Chapter 11: Sleep Disorders & ADHD Treatment

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Questions and Answers

What characterizes Stage 1 of sleep?

Dreaming occurs and brain activity is high

Easily awakened with possible sudden contractions of the limbs (correct)

Deep sleep with disorientation upon awakening

Eye movements stop and brain activity increases

How much sleep do teenagers typically require?

8 to 9 hours (correct)

9 to 10 hours

7 to 8 hours

5 to 6 hours

What is a common sign of sleep deprivation?

Awakening without feeling disoriented

Difficulty falling asleep within 15 minutes

Drowsy feeling during the day (correct)

Feeling refreshed after 4 hours of sleep

Which factor is associated with contributing to sleep deficiency?

Chronic illnesses Signup and view all the answers

What device is used as a non-pharmacologic measure for sleep apnea?

CPAP device Signup and view all the answers

What is the primary external cue that influences circadian rhythms?

Sunlight Signup and view all the answers

Which of the following is a function of sleep?

Healthy functioning of the immune system Signup and view all the answers

Which neurotransmitter is known to induce sleepiness?

Melatonin Signup and view all the answers

What is the term for sleep cycles characterized by rapid eye movements?

REM sleep Signup and view all the answers

What is rebound hypersomnia?

Excessive sleeping after sleep deprivation Signup and view all the answers

Which of the following symptoms is commonly associated with sleep deprivation?

Impaired memory Signup and view all the answers

What type of medication is typically used to treat insomnia?

Hypnotics Signup and view all the answers

Which of the following is NOT a reason why sleep is deemed necessary?

Increased social media interaction Signup and view all the answers

What is the defining characteristic of long-term insomnia?

Lasts longer than 3 weeks Signup and view all the answers

Which of the following medications is an example of a benzodiazepine used to treat insomnia?

Temazepam Signup and view all the answers

Which of the following statements about insomnia is incorrect?

Long-term insomnia lasts less than 3 weeks. Signup and view all the answers

What is the primary mechanism of action for imidazopyridines and cyclopyrrolone derivatives?

They modulate the GABAA receptor chloride channel. Signup and view all the answers

Which drug is classified as an OTC option for short-term relief of insomnia?

Diphenhydramine Signup and view all the answers

Benzodiazepines used for insomnia have what notable safety characteristic compared to barbiturates?

More desirable safety profile Signup and view all the answers

Which of the following sleep disorders is characterized by sudden episodes of falling asleep?

Narcolepsy Signup and view all the answers

What class of medications generally has the suffixes '-epam' and '-olam'?

Benzodiazepines Signup and view all the answers

What is the primary mechanism of action believed to be utilized by modafinil and armodafinil?

Stimulation of alpha1-adrenergic receptor sites Signup and view all the answers

Which of the following is NOT listed as an adverse effect of modafinil?

Weight gain Signup and view all the answers

Which of the following factors is considered an environmental risk factor for ADHD?

Food additives Signup and view all the answers

What is one of the warning labels associated with modafinil?

May decrease effect of oral contraceptives Signup and view all the answers

Which subtype of ADHD is characterized primarily by impulsiveness and hyperactivity?

Hyperactive-impulsive Signup and view all the answers

In how many subtypes is ADHD classified?

Three Signup and view all the answers

Which of the following is a commonly held misconception regarding the etiology of ADHD?

It is solely genetic Signup and view all the answers

Which of these substances during pregnancy has been implicated as a risk factor for ADHD?

Cigarette smoke Signup and view all the answers

What is the primary purpose of pharmacotherapy in ADHD treatment?

To control and manage symptoms Signup and view all the answers

Which of the following is a characteristic of amphetamines when treating ADHD?

They improve focus in individuals with ADHD Signup and view all the answers

What mechanism of action do amphetamines NOT utilize in ADHD treatment?

Blocking norepinephrine receptors Signup and view all the answers

Which of the following drugs is a nonamphetamine stimulant used for ADHD?

Atomoxetine (Strattera®) Signup and view all the answers

What is a common adverse effect associated with the use of stimulant medications for ADHD?

Decreased appetite Signup and view all the answers

What important warning label is associated with stimulant medications for ADHD?

