Sleeping pills, insomnia, and medical practice : report of a study / Institute of Medicine, Division of Mental Health and Behavioral Medicine.

Format:

Book

Government document

Author/Creator:

Institute of Medicine (U.S.). Division of Mental Health and Behavioral Medicine.

Contributor:

National Academy of Sciences (U.S.)

Series:

IOM publication ; 79-04.

Institute of Medicine. Publication IOM ; 79-04

Language:

English

Subjects (All):

Hypnotics.

Insomnia.

Drug utilization--United States.

Drug utilization.

Drugs--Prescribing--United States.

Drugs.

Physical Description:

1 online resource (208 p.)

Edition:

1st ed.

Place of Publication:

Washington : National Academy of Sciences, 1979.

Language Note:

English

Contents:

Sleeping Pills, Insomnia, and Medical Practice

Copyright

Contents

PREFACE

ACKNOWLEDGEMENTS

INTRODUCTION AND SUMMARY

SLEEP AND MEDICATION - AN OVERVIEW

EPIDEMIOLOGY OF SLEEP PROBLEMS AND PRESCRIBING

PUBLIC HEALTH PROBLEMS ASSOCIATED WITH HYPNOTICS

INSOMNIA

RESEARCH, DIAGNOSIS, AND THERAPY

EFFICACY AND HAZARDS OF HYPNOTICS

SLEEP DISTURBANCE IN THE ELDERLY

CONCLUSIONS

BENZODIAZEPINES VS. BARBITURATES AS HYPNOTICS

PROFESSIONAL EDUCATION

ADVERTISING AND LABELING

RESEARCH NEEDS

INITIATION AND COORDINATION OF FEDERAL EFFORTS

REFERENCES

Chapter 1 AN OVERVIEW OF SLEEP AND MEDICATION

A. THE ANATOMY OF SLEEP

B. PRESCRIPTION DRUGS MARKETED AS HYPNOTICS

Barbiturates

Glossary of Sleep Research Terms

Benzodiazepines

Non-Barbiturate, Non-Benzodiazepine Hypnotics

C. PRESCRIPTION DRUGS NOT MARKETED AS HYPNOTICS

D. SELF-MEDICATION FOR SLEEP

Chapter 2 EPIDEMIOLOGY OF SLEEP COMPLAINTS AND PRESCRIBING PRACTICES

A. PREVALENCE OF SLEEP COMPLAINTS

B. TRENDS IN PRESCRIBING MEDICATION FOR SLEEP

C. THE PHYSICIAN'S DIAGNOSTIC AND THERAPEUTIC RESPONSES

D. HOSPITAL USE OF HYPNOTIC DRUGS

E. THE POPULATION'S USE OF HYPNOTICS

Chapter 3 PUBLIC HEALTH PROBLEMS ASSOCIATED WITH USE OF HYPNOTIC DRUGS

A. SUICIDE AND ACCIDENTAL OVERDOSE

Suicide Attempts

B. TRAFFIC SAFETY

C. NON-MEDICAL USE OF DRUGS

Chapter 4 INSOMNIA: RESEARCH FINDINGS, DIAGNOSTIC APPROACHES, AND THERAPEUTIC OPTIONS

A. THE MEANING OF INSOMNIA

The Complaint of Being Unable to Fall Asleep (Sleep Latency Problem)

The Complaint of Being Unable to Stay Asleep (Sleep Maintenance Problem)

The Complaint of Daytime Consequences

B. TYPES OF INSOMNIA

Transient and Situational Insomnia

Insomnia Associated with Mental Disorders.

Insomnia Associated with Drugs and Alcohol

Sleep-Induced Ventilatory Impairment

Insomnia Associated with Nocturnal Myoclonus or Restless Legs Syndrome

Insomnia Associated with Disruptions of the 24-hour Sleep-Wake Cycle

Insomnia Associated with Medical Disorders

Other Conditions Associated with Insomnia

Persistent Insomnia of Unknown Origin

C. THE "SLEEP DISORDER HISTORY"

D. HYPNOTIC DRUG THERAPY: AN OVERVIEW

E. NON-PHARMACOLOGICAL THERAPIES FOR INSOMNIA

Office Counseling

Psychotherapy

Behavioral Therapy

Chapter 5 SLEEP DISTURBANCE IN THE ELDERLY

A. PREVALENCE OF SLEEP DISTURBANCE IN THE ELDERLY

B. HYPNOTIC DRUG USE BY THE ELDERLY

C. PHARMACOLOGIC TREATMENT OF INSOMNIA IN ELDERLY PATIENTS

Efficacy and Safety of Hypnotics

Some Clinical Issues

Factors in the Choice of hypnotics

D. NON-PHARMACOLOGICAL TREATMENT OF SLEEP DISTURBANCE

Chapter 6 CONCLUSIONS

A. CLINICAL PRACTICE, PATIENT INFORMATION, AND PUBLIC HEALTH

Diagnostic Appraisal

Prudent Prescribing

Patient Information

Suicide Prevention

Toxicology

Epidemiology

B. BENZODIAZEPINES VS. BARBITURATES AS HYPNOTIC DRUGS

C. PROFESSIONAL EDUCATION

D. ADVERTISING AND LABELING

E. RESEARCH NEEDS

Insomnia and Appropriate Therapeutic Responses

The need for Independent Research and Evaluation of Hypnotics

F. INITIATION AND COORDINATION OF FEDERAL EFFORTS

APPENDIX ASSESSING HAZARDS AND BENEFITS OF HYPNOTIC DRUGS

A. APPROACHES TO THE STUDY OF THE EFFECTS OF HYPNOTIC DRUGS

Target Populations and Sample Selection

Nighttime Measures of Hypnotic Effects and Adverse Effects

Daytime Measures of Hypnotic Effects and Residual Adverse Effects

Overall Study Design

B. DAYTIME RESIDUAL EFFECTS OF HYPNOTIC DRUGS

Overview

Findings.

C. SPECIAL VULNERABILITIES TO THE HAZARDS OF HYPNOTICS: RESPIRATORY DIFFICULTIES, KIDNEY DISEASE AND PREGNANCY

Patients with Respiratory Difficulties

Patients with Impaired Renal Function

Women of Childbearing Age

D. ISSUES IN THE LONG-TERM USE OF HYPNOTIC DRUGS

Efficacy

Reliance on Drugs for Sleep

Hazards

E. AN OVERVIEW OF AVAILABLE STUDIES OF HYPNOTIC DRUG EFFICACY

Barbiturate Hypnotics

Nonbarbiturate, Nonbenzodiazepine Hypnotics

Comparisons of Efficacy

REFERENCES.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references.

ISBN:

1-280-24719-3

9786610247196

0-309-59327-1

OCLC:

609623350