Data gathering
- Red flags
- Others – sleeping pattern, triggers, mood, anxiety, drugs, alcohol, thyroid
Clinical management
- Investigations
- Sleep diary
- Bloods – TFTs
- Treatment
- Lifestyle – avoid caffeine, alcohol, smoking – especially 6 hours before sleep
- Sleep hygiene – avoid napping, avoid weekend lie ins, just sleep/sex in bed, wind down before bed, get out of bed if not sleepy
- Stress management
- CBT
NB:
Zopiclone – tolerance, dependence. Increased risk of falls and cognitive impairment.