NURS6521wk5d1r1.docx - NURS6521wk5d1r1 Hi Lynne Thank you...

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NURS6521wk5d1r1 Hi Lynne, Thank you for the information you shared. Sleep can affect the individual’s day to day function which can be an indicator of the person’s health and well-being. Inability to obtain adequate sleep can be caused by various factors such as physiological changes, underlying health condition, psychosocial and environmental determinants. Insomnia is a condition of difficulty in falling or staying asleep, even when a person has the chance to do so and people with the disorder can feel dissatisfied with their sleep causing the experience of fatigue, low energy, difficulty concentrating, mood disturbances, and decreased performance in work or at school (National Sleep Foundation, 2017). Although many drugs have been widely used to treat insomnia, nonpharmacological measures should be the first-line of treatment selection. Pharmacological treatments for insomnia should only be initiated when non-pharmacological management fails, and the use of drugs should be indicated for short term. As you mentioned that benzodiazepine agent is one of the primary drugs used to treat insomnia, not every medication under the class of benzodiazepine will be appropriate to manage the sleep disorder. Although many benzodiazepines are used to treat insomnia, only five are approved by the U.S. Food and Drug Administration (FDA) for this indication (Hainer & Matheson, 2017). Different drugs in the class of benzodiazepines have a different mechanism of actions. In choosing a benzodiazepine, the practitioner should select an agent with an onset of action that matches the patient’s complaints yet has a short duration of effect, lacks rebound insomnia, and causes few or no cognitive problems (Arcangelo, Peterson, Reinhold, & Wilbur, 2017, p. 724). Essential differences must be taken into account when prescribing the drug for insomnia. Cautious measures must be taken on prescribing a benzodiazepine to the elderly population. As studied in
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an article, the rate of metabolism is particularly important in patients with impaired liver or kidney function or advanced age because these agents can bio-accumulate, resulting in adverse effects such as memory impairment, loss of coordination, and daytime somnolence (Hainer & Matheson, 2017). Pharmacokinetic characteristics of benzodiazepine vary from short-acting, intermediate-acting, and long-acting and longer half-life have a higher potential for adverse effects (Arcangelo, Peterson, Reinhold, & Wilbur, 2017, p. 727). When benzodiazepines are
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