British Association for Pyschopharmacology. To advance education and research in the science of psychopharmacology
This module on Sleep is divided into 2 topics. Firstly Sue Wilson describes the underlying brain mechanisms of sleep regulation, the role of neurotransmitters, the measurement of sleep and the diagnosis and classification of sleep disorders. Spilios Argyropoulos describes the clinical course and treatment of sleep disorders: insomnia, hypersomnia, parasomnias and circadian rhythm disorders, with reference to clinical guidelines. Also included is the treatment of sleep problems in depression.
This module describes normal sleep and its regulation in the brain, how sleep is measured and the staging of sleep using polysomnography. The neurotransmitters known to be involved in sleep and waking are described, and the effects of drugs on sleep summarised. There is a detailed description of the most common sleep disorders, with a useful algorithm for diagnosis and some key questions used in taking a sleep history. Finally there is a summary of sleep disorders associated with psychiatric disorders.
The first part of this topic covers the psychological and pharmacological treatment of insomnia, taken from the BAP consensus guidelines 2010 (Wilson et al., J Psychopharm. 2010; 24(11): 1577–1600). There is a useful treatment algorithm and a summary of the efficacy and safety of licensed hypnotics, as well as some recommendations on duration of pharmacological treatment. There are some recommendations for the treatment of insomnia in depression, although this was not covered in the above guidelines. There is a brief description of pharmacological treatment of hypersomnia, references to guidelines on treatment of narcolepsy and restless legs syndrome. Finally there are recommendations for treatment of parasomnia and circadian rhythm disorders.
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