Responses for wk 7 Treating Sleep Disorders

Responses for wk 7 Treating Sleep Disorders

Read a selection of your colleagues' postings.

Respond at least two of your colleagues’ posts by doing one of these 3 things listed below support it with references each one only has to be a couple sentences

Offering additional support for your colleague’s stance from the Learning Resources or peer-reviewed articles

Offering an alternative interpretation and support with material from the Learning Resources or peer-reviewed articles

Offering a compromise between the extreme positions and support with material from the Learning Resources or peer-reviewed articles

The 2 peers posts are listed below:

Peer 1: Nicole Owens 

The controversy I chose is psychiatrists prescribing sleep aids to clients in recovery from substance abuse. The two peer reviewed articles are:

Mahfoud, Y., Talih, F., Streem, D., & Budur, K. (2009). Sleep disorders in substance abusers: how common are they?. Psychiatry (Edgmont (Pa. : Township)), 6(9), 38–42.

Pieters, S., Burk, W., Vorst, H., Dahl, R., Wiers, R., & Engels, R. (2015). Prospective Relationships Between Sleep Problems and Substance Use, Internalizing and Externalizing Problems. Journal of Youth & Adolescence, 44(2), 379–388. https://doi-org.ezp.waldenulibrary.org/10.1007/s10964-014-0213-9

Many people suffer from unhealthy sleep related problems. Sleep problems are very common among people with substance use disorders. They can occur during withdrawls and last months and years into recovery (Pieters et al., 2015). It may also be associated with relapse. I feel psychiatrists should not prescribe sleep aides to clients in recovery from susbtance abuse. Nonpharmacological treatments should be preferred because pharmacological treatments for insomnia have potential for abuse and can intefere with recovery (Pieters et al., 2015). Several studies have reported sleep problems associated with the use of several illicit drugs, and the vast majority of alcoholic patients entering treatment reported insomnia-related symptoms, such as difficulty falling and maintaining sleep (Mahfoud et al., 2009).

Peer 2: Diana Thomas 

Psychiatrists prescribing a potentially addictive sleep aid to adolescents

Many parents are understandingly concerned about the use of habit form addictive drugs to treat their children. As a professorial it is important to talk openly with the parents about these concerns. Most clinician agrees that the child needs to be including in discussion. So, they can talk about the fears of the drug, how it makes one feel and the addiction. Parents need to devote a good deal of times addressing all the concerns of drug treatment. Among psychiatric medications there are two classes of drugs that a potential for drug abusers: stimulants (Ritalin) and benzodiazepines. (Xanax). However, most children do not use this type of medication. (Preson, 2017)

According to Preston the normal rate of hepatic metabolism is high in children until puberty. The result is most medications are aggressively metabolized in the liver rapidly. So, dosing prepubertal children may require does that approach adults but needs severe monitoring. During this period the child who has maintained on a dosage and tolerating it well may begin to show signs of increasing side effects when the metabolic rate occurs. There would need to be continues medication dosages adjustments. It may be more appropriate to utilize non-pharmacological interventions. 

A Systematic approach is advocated by The World Health Organization that says especially for children the physician should follow these steps:

Evaluate and clearly define the patient’s problem

Specify the therapeutic objective

Select the appropriate drug treatment

Initiate therapy with appropriate details and consider non-pharmacologic therapy, melatonin, exercise, warm bath, warm milk, hot tub, story time, car ride 

Give information instructions and warning to parents, child and all involved

Evaluate therapy regular, monitor treatment results

Consider drug process and cost when prescribing and make sure family know what they are getting into financially 

Use computers and other tools to educate and reduce errors. (Pollock,2007)

Neurologist warns about prescribing sleep aids to adolescents. Doctors caring for children and teens have a professional obligation to always protect the best interest the child, to protect vulnerable populations and prevent misuse of medications. (Graf, 2013)

Children with psychiatric and neurodevelopment disorders often resist bedtime and have trouble falling as sleep and staying asleep. Judith Owens, MD and associate professor of pediatrics at Brown University led a study team that studied prescription practice on children with sleep problems. The results were that daytime sleepiness ad fatigue may disrupt family life and functioning throughout the day. Poor sleep may exacerbate other disorders. In summary child psychiatrist use a wide variety of pharmacologic interventions to retreat insomnia. They called the clinical trials with standardized methodologies such as polysomnography and actigraphy to establish the various medications effective doing ranges, safety and tolerably, withdrawal, and decondition effects and relatively efficacy in inducing and maintaining sleep. So, if it is done safely, it can be beneficial to client and their families. But if not some children and adolescents have more probes and it can even lead to suicide. (Lamberg, 2010)

References

Barlas,S (2008) Concern about Psychotropic Drugs ad kids, Life Sciences Journal

Efren, D (2003) Prescribing psychotropic medications for children by Australian pediatricians and child psychiatrists

Jailor, M (2013) Neurologists warn against prescribing ADHD to kids as “Study drugs”

Lambert, L (2010) Child Sleep disorders treated with a range of medications, Journal of Psychiatric news 

Pollack, M (2007) Appropriate Prescribing of Medications: An Eight Step Approach

Psychiatric Co morbidity in children and adolescents with sleep syndromes, Journal of Clinical Sleep Medicines (2011) 

Pullman, S (2001) Psychiatry Co morbidity in Children and adolescents, Journal of Clinical Sleep Medicine