see below

1. What screening tools can be used to affirm your initial diagnosis that a patient may meet the diagnostic criteria for a sleep disorder?

The best screening tool to use to affirm a diagnosis of a sleep disorder in a patient would be the Diagnostic and Statistical Manual of Mental Disorders by American Psychiatric Association (2013). The DSM-5 classification of sleep-wake disorders includes ten disorders/disorder groups. Within the DSM-5, there are also codes from the International Classification of Diseases that specify non-psychiatric listings as well. The DSM-5 also includes such sleep-wake disorders as restless leg syndrome and breathing-related sleep disorders within which formal sleep studies (polysomnography) are indicated (APA, 2013).

2. Describe the pharmacological actions of non-z sleep medications?

Non-z sleep drugs would be benzodiazepines. Benzos bind to specific GABA receptors and act as a GABA agonist. They increase the activity of GABA and increase the inhibitory postsynaptic potentials. Benzos increase the frequency at which GABA channels open. Research has shown that benzos that act on a1 subunits perform more anxiolytic activity and those acting on the a3 or a5 subunit perform more sedative effects (Stahl et al., 2021)

3. What problems can occur when benzodiazepines are used to help with sleep?

Using benzos for short-term use helps with immediate and noticeable decreases in anxiety, however long-term use can present lots of problems. Benzos cause both psychological and physiological tolerance, which can lead to abuse and addiction, as the does of the drug needed needs to continually be increases to achieve the same effect. Serious side effects such as sedation, memory loss and cognitive dulling are common. Elderly patients also are put more at risk for dizziness and falls when taking benzos, and as such are not recommended for those over age 65. Benzos also make anxiety and depression worse in the long term, as all the anxiolytic effects experienced while taking them are reversed in the withdrawal phase, leading to rebound anxiety, restlessness, and insomnia. Patients can actually become even more anxious than before after taking benzos because the brain becomes used to the presence of benzos and stops being as used to GABA (Heldt, 2017).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Arlington, VA: American Psychiatric Publishing

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Heldt, J. P. (2017). Memorable psychopharmacology. Createspace Independent Publishing

Platform.

Stahl, S., Muntner, N., & Grady, M. M. (2021). Stahl’s essential psychopharmacology:

Neuroscientific basis and clinical applications (5th ed.). Cambridge University Press.

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