May be habit-forming Signup and view all the answers

Which of the following statements about guanfacine (Intuniv XR®) is true regarding its use in ADHD?

Its mechanism of action in ADHD is unknown Signup and view all the answers

What notable effect do amphetamines have in individuals with ADHD?

They enhance alertness and responsiveness Signup and view all the answers

What is one of the adverse effects specifically associated with zaleplon?

Photosensitivity Signup and view all the answers

Which herb is known to help with sleep and has been used for over 2000 years?

Valerian root Signup and view all the answers

What should be avoided close to bedtime to help treat insomnia?

Stimulants Signup and view all the answers

How long should daily exercise be performed to help with insomnia?

20 to 30 minutes Signup and view all the answers

What is a common warning about benzodiazepines?

They may cause drowsiness Signup and view all the answers

Which stimulant is used to treat narcolepsy and is classified as a nonamphetamine?

Modafinil Signup and view all the answers

What is a recommended action if you cannot fall asleep within a certain time after going to bed?

Engage in a nonstimulating activity Signup and view all the answers

Which of the following is NOT an adverse effect of imidazopyridines and cyclopyrrolone derivatives?

Stomach cramps Signup and view all the answers

Study Notes

Chapter 11: Treatment of Sleep Disorders and Attention-Deficit Hyperactivity Disorder

Sleep Disorders and Medications Used to Treat Them:
- Learn terminology associated with sleep disorders and ADHD
- Discuss why sleep is necessary
- Describe the phases of a normal sleep cycle
- Describe symptoms associated with sleep deprivation
- Describe different types of sleep disorders
- Describe the function of neurotransmitters related to sleep
- Classify medications used to treat sleep disorders
- Describe the mechanism of action for each class of drugs used to treat sleep disorders
- Identify warning labels and precautionary messages associated with medications used to treat sleep disorders

Key Terms

Hypnotic
Insomnia
Melatonin
Non-REM sleep
Rapid eye movement (REM) sleep
Rebound hypersomnia
Sedative
Stimulant

Overview

Sleep is vital for a healthy body and encompasses a variety of functions including immune system health, nervous system health, emotional and social functioning, physical and mental agility, and memory improvement

The Sleep Cycle

The sleep cycle is influenced by circadian rhythms, which are biological changes influenced by daylight
The pineal gland plays a critical role in releasing melatonin, which promotes drowsiness and regulates body temperature and hormone secretion

Five Stages of Sleep

Stage 1: Easily awakened, limb movements may occur
Stage 2: Eye movements stop, brain activity decreases
Stage 3 & 4: Deep sleep, difficult to awaken, disorientation upon waking
REM (Rapid Eye Movement): Dreaming occurs

Sufficient Sleep Varies

Sleep needs vary between 5 and 16 hours per day depending on age
- Infants may need up to 16 hours
- Teenagers often need 9 hours
- Adults need 5-8 hours
- Seniors may sleep less than young adults

Sleep Deprivation

Signs include daytime drowsiness, falling asleep quickly, and factors like sleep apnea, restless leg syndrome, caffeine consumption, prescriptions, and chronic illnesses

Sleep Disorders

Common disorders include insomnia, restless legs syndrome, Ropinirole, , Pramipexole, sleep apnea, and narcolepsy

Insomnia

Categorized by duration: transient (less than 7 days), short-term (up to 3 weeks), and long-term (more than 3 weeks)

Treatment of Sleep Disorders

Prescription drugs, such as benzodiazepines and other sedative-hypnotics, are used to treat insomnia.

Benzodiazepines Used in The Treatment of Insomnia

Common names end in "-epam" or "-olam"
Reduce neuronal excitability by opening calcium channels
More desirable safety profile than barbiturates

Miscellaneous Drugs Used for Insomnia

Zaleplon, zolpidem, eszopiclone, zopiclone, diphenhydramine, and doxylamine are other common medications to treat insomnia

MOA of Imidazopyridines and Cyclopyrrolone Derivatives

Act on benzodiazepine receptors subtype v-1
Modulate GABA receptors, chloride channel, to reduce neuronal excitability

Imidazopyridines and Cyclopyrrolone Derivatives Adverse Effects

Side effects include sedation, dizziness, tolerance/dependence, photosensitivity, and bitter/metallic taste

