Psych Vivas · Specialty psychiatry — sleep medicine interface
Sleep disorders in psychiatry — structured clinical viva
Fellowship viva on geriatric insomnia, hypnotic risk, CBT-I, OSA, and deprescribing.
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FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the psychiatry registrar in clinic. A 62-year-old man with late-life depression and anxiety has taken temazepam nightly for 6 years. He falls twice in 3 months, scores high on an insomnia severity measure, and his daughter wants 'a stronger sleeping tablet.' BMI 36, loud snoring, ESS elevated. Discuss diagnosis hierarchy, why long-term benzodiazepines are problematic, CBT-I components, OSA work-up, and a safe deprescribing and safety plan.
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References6ShowHide
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- [2]Qaseem A, Kansagara D, Forciea MA, et al. Management of Chronic Insomnia Disorder in Adults: A Clinical Practice Guideline From the American College of Physicians Ann Intern Med, 2016.PMID 27136449
- [3]Edinger JD, Arnedt JT, Bertisch SM, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline J Clin Sleep Med, 2021.PMID 33164742
- [4]Peppard PE, Young T, Barnet JH, et al. Increased prevalence of sleep-disordered breathing in adults Am J Epidemiol, 2013.PMID 23589584
- [5]Sateia MJ, Buysse DJ, Krystal AD, et al. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults J Clin Sleep Med, 2017.PMID 27998379
- [6]Wilson S, Anderson K, Baldwin D, et al. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update J Psychopharmacol, 2019.PMID 31271339