Goals of Therapy
- To cure insomnia and to achieve a healthy sleeping pattern
- To raise the awareness of self-treatment and OTC and to notify S.H. about their possible harmful consequences
- To educate the patient about the perimenopausal period, its symptoms and the ways of handling it effectively
Drug Therapy
Low sleep quality can cause changes in blood pressure level, lead to its increase, and make the treatment of hypertension less efficient. Researchers note that there is a strong correlation between short sleep and hypertension, and short sleep was consistently more closely related to risk for hypertension in women compared with men. (Grandner, 1038). Doxylamine has a hypnotic, antihistamine, sedative effect. Sleep disorders are one of the indications for the use of this drug with a treatment duration of up to 2 weeks. It is possible to note that “short-term treatment with doxylamine formulations had marked positive clinical effects in acute insomnia, combined with satisfactory tolerance by the patients” (Mel’nikov, 2019, p. 45). This drug helps to significantly reduce the time of falling asleep, to increase the total duration of sleep, and to lessen frequent night awakenings and to improve the level of wakefulness after sleep.
Parameters for Monitoring the Success of the Therapy
- The decrease in the time of wakefulness within sleep and the duration of the 1st stage of sleep
- The increase in the length of the 2nd stage of sleep
- Reduced number of awakenings
- Analyzing the duration of the 4th stage of the slow sleep phase, the REM sleep phase, and the number of sleep cycles
Specific Information for the Patient
One of the main purposes of sleep is to rest the body’s cardiovascular system. Healthy sleep helps to reduce blood pressure for 7-8 hours; it decreases and gives rest to the heart and arteries. The necessity for a restorative sleep continuing about 7-8 hours is directly connected with the cardiovascular system, and it allows the patients to manage not only hypertension but also diabetes. According to Bathgate (2018), “Insomnia is a strong candidate to join the list of risk factors for hypertension along with obstructive sleep apnea” (p.52). Those people who suffer from sleep disorders are much more likely than others to have problems with blood pressure. Poor sleep, quality, and the number of sleeping hours can complicate the treatment of hypertension.
Possible Side Effects
- Abnormal heart rhythms or altered heart rate
- Severe allergic reaction
Second-Line Therapy
Zolpidem has a tranquilizing and simultaneously stimulating, but delayed effect, so the expected impact in terms of improving the quality of sleep will appear gradually.
Alternative Medicines
Treatment of insomnia can be carried out not only by taking sleeping pills or psychotherapy methods. A positive result is also given by proven methods of alternative medicine. People with cardiovascular problems can try taking a bath before going to bed with the addition of medicinal decoctions, essential oils, or sea salt. Chamomile for insomnia is one of the most effective methods for improving sleep. The plant quickly calms the nervous system, relieves tension and fatigue. Valerian root has an antidepressant, sedative, hypnotic, anxiolytic, hypotensive, and anti-spastic effect.
Recommended Dietary and Lifestyle Changes
- S.H. should monitor her blood pressure and take the necessary medications
- The patient should do more physical activity such as gymnastics, yoga, and sports
- Eat healthy food and exclude everything fried, salted, or canned from the menu
- S.H. should avoid daytime sleep because it might lead to insomnia at night
Interaction of Doxylamine with Other Substances
It is necessary to avoid the simultaneous use of doxylamine and alcoholic beverages because alcohol increases the sedative effect of doxylamine. Interaction of doxylamine with zolpidem may lead to adverse reactions such as dizziness, sleepiness, confusion.
References
Bathgate, C. J., & Fernandez-Mendoza, J. (2018). Insomnia, short sleep duration, and high blood pressure: recent evidence and future directions for the prevention and management of hypertension. Current hypertension reports, 20(6), 52.
Grandner, M., Mullington, J. M., Hashmi, S. D., Redeker, N. S., Watson, N. F., & Morgenthaler, T. I. (2018). Sleep duration and hypertension: analysis of > 700,000 adults by age and sex. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 14(6), 1031-1039.
Mel’nikov, A. Y., Lavrik, S. Y., Bikbulatova, L. F., Raginene, I. G., Ivanova, Y. A., & Zakharov, A. V. (2019). Efficacy of Reslip (doxylamine) in Acute Insomnia: A Multicenter, Open, Comparative, Randomized Trial. Neuroscience and Behavioral Physiology, 49(1), 45-47.