Pharmacotherapy is Not the Only Ideal Treatment for Insomnia

Pharmacotherapy is Not the Only Ideal Treatment for Insomnia
Aging brings about several repercussions that affect the normal functioning of a person’s nervous system. It affects body balance similarly to other long-term medical illnesses such as arthritis, Parkinson’s disease, Multiple Sclerosis, or Alzheimer’s. Certain chronic disorders of the heart can also cause unsteadiness. The critical factors, in this case, are the patient’s age, medication, and social isolation due to his wife’s passing, causing him to be physically and psychologically vulnerable. These stressors manifest as insomnia, anxiety, unsteadiness, and a mental blur due to altered consciousness. Elderly patients show the presence of numerous comorbidities, which contribute to frequent falls and mortality after hip joint fractures. As a psychiatric-mental health nurse practitioner, it is essential to check for neuropsychiatric disorders, one of the most common comorbidities in older people. The patient’s complaints could be common side effects of their medication. The common side effects of Triazolam and Clonazepam include drowsiness and coordination issues and feeling dizzy, lightheaded, nervous, confused, and nauseous (Abad & Guilleminault, 2018). The patient’s balance-related problems could also be due to disturbances in the inner ear, such as vestibular issues. Specific abnormalities in the inner ear can make people feel like they are floating and causes unsteadiness. Another reason could be damage to the nerves in the legs following hip fracture surgery. From the overall observation, it seems he has trouble managing anxiety, and his symptoms are the predominant side effects of his sleep and anxiety medication.
Necessary information to collect from the visit would be the patient’s blood pressure and blood glucose levels to check for any hematic problem. Moreover, a CT scan, chest x-ray, and blood serology would be important in determining any underlying cause of his problems, such as brain tumors, nerve damage, abnormal serology, or cardiomyopathies. It is also essential to ask the patient about his lifestyle, anxiety triggers, and how he manages his day-to-day life. Since he is a widower, it could be that he lives alone and is malnourished. He may also be experiencing medication errors, such as taking a dosage more than he is prescribed, which could make him lose balance and be confused. He might require a caregiver to ensure that he’s eating well and taking his medication on time and correctly. Such patients must check for chronic illnesses such as diabetes and medication that could affect their health. Drugs that cause people to lose body balance or have a mental blur include insulin, anti-arrhythmic drugs, vasodilators, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and sleep inducers, such as Triazolam (Xiong & Hategan, 2019). Therefore, the primary goal of the patient’s treatment is to change their sleep and anxiety medication and check if their symptoms improve.
Furthermore, an obstacle in such cases is that older people struggling with their health have one of the highest rates of mental disorders such as depression and delirium. Depression causes them to fixate their stress over certain stimulants; they tend to overthink and get anxious. The patient had recently undergone surgery, so depression could have worsened his functionality. On the other hand, delirium manifests as an increased limitation in the functionality related to daily tasks such as walking, cooking, driving, or using the toilet. Delirium is related to a higher number of patients placed in care homes and increased mortality. ...