Therapy for Patients Sleep Wake Disorders

NURSING

Nursing: Therapy for Patients with Sleep-Wake Disorders

Depression and stress disorder are some of the most prominent causes of sleep-wake disorders. Insomnia is one of the most commonly discussed problems, ad n sleep difficulties have caused physical and worsened emotional problems. Seep is studied vastly by medical professionals because seven to nine hours of sleep is recommended by scientists for accurate body functioning. The co-existing complication of health start showing as soon as signs of stress, depression, and anxiety appear, further obscuring neurobiology and leading to heart failure, osteoarthritis, and Parkinson’s diseases in severe conditions (American Psychiatric Association, 2020). This paper aims to reflect on psychopharmacological treatments for patients suffering from sleep-wake disorders and other co-existing mental disorders that could degrade the effects of those medications.

Major depressive disorder (MDD) and alcohol abuse are usually seen going hand in hand as patients suffering from depression feel they need to find solace, and alcohol numbs their nerves for some time, helping them relieve distress for a little while (Chan et al., 2015). For such patients, evidence has corroborated the effectiveness of medications like nefazodone, imipramine, desipramine, fluoxetine, and sertraline (Chan et al., 2015; DeVido & Weiss, 2012). Behavioral therapies are also suggested along with medication to bring about a change in alcohol use. Medications alone have not been proved to show a higher prevalence of sobriety since some drugs have different impacts on the various sociodemographic factors of patients, such as homelessness, low socioeconomic status, smoking, and family history, leading to higher hospital re-admission rates (Chan et al., 2015).

Most studies have indicated that the use of two drugs at a single time might create adverse symptoms for patients with MDD and alcohol. The results might be witnessed in greater dependency on alcohol as confusion is aggravated. An example of such a situation is the prescription of sertraline and naltrexone as polytherapy showed greater side effects or drug reactions for extremely sensitive patients (Chan et al., 2015). Long-term results might be different for diverse people as the benefits would be visible for those with high motivation for behavioral change instigation. Patients cannot be forced to stop drinking since long-term positive outcomes are less clear due to weak self-control and overwhelming depression in certain cases that could deteriorate a person’s health within no time (Collins, n.d.).

The four major predictors of the late onset of a generalized anxiety disorder (GAD) include gender, possessing physical disability, the prevalence of recent unfavorable life events, and psychological disorders (Zhang et al., 2015). Females are more affected by GAD as phobia as are highly related to this disorder’s graveness. GAD usually follows Panic disorders in females; however, family history and prescriptions that female patients have been relying upon need to be further explored for clarity of conclusion (Zhang et al., 2015). Age-related chronic illness also causes complications in GAD incidence as the nervous system and adrenaline changes within the body are strongly associated with GAD. Studies have clearly emphasized stress and heart rate response to this condition exasperating the GAD conditions due to the probability of dominance of adrenergic sympathetic stress (Zhang et al., 2015). This fact leads to another finding that psychological impacts of stress create uncertainty for stable cognitive functioning that highly relies on prefrontal processing, growing the risk of late-onset of GAD (Zhang et al., 2015). Uncertain life events and environmental stressors cause serious implications on the said condition as cognitive impairment is witnessed deteriorating with symptoms like lack of verbal fluency, intricacies in expressing one’s thoughts, and suppression of feelings (Zhang et al., 2015). Negative parenting, insecurity, family abuse history, partner abuse, or abandonment are some of the environmental stressors that are clear examples of unfavorable life events (Zhang et al., 2015).

The worse form of MDD is a major psychotic disorder that inculcates hallucinations and serious depression (Dubovsky et al., 2021). According to DSM III, DSM IV, and DSM V, the neurobiological condition includes melancholic depression and distortion of reality, and delusions (Dubovsky et al., 2021). Mood disorder is another complexity formed by neurobiological intricacy as frequently as subsequent episodes witnessed among such patients (Dubovsky et al., 2021). The severity of depression has become uncertain due to changing environmental conditions and the recent diet and lifestyles people undergo. The diagnostic criteria cause diverse clinical implications as MDE, a serious indicator of psychotic depression, could be unipolar or bipolar (Dubovsky et al., 2021).

An episode of major depressive disorder is believed to last at least two weeks. The symptoms of such an episode include having a depressed mood for a major portion of the day, such as a feeling of sadness, hopelessness, and barrenness, loss of interest in daily activities and appearing subjective to others, decrease in weight due to a fall in appetite which would be up to 5%, insomnia or sometimes hypersomnia and extreme weariness and tiredness (MD Calc, n.d.).

The three classifications of drugs that can precipitate insomnia include (National Jewish Health, 2017):

· Selective serotonin reuptake inhibitors. This classification includes Zoloft and Prozac (National Jewish Health, 2017).

· Psychostimulants and amphetamines. The examples of this classification encompass Addrerall XR and Dexedrine (Cherney, 2020). Both are generically variable.

· Anticonvulsants. This category includes drugs like Tegretol- Csrbatrol, Lyrica, Neurotin, Depakote, etc. (Web MD, 2022).

References

American Psychiatric Association. (2020, August). What are sleep disorders? https://www.psychiatry.org/patients-families/sleep-disorders/what-are-sleep-disorders#:~:text=There%20are%20several%20different%20types,both%20physical%20and%20emotional%20problems.

Chan, P., Yomen, K., Turcios, J. & Richman, M. (2015). Prescription for antidepressants in reducing future alcohol-related re-admission in patients suffering from depression and alcohol use disorder: A retrospective medical record review. Substance Abuse Treatment, Prevention, and Policy, 10. https://doi.org/10.1186/s13011-015-0045-y