EENT and Sleep Disorders Q 94 - Gyan Darpan : Learning Portal
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Monday, 21 March 2022

EENT and Sleep Disorders Q 94

A client taking a beta-adrenergic blocker for HTN can experience interference with sleep patterns such as:
     A. Nocturia
     B. Increased daytime sleepiness.
     C. Increased awakening from sleep.
     D. Increased difficulty falling asleep.

Correct Answer: B. Increased daytime sleepiness.

Beta-Blockers can cause nightmares, insomnia, and awakenings from sleep. Sleep disorders are the common side effects of beta-blockers. Beta-blockers have been shown to reduce the production of melatonin via specific inhibition of adrenergic beta1-receptors.

Option A: Results of two placebo-controlled studies of hypertensive patients, investigating the relationship between beta-blocker induced central nervous system (CNS) side effects and the nightly urinary excretion of melatonin, demonstrated that the CNS side effects (sleep disorder, nightmares) during beta-blockade are related to a reduction of melatonin levels.
Option C: Beta-blockers have been shown to reduce the production of melatonin via specific inhibition of beta-1 adrenergic receptors. Although atenolol had no effect on subjective measures of sleep this hydrophilic drug also reduced REM frequency, suggesting that either it has some central effect, or that REM reduction is due to a peripheral ‘shielding’ effect.
Option D: Beta-blockers have long been associated with sleep disturbances, including awakenings at night and nightmares. They are thought to do this by inhibiting the nighttime secretion of melatonin, a hormone involved in regulating both sleep and the body’s circadian clock. Low levels of melatonin have sometimes been observed in chronic insomnia.

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