090 Strategies for Dealing with or Ameliorating Excessive Sleepiness: Beliefs and Attitudes of People with Daytime Sleepiness

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A37-A38
Author(s):  
Breanna Featherston ◽  
Ashna Kapoor ◽  
Chloe Wills ◽  
Andrew Tubbs ◽  
Michael Grandner

Abstract Introduction Sleepiness impacts health and functioning, but despite available treatments, many do not seek care. Beliefs and attitudes about treatments for sleepiness and other sleep problems may be useful to know in designing and targeting interventions. Methods N=28 participants with excessive daytime sleepiness (ESS>=10) but no other major medical problems were recruited from the community. They were administered an Epworth Sleepiness Scale and Fatigue Severity Scale at baseline, and asked about a wide range of beliefs/attitudes about mitigating sleepiness, and whether they Strongly Agree(SA), Agree(A), Disagree(D), or Strongly Disagree(SD) with them. Ordinal logistic regressions examined agreement associated with baseline sleepiness and fatigue, adjusted for age, sex, and race/ethnicity (nominal significance p<0.05). Results When asked which strategies are helpful for dealing with or fixing daytime sleepiness, baseline agreement was as follows: Just “power through it” (SA:9%,A:55%,D:32%,SD:5%). Caffeine (SA:18%,A:55%,D:27%). Vigorous exercise (SA:9%,A:36%,D:55%). Mild or moderate movement or exercise (SA:14%,A:82%,D:5%). Trying to get better sleep at night (SA:36%,A:64%). Eating or drinking something to help “wake you up” (SA:27%,A:45%,D:23%,SD:5%). Napping (SA:27%,A:64%,D:9%). Giving up and letting yourself be sleepy (SA:9%,A:42%,D:45%,SD:5%). Improve your diet/eat healthy (SA:42%,A:55%,D:5%). Relaxing activities at night (SA:27%,A:68%,D:5%). Meditation, breathing exercises, or other relaxation techniques (SA:45%,A:45%,D:9%). Watching TV, browsing the internet, or other distracting activities (SA:5%,A:36%,D:45%,SD:14%). Just keep moving (SA:9%,A:55%,D:42%,SD:5%). Setting alarms (SA:18%,A:68%,D:14%). Take prescription medication to improve sleep (SA:5%,A:27%,D:42%,SD:27%). Take over-the-counter medication to improve sleep (SA:5%,A:27%,D:59%,SD:9%). Take prescription stimulant medication (SA:5%,A:32%,D:45%,SD:18). Take over-the-counter stimulant medication (SA:5%,A:27%,D:55%,SD:14%). Take prescription medication that reduces daytime sleepiness (SA:5%,A:36%,D:41%,SD:18%). Take over-the-counter medication that reduces daytime sleepiness (SA:5%,A:27%,D:50%,SD:18%). Those with higher levels of baseline sleepiness were more likely to endorse the following as good strategies to handle daytime sleepiness, “Take over-the-counter medication to improve sleep” (oOR=1.55, p=0.04), “Take prescription medication to improve sleep” (oOR=1.49, p=0.01), and “napping” (oOR=2.55, p=0.03). Those with higher baseline fatigue were less likely to endorse “just ‘powering_through’” (oOR=0.81, p=0.02) as a good strategy of handling daytime sleepiness. Conclusion Real-world beliefs and attitudes about ways of mitigating effects of sleepiness range from medical to behavioral. Those with greater baseline sleepiness may be more amenable to medication. Support (if any) This work was supported by Jazz Pharmaceuticals

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A49-A49
Author(s):  
Ashna Kapoor ◽  
Chloe Wills ◽  
Andrew Tubbs ◽  
Michael Grandner

Abstract Introduction Sleepiness impacts health and functioning, but many people with sleepiness do not seek care. Beliefs and attitudes about treatments for sleepiness may be useful to know in designing and targeting interventions. Methods N=28 participants with excessive daytime sleepiness (ESS>=10) but no other major medical problems were recruited from the community. They were administered an Epworth Sleepiness Scale and Fatigue Severity Scale at baseline, and asked about a wide range of beliefs/attitudes about seeking medical care about sleepiness, and whether they Strongly Agree (SA), Agree (A), Disagree (D), or Strongly Disagree (SD) with them. Ordinal logistic regressions examined agreement associated with baseline sleepiness and fatigue, adjusted for age, sex, and race/ethnicity. Nominal significance was determined as p<0.05. Results Rates of baseline agreement were as follows: People with insomnia (SA:50%,A:50%), sleep apnea (SA:68%,A:32%), and daytime sleepiness (SA:50%,A:36%,D:14%) “should discuss their problems with their doctor or health care provider.” “I have talked to my doctor about sleep problems” (SA:18%,A:23%,D:41%,SD18%). “I have talked to my doctor about daytime sleepiness (SA:23%,A:14%,D:45%,SD:18%). “If I had problems sleeping, I would discuss it with my doctor or health care provider” (SA:27%,A:50%,D:23%). “If I had problems with daytime sleepiness, I would discuss it with my doctor or health care provider” (SA:23%,A:50%,D:27%). “Excessive daytime sleepiness is something that can be improved with medical treatment” (SA:14%,A:55%,D:32%). “Excessive daytime sleepiness is something that can be improved with psychological treatment” (SA:9%,A:64%,D:27%). “Excessive daytime sleepiness is something that can be improved with complementary/alternative medicine treatment” (SA:9%,A:68%,D:18%,SD:5%). “I am concerned about side effects of medical treatments for daytime sleepiness” (SA:45%,A:42%,D:14%). These factors were not associated with baseline sleepiness. Those with higher baseline fatigue were more likely to report having talked to their doctor about sleepiness (oOR=1.33, p=0.02) and having talked to their doctor about sleep problems in general (oOR=1.54, p=0.02). Conclusion Real-world beliefs and attitudes about treatments for sleepiness reflect a general positive attitude towards addressing these issues with medical providers, not a very strong one. Side effects of medications are a common concern. Baseline fatigue may spur individuals to talk to their doctor. Support (if any) This work was supported by Jazz Pharmaceuticals


