Medications and Their Effects on Sleep and Sleep Disorders

DEBBIE AKERS

NOTE: This chapter corresponds to Chapter 24 in Fundamentals of Sleep Technology, 2nd edition.

1. The most common prescribed sleeping pills are nonbenzodiazepine hypnotics (“z-drugs” such as zolpidem, zopiclone, and zaleplon). The effects of these medications on sleep pattern include:

A. Decreased sleep onset latency and reduced N1 sleep

B. Increased REM sleep and decreased REM latency

C. Increased sleep latency and increased sleep-related breathing events

D. Decreased total sleep time and increased slow-wave sleep time

2. In comparison to most benzodiazepines, the nonbenzodiazepine hypnotics (“z-drugs” such as zolpidem, zopiclone, and zaleplon) have:

A. Longer latency to onset of action

B. More suppression of stage N3 sleep

C. More risk of increased sleep-related breathing events

D. A shorter half-life

3. Tricyclic antidepressants cause profound decreases in:

A. N2 sleep and sleep spindles

B. N3 sleep

C. REM sleep

D. Daytime sleepiness

4. First-generation antihistamines often give rise to as an unwanted side effect.

A. Seizures

B. Increased sleep latency

C. Sedation

D. Sleep-onset REM episodes

5. Modafinil belongs to which class of drugs?

A. Stimulants

B. Sedative hypnotics

C. Anticonvulsants

D. Opioids

CONSIDER THE FOLLOWING HISTORY OF A SLEEP CENTER PATIENT

A 34-year-old man comes to the sleep center with a complaint of daytime sleepiness. He takes clonazepam (Klonopin) as needed during the day to control panic attacks. He has difficulty falling asleep, and his primary care physician has prescribed quazepam (Doral) at bedtime. Other medical conditions include high blood pressure, for which he takes lisinopril (Zestril); allergies to pollen and tree mold treated with diphenhydramine (Benadryl); and high cholesterol treated with simvastatin (Zocor). His primary care doctor has sent him to the sleep center for possible treatment with modafinil (Provigil). After reviewing the patient’s medical history and medication list, you decide to contact the primary care doctor to discuss replacement of some the medications because they may be causing daytime sleepiness.

Which of the medications listed above are associated with daytime sedation?

What alternatives might be considered for the medications causing sedation?