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Diclofenac, sold under the brand name Voltaren among others, is a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain and inflammatory diseases such as gout. [6] [9] It can be taken orally (swallowed by mouth), inserted rectally as a suppository, injected intramuscularly, injected intravenously, applied to the skin topically, or through eye drops.
Insomnia can be grouped into primary and secondary, or comorbid, insomnia. [124] [125] [126] Primary insomnia is a sleep disorder not attributable to a medical, psychiatric, or environmental cause. [127] There are three main types of primary insomnia.
“Short track record means that new, unexpected side effects are possible,” it explains. “Since this drug has a different way of acting than other insomnia drugs, the experience with it is particularly limited.” The label gives brief details on alternative remedies for insomnia, like cutting down on caffeine.
Insomnia can occur independently or as a result of another problem. [2] Conditions that can result in insomnia include psychological stress, chronic pain, heart failure, hyperthyroidism, heartburn, restless leg syndrome, menopause, certain medications, and drugs such as caffeine, nicotine, and alcohol.
EDS can affect the ability to function in family, social, occupational, or other settings. [1] [2] A proper diagnosis of the underlying cause and ultimately treatment of symptoms and/or the underlying cause can help mitigate such complications. [3] According to the National Sleep Foundation, around 20 percent of people experience EDS. [4]
Insomnia disorder (primary insomnia), chronic difficulty in falling asleep or maintaining sleep when no other cause is found for these symptoms. Insomnia can also be comorbid with or secondary to other disorders. Kleine–Levin syndrome, a rare disorder characterized by persistent episodic hypersomnia and cognitive or mood changes. [84]
It is not advisable to prescribe somnifacients for routine insomnia treatment, and they should only be used for short periods in patients who are severely distressed or with transient insomnia. [40] An important drawback of prolonged use is that it can result in rebound insomnia and withdrawal syndrome upon discontinuation. [ 40 ]
About 50% of dialysis patients have hypersomnia, as severe kidney disease can cause uremic encephalopathy, increased sleep-inducing cytokines, and impaired sleep efficiency. About 70% of dialysis patients are affected by insomnia, and RLS and PLMD affect 30%, though these may improve after dialysis or kidney transplant. [23]
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