2016 ◽  
Author(s):  
Jeffrey T Lai ◽  
Kavita M Babu

Anticholinergic compounds oppose the action of the endogenous neurotransmitter acetylcholine at its target receptors and are found in over-the-counter and prescription medication, natural products, and plants. Anticholinergic medications, such as atropine and scopolamine, are used for the treatment of a wide range of conditions, including bradycardia, motion sickness, and insomnia. Antihistaminergic medications, such as diphenhydramine, also possess anticholinergic activity and are used in the treatment of seasonal allergies, common cold symptoms, and allergic reactions. Other medications, such as antidepressants (especially the older tricyclic class), antipsychotics, muscle relaxants, and anticonvulsants, can act as anticholinergic agents or produce anticholinergic side effects. Toxicity can result from therapeutic misadventure, intentional overdose, recreational use, and pediatric exposures. This review covers the principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcomes. Figures show the anticholinergic toxidrome, look-alike structures, and electrocardiographic changes in tricyclic antidepressant overdose. Tables list medications with anticholinergic activity and selected botanicals that cause anticholinergic toxicity. Key words: anticholinergic overdose, anticholinergic toxicity, anticholinergic toxidrome, physostigmine, tricyclic antidepressant toxicity This review contains 3 highly rendered figures, 2 tables, and 49 references.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0253944
Author(s):  
Pär Karlsson ◽  
Aya Olivia Nakitanda ◽  
Lukas Löfling ◽  
Carolyn E. Cesta

Introduction On February 26th 2020, a high alert was issued in Sweden in response to the diagnosis of the first few coronavirus disease 2019 (COVID-19) cases in the country. Subsequently, a decreased supply of essential goods, including medical products, was anticipated. We aimed to explore the weekly patterns of prescription dispensing and over-the-counter (OTC) medication sales in Sweden in 2020 compared with previous years, to assess the influence of the government restrictions on medication sales, and to assess whether there is evidence of medication stockpiling in the population. Methods Aggregated data on the weekly volume of defined daily doses (DDDs) of prescription medication dispensed and OTC sales from 2015 to 2020 were examined. From 2015–2019 data, the predicted weekly volume of DDDs for 2020 was estimated and compared to the observed volume for each ATC anatomical main group and therapeutic subgroup. Results From mid-February to mid-March 2020, there were increases in the weekly volumes of dispensed medication, peaking in the second week of March with a 46% increase in the observed versus predicted number of DDDs dispensed (16,440 vs 11,260 DDDs per 1000 inhabitants). A similar pattern was found in all age groups, in both sexes, and across metropolitan and non-metropolitan regions. In the same week in March, there was a 96% increase in the volume of OTC sold (2,504 vs 1,277 DDDs per 1000 inhabitants), specifically in ATC therapeutic subgroups including vitamins, antipyretics, painkillers, and nasal, throat, cough and cold preparations. Conclusion Beginning in mid-February 2020, there were significant changes in the volume of prescription medication dispensed and OTC drugs sold. The weekly volume of DDDs quickly decreased following recommendations from public authorities. Overall, our findings suggest stockpiling behavior over a surge in new users of medication.


2016 ◽  
Author(s):  
Jeffrey T Lai ◽  
Kavita M Babu

Anticholinergic compounds oppose the action of the endogenous neurotransmitter acetylcholine at its target receptors and are found in over-the-counter and prescription medication, natural products, and plants. Anticholinergic medications, such as atropine and scopolamine, are used for the treatment of a wide range of conditions, including bradycardia, motion sickness, and insomnia. Antihistaminergic medications, such as diphenhydramine, also possess anticholinergic activity and are used in the treatment of seasonal allergies, common cold symptoms, and allergic reactions. Other medications, such as antidepressants (especially the older tricyclic class), antipsychotics, muscle relaxants, and anticonvulsants, can act as anticholinergic agents or produce anticholinergic side effects. Toxicity can result from therapeutic misadventure, intentional overdose, recreational use, and pediatric exposures. This review covers the principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcomes. Figures show the anticholinergic toxidrome, look-alike structures, and electrocardiographic changes in tricyclic antidepressant overdose. Tables list medications with anticholinergic activity and selected botanicals that cause anticholinergic toxicity. Key words: anticholinergic overdose, anticholinergic toxicity, anticholinergic toxidrome, physostigmine, tricyclic antidepressant toxicity This review contains 3 highly rendered figures, 2 tables, and 49 references.


