical response immediately. Improvement in physical symptoms, such as sleep, appetite, and energy, can occur within the first week or so of treatment. Although a recent meta-analysis suggests earlier effects of antidepressant treatment,36 it is widely accepted that it takes approximately 2 to 4 weeks of treatment before improvement is seen in emotional symptoms of depression, such as sadness and anhedonia. Furthermore, it may take as long as 6 to 8 weeks of treatment to see the full effects of antidepressant therapy.7 22 23... 

Interpersonal, family, or group therapy with a licensed psychiatric nurse practitioner/clinical nurse specialist, psychologist, social worker, or counselor assists individuals with bipolar disorder to establish and maintain a daily routine and sleep schedule and to improve interpersonal relationships.3,20 These therapies may help treat and protect against manic episodes. 

Encourage good nutrition (with regular protein and essential fatty acid intake), exercise, adequate sleep, stress reduction, and psychosocial therapy... 

Benzodiazepines are recommended for acute treatment of generalized anxiety disorder when short-term relief is needed, as an adjunct during initiation of antidepressant therapy, or to improve sleep. 

Recommend and optimize appropriate sleep hygiene and nonpharmacologic therapies for the management and prevention of sleep disorders. 

Educate patients about preventive behavior, appropriate lifestyle modifications, and drug therapy required for effective treatment and control of sleep disorders. 

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