Sleep issues

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

Zopiclone – tolerance, dependence. Increased risk of falls and cognitive impairment.