Herbal Treatments for Insomnia

Herbal treatments such as melatonin and valerian root are used
Melatonin: hormone produced by the pineal gland, sensitive to light changes
Valerian root: dates back over 2000 years

Non-pharmacological Treatment of Insomnia

Avoid stimulants close to bedtime (eg., caffeine, colas, tea, highly caffeinated beverages)
Establish a regular sleep schedule
Avoid daytime naps
Create a comfortable sleep environment free of noise and light
Reduce use of electronics before bed

Non-pharmacological Treatment of Insomnia (cont'd)

Don't go to bed hungry
Exercise 20-30 minutes daily (5-6 hours before sleep)
If you can't fall asleep, get up and do something relaxing for 10-15 minutes before trying again.

Benzodiazepines: Warning Labels

May cause drowsiness, impair driving ability
Avoid alcohol consumption
Can be habit-forming

Pharmacotherapy for Narcolepsy

Stimulants are used to treat narcolepsy
Modafinil: a non-amphetamine stimulant believed to stimulate alpha1-adrenergic receptor sites
Modafinil can treat sleep apnea as well
Amphetamine and methylphenidate are also used

MOA of Drugs Used to Treat Narcolepsy

Modafinil and armodafinil stimulate alpha1-adrenergic receptor sites
Amphetamine and methylphenidate are sympathomimetics

Modafinil: Adverse Effects

Stimulation, insomnia, tolerance, and dependence

Modafinil: Warning Labels

Avoid alcohol
May decrease effect of oral contraceptives
May be habit-forming

Attention-Deficit Hyperactivity Disorder and Medications Used to Treat It

Describe etiology (cause) of ADHD
Classify ADHD medications
Discuss mechanism of action for each class of ADHD medications
Identify warning labels and precautions
Identify significant look-alike or sound-alike drug issues

Attention-Deficit/Hyperactivity Disorder (ADHD)

Most common childhood behavioral disorder
Symptoms include hyperactivity, restlessness, impulsiveness, inattention, distractibility, forgetfulness, and inability to complete tasks
Three subtypes of ADHD: hyperactive-impulsive, predominantly inattentive, and combined type

Environmental and Nutritional Risk Factors for ADHD

Genetic component (up to 25% of children with ADHD have a relative affected by it too)
Cigarette smoke and alcohol consumption during pregnancy
High lead levels (from lead-based paint or gasoline)
Food additives and sugar consumption might exacerbate ADHD symptoms

Look-Alike/Sound-Alike Drugs

Adderall® and Inderal®
Ritalin®, Ritalin® SR

Treatment of ADHD

No cure, only treatment of symptoms with pharmacotherapy and behavioral therapy is possible
Drug treatment can involve amphetamines and non-amphetamines.
Amphetamines affect individuals with ADHD differently than people without ADHD. They decrease hyperactivity and improve focus

Drugs Used in the Treatment of ADHD

Adderall (mixed salts of amphetamine)
Dexedrine (dextroamphetamine)
Focalin (dexmethylphenidate)
Biphentin/Concerta/Ritalin (methylphenidate)
Vyvanse (lisdexamfetamine)
Atomoxetine (Strattera): non-amphetamines stimulant and inhibits the reuptake of norepinephrine

MOA of Amphetamines

Stimulates the release of norepinephrine and dopamine
Increases stimulation of adrenergic receptors (resulting in increased alertness and responsiveness, and wakefulness)
Decreases feelings of tiredness or fatigue

Adverse Effects of Amphetamines

Decreased appetite, nausea, stomach ache, anxiety, irritability, insomnia, increased heart rate, palpitations, arrhythmia, dizziness, tremor, and amphetamine syndrome (a drug-induced psychosis).

Warning Labels for Amphetamines

Take with food
Can be habit-forming
Swallow whole; crushed/chewed formulations may be dangerous

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Explore the intricacies of sleep disorders and ADHD in this detailed quiz based on Chapter 11. Understand sleep cycles, the importance of sleep, symptoms of sleep deprivation, and the medications used in treatment. Learn about the mechanisms of action for various classes of drugs and the associated warnings.