Short-term insomnia is often associated with situational stress and related to acute life stresses, though somewhat longer in duration. Long-term insomnia has a duration of more than three weeks and is challenging to evaluate. Underlying psychiatric problems may play a role in most cases of clinically relevant insomnia. 4 Medical conditions such as diabetes mellitus, coronary artery disease, angina pectoris, hyperthyroidism, esophageal reflux, peptic ulcer, asthma, obstructive lung disease, and Parkinson's disease may disrupt sleep. Dementia, depression, anxiety, and chronic pain may impair sleep.
Numerous medications can contribute to insomnia.
Methods A systematic approach using the following interventions was applied during this study. A systematic approach was used to quantify and decrease the number of routine sedative-hypnotic medications, when appropriate. Information from members of the team and data from the drug regimen review were used to identify problems and potential solutions as a continuous quality improvement project. Three surveys involving more than 1,000 residents were conducted in 10 nursing homes in three Texas counties. During the initial visit to each facility, the number of residents receiving sedative-hypnotic agents was determined.