| Term 
 | Definition 
 
        | bupropion, venlafaxine, prednisone, stimulants, theophylline and antineoplastics |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | benzodiazepine receptor agonists (BZRAs and BZDs) and melatonin receptor agonist |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | BDZ, BZRAs not previously chosen |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | sedating low dose antidepressant |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | combo of BZRAs and antidepressant; anecdotal evidence at this point, makes sense as they have differing MOA without as many SEs |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Restoril (temazepam), Halcion (triazolam) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | has more rebound anxiety, makes old people crazy, and not recommended for first line |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | binds the BZD receptor on GABAergic neurons to increase INHIBITORY firing in the CNS |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | better sedative hypnotic effects than long acting BZDs but more anxiety and withdrawal symptoms |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | alprazolam, clonazepam, lorazepam, oxazepam, and temazepam |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Ambien (zolpidem), Sonata (zaleplon), and Lunesta (eszopiclone) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | of the intermediate acting, it is most commonly used for sleep |  | 
        |  | 
        
        | Term 
 
        | HA, dizziness, day time sedation, parasomnias, potential for CNS depression |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | reduce sleep latency, increased total sleep time; no tolerance, dependence, rebound insomnia "hangover" |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | reduces sleep latency; if taken with food will increase daytime sedation without increased sleep benefit |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | FDA approved for chronic insomnia, decreased awakening and sleep onset; increased HA and unpleasant taste |  | 
        |  | 
        
        | Term 
 
        | Melatonin receptor agonist |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | MOA melatonin receptor agonist |  | Definition 
 
        | agonist at MT1 and MT2 contributing to sleep promotion and maintenance of circadian rhythm |  | 
        |  | 
        
        | Term 
 
        | most appropriate for patients with a history of substance abuse and has less side effect profile for elderly patients |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | trazedone, mirtazapine, doxepin |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | little anti-cholinergic effect, studied as an adjunct sleep aid with full dose antidepressant |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | associated with wt gain but effective in elderly patients with comorbid depression and wt loss |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | monamine oxidase inhibitors |  | Definition 
 
        | isocarboxazid, phenelzine, tranylcypromine, selegiline |  | 
        |  | 
        
        | Term 
 
        | MAOIs mechanism of action |  | Definition 
 
        | suppress REM sleep, no effect on memory, transient alleviation of depressive symptoms |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | amitriptyline, desipramine, nortriptyline, imipramine |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | suppresses REM sleep, no effect on memory, more often used as sleep aids than antidepressants |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | antihistamine for sleep aids |  | Definition 
 
        | unfavorable SE profile, used often but little support for use in insomnia but occasional use could be beneficial |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | possibly the most used insomnia self-treatment |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | not recommended due to: short duration of action, adversely affects sleep stages/ cycles, exacerbates sleep apnea and large potential for abuse and dependence |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | small benefit on sleep latency but no significance in sleep duration; inconsistent effects on sleep continuity and structure |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | small effect on sleep latency, little to no effect on wakening and total sleep time; studies show there is chronobiotic effect but no hypnotic effect |  | 
        |  | 
        
        | Term 
 
        | FDA approved but not recommended |  | Definition 
 
        | chloral hydrate, barbituates, and non-barbituate/ non-BZD (meprobamate) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | can be used to procedural sedation or EtOH withdrawal suppression |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Orexin/ hypocretin-cells in the brain that maintain wakefulness |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | PAP, wt loss, surgical treatment, oral appliances and pharmacotherap |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | continuous positive airway pressure that keeps airways open |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | bilevel positive airway pressure, that provides less pressure for the expiration and more pressure for inspiration |  | 
        |  | 
        
        | Term 
 
        | surgical options for sleep apnea |  | Definition 
 
        | adenoidectomy, tonsillectomy, bariatric surger and tracheostomy |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | acetazolamide, theophylline, progesterone |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | carbonic anhydrase inhibitor leads to metabolic acidosis; lowers the CO2 apnea threshold |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increases central respiratory drive and cardiac contractility in cases of SOB |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increases chemoreceptiveness and improves daytime gas exchange in OH |  | 
        |  | 
        
        | Term 
 
        | narcolepsy treatment: daytime sleepiness |  | Definition 
 
        | stimulants: modafanil/ammodafamil, amphetamines and maxindol |  | 
        |  | 
        
        | Term 
 
        | narcolepsy treatment: cataplexy |  | Definition 
 
        | antidepressants: TCAs, (SS, SN, NSRIs), and MAOIs |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | chemically unrelated to amphetamine and methylphenidates |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | alpha 1 stimulation, direct and indirect stimulation of dopamine, serotonergic/ GABAergic are all possible |  | 
        |  | 
        
        | Term 
 
        | side effect profile for modafanil |  | Definition 
 
        | HA (should resolve ater weeks of treatment), nausea, and nervousness |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | less reductionin appetite and less effect on blood ressure than amphetamine products |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | low dose dopamine release is greater than NE and 5HT release; high dose monaminergic depletion and reuptake inhibition occurs (not seen with methylphenidate use) |  | 
        |  | 
        
        | Term 
 
        | SE profile for stimulants |  | Definition 
 
        | minor irritability, hyperactivity, mood changes, HA, palpitations, sweating, tremors, anorexia, insomnia |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | neurotransmitter that may acti via stimulation of GABA-B, silencing DAminergic neurons |  | 
        |  | 
        
        | Term 
 
        | treats cataplexy in narcolepsy and may enhance daytime alertness and improve night sleep |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | SE profile for sodium oxybate |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | worsens cataplexy seizures |  | 
        |  | 
        
        | Term 
 
        | increases oral contraceptive metabolism |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | dopamine agonist with DOPA decaarboxylase inhibitor; used in RLS |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | SE of L-DOPA with Carbidopa |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | decreases nausea associated with levodopa |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ergot derivative and dopamine agonist, pro-lactin inhibitor |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | pramipexole and popinirole |  | Definition 
 
        | binds to D2 and D3 (non-ergot) dopamine |  | 
        |  | 
        
        | Term 
 
        | dizziness, hypotension, nausea |  | Definition 
 
        | SE or pramipexole and popinirole |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | potential for benefit in pts who cannot tolerate the insomnia from dopamine agonists and when avoiding opiods is optimal |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | iron supplementation is appropriate for patients who are anemic and have RLS, magnesium has been associated with improving symptoms of RLS |  | 
        |  |