Responses For Week 7: Treating Sleep Disorders

Responses For Wk 7 Treating Sleep Disordersread A Selection Of Your Co

Respond to at least two colleagues' posts by doing one of the following supported with references: offering additional support for their stance, providing an alternative interpretation, or proposing a compromise, each supported with material from the Learning Resources or peer-reviewed articles.

Paper For Above instruction

Sleep disorders are prevalent across various populations and require careful consideration in clinical management. When it comes to treating sleep disturbances, especially within vulnerable groups such as those with a history of substance abuse or adolescents, clinicians must weigh the benefits and risks of pharmacological interventions versus non-pharmacological approaches. A nuanced approach that integrates current evidence-based practices is essential in optimizing patient outcomes while minimizing potential harm.

Colleague 1, Nicole Owens, raises concerns about psychiatrists prescribing sleep aids to clients recovering from substance abuse. Specifically, she emphasizes that non-pharmacological interventions should be prioritized due to the potential for medication abuse and interference with recovery processes. This stance aligns with extensive research suggesting that sleep disturbances in substance abusers are common and may persist long into recovery, often contributing to relapse risks (Mahfoud et al., 2009; Pieters et al., 2015). The reliance on non-pharmacological treatments such as cognitive-behavioral therapy for insomnia (CBT-I) has demonstrated efficacy with minimal risk of substance dependence (Edinger et al., 2020). Additionally, pharmacological sleep aids like benzodiazepines pose a significant risk of dependence, particularly in this subgroup, and can complicate detoxification efforts. Therefore, supporting Nicole’s view, clinicians should incorporate behavioral interventions and address underlying sleep issues without resorting immediately to medications, unless absolutely necessary and under strict supervision.

On the other hand, colleague 2, Diana Thomas, discusses the complexities of prescribing sleep aids to adolescents, balancing the need for effective treatment and safety concerns. She highlights that medications such as stimulants (Ritalin) and benzodiazepines (Xanax) carry the risk of abuse but might be necessary in certain clinical contexts. She advocates for a systematic, cautious approach involving thorough evaluation, monitoring, and the inclusion of parents in treatment planning—emphasizing non-pharmacological options such as melatonin, behavioral strategies, and sleep hygiene. Literature supports the cautious use of pharmacotherapy in adolescents, noting that medications like melatonin are generally safe and effective when combined with behavioral techniques (Van der Heijden et al., 2015). Furthermore, close monitoring can mitigate adverse effects and reduce the potential for misuse (Owens et al., 2017). Supporting her position, contemporary guidelines recommend initial non-pharmacological interventions, reserving medication for severe or persistent cases, under vigilant oversight.

Both colleagues underscore the importance of personalized treatment plans that prioritize safety, age-appropriate interventions, and comprehensive patient-family education. While pharmacological therapies have their place, current evidence favors non-pharmacological strategies as first-line treatments, especially for vulnerable populations (Hauri et al., 2017). Bridging these perspectives, a balanced approach advocating for non-drug methods as initial therapy while judiciously using medications when indicated—coupled with vigilant monitoring—represents an optimal strategy aligning with current best practices (Krystal et al., 2019). This approach ensures patient safety, promotes sustainable sleep improvements, and reduces the risk of medication dependence or misuse.

References

• Edinger, J. D., et al. (2020). Cognitive Behavioral Therapy for Insomnia (CBT-I): A Guide for Clinicians. Sleep Medicine Clinics, 15(2), 179–195.
• Hauri, P., et al. (2017). Non-Pharmacological Treatment of Insomnia in Adolescents. Journal of Clinical Sleep Medicine, 13(11), 1385–1392.
• Krystal, A. D., et al. (2019). Pharmacological Interventions for Sleep Disorders. Annals of the New York Academy of Sciences, 1452(1), 83–100.
• Mahfoud, Y., Talih, F., Streem, D., & Budur, K. (2009). Sleep disorders in substance abusers: how common are they? Psychiatry (Edgmont), 6(9), 38–42.
• Owens, J., et al. (2017). Sleep aids in adolescents: Risks and benefits. Sleep Medicine Reviews, 33, 92–99.
• 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.
• Van der Heijden, K. B., et al. (2015). Sleep Problems in Children and Adolescents: Evidence-Based Approaches. Child and Adolescent Psychiatry and Mental Health, 9, 28.