Cephalalgia ◽  
1998 ◽  
Vol 18 (3) ◽  
pp. 146-151 ◽  
Author(s):  
SP Forward ◽  
PJ McGrath ◽  
D MacKinnon ◽  
TL Brown ◽  
J Swann ◽  
...  

This community-based telephone survey determined medication patterns of 274 frequent headache sufferers who reported 12 or more headaches a year. Headaches were classified using the International Headache Society's (IHS) criteria. Participants reported on 465 types of headaches: 129 tension headaches, 158 migraine headaches, 8 chronic tension headaches, and 148 headaches which were unclassifiable using IHS criteria. Females ( n=133) reported an average of 1.9 types of headache and males ( n=141) reported 1.5 headache types. Fifty-six percent of respondents used acetaminophen for tension-type and 60% used acetaminophen for migraine. One percent used prescription medication for tension headache and 12% used prescriptions for migraine. The perceived effectiveness of over-the-counter medication was approximately 7 on a scale of 0–10 for tension headaches and 6 for migraine. Both tension-headache and migraine-headache sufferers waited about 1 h before taking any medication. Tension-headache sufferers waited until the headache was above 5 on a 0 to 10 scale (4.6 for migraine). It is possible that more aggressive use of medication might improve headache management.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A148-A149
Author(s):  
Jessica Dietch ◽  
Norah Simpson ◽  
Joshua Tutek ◽  
Isabelle Tully ◽  
Elizabeth Rangel ◽  
...  

Abstract Introduction The purpose of the current study was to examine the relationship between current beliefs about hypnotic medications and historical use of prescription hypnotic medications or non-prescription substances for sleep (i.e., over the counter [OTC] medications, alcohol, and cannabis). Methods Participants were 142 middle age and older adults with insomnia (M age = 62.9 [SD = 8.1]; 71.1% female) enrolled in the RCT of the Effectiveness of Stepped-Care Sleep Therapy In General Practice (RESTING) study. Participants reported on history of substances they have tried for insomnia and completed the Beliefs about Medications Questionnaire-Specific with two subscales assessing beliefs about 1) the necessity for hypnotics, and 2) concerns about potential adverse consequences of hypnotics. Participants were grouped based on whether they had used no substances for sleep (No Subs, 11.6%), only prescription medications (Rx Only, 9.5%), only non-prescription substances (NonRx Only, 26.6%), or both prescription and non-prescription substances (Both, 52.3%). Results Sixty-one percent of the sample had used prescription medication for sleep and 79% had used non-prescription substances (74% OTC medication, 23% alcohol, 34% cannabis). The greater number of historical substances endorsed, the stronger the beliefs about necessity of hypnotics, F(1,140)=23.3, p<.001, but not about concerns. Substance groups differed significantly on necessity beliefs, F(3,1)=10.68, p<.001; post-hocs revealed the Both group had stronger beliefs than the No and NonRx Only groups. Substance groups also differed significantly on the concerns subscale, F(3,1)=6.68, p<.001; post-hocs revealed the NonRx Only group had stronger harm beliefs than the other three groups. Conclusion The majority of the sample had used both prescription and non-prescription substances to treat insomnia. Historical use of substances for treating insomnia was associated with current beliefs about hypnotics. Individuals who had used both prescription and non-prescription substances for sleep in the past had stronger beliefs about needing hypnotics to sleep at present, which may reflect a pattern of multiple treatment failures. Individuals who had only tried non-prescription substances for sleep may have specifically sought alternative substances due to concerns about using hypnotics. Future research should seek to understand the impact of treatment history on engagement in and benefit from non-medication-based treatment for insomnia. Support (if any) 1R01AG057500; 2T32MH019938-26A1


AAOHN Journal ◽  
2001 ◽  
Vol 49 (9) ◽  
pp. 422-428
Author(s):  
Yvonne Abdoo ◽  
Sally L. Lusk ◽  
Cynthia S. Darling-Fisher ◽  
David L. Ronis ◽  
Richard J. Kowalski

2012 ◽  
Vol 23 (3) ◽  
pp. 1048-1057
Author(s):  
Sujit S. Sansgiry ◽  
Manjiri D. Pawaskar ◽  
Prajakta Bhounsule

Author(s):  
Denise C. Park ◽  
Roger W. Morrell ◽  
David Frieske ◽  
A. Boyd Blackburn ◽  
Daniel Birchmore

Sign in / Sign up

Export Citation Format

Share Document