Sedating antihistamine abuse

22-Mar-2020 10:25 by 5 Comments

Sedating antihistamine abuse

Evaluation of insomnia primarily comes from a detailed clinical history that includes a medical, psychiatric, and sleep history.The sleep history should elucidate the type of insomnia (eg, sleep initiation, sleep maintenance), its duration (transient, acute, or chronic), and its course (recurrent, persistent), as well as exacerbating and alleviating factors.

The sleep diary is essential for insomnia evaluation; its duration should be for 1-2 weeks.In primary care medicine, approximately 30% of patients report significant sleep disturbances.Despite inadequate sleep, many patients with insomnia do not complain of excessive daytime sleepiness, such as involuntary episodes of drowsiness in boring, monotonous, nonstimulating situations.In addition, chronic insomnia is associated with impaired occupational and social performance and an absenteeism rate that is 10-fold greater than controls.Furthermore, insomnia is associated with higher health care use, including a 2-fold higher frequency of hospitalizations and office visits.Moreover, patients with chronic insomnia report reduced quality of life, comparable to that experienced by patients with such conditions as diabetes, arthritis, and heart disease.

Quality of life improves with treatment but still does not reach the level seen in the general population.

Insomnia is more prevalent in women; middle-aged or older adults; shift workers; and patients with medical and psychiatric diseases.

In young adults, difficulties of sleep initiation are more common; in middle-aged and older adults, problems of maintaining sleep are more common.

Sedative-hypnotics are the most commonly prescribed drugs for insomnia.

Though not usually curative, they can provide symptomatic relief when used alone or adjunctively.

Such agents include the following: Insomnia is defined as repeated difficulty with sleep initiation, maintenance, consolidation, or quality that occurs despite adequate time and opportunity for sleep and that results in some form of daytime impairment.