CBT-I for insomnia
I understand that CBT-I is the gold standard for insomnia, but in my area, very few professionals actually do it, some for a price that most of my patients can't pay. Now, I don't want to actually be a CBT-I trained professional myself, but I was wondering if there is any material that I can access that offers the gist of it or at least a few techniques that I can actually apply in my practice. Thanks in advance! (Source: Student Doctor Network)
Source: Student Doctor Network - August 25, 2023 Category: Universities & Medical Training Authors: thelastpsych Tags: Psychiatry Source Type: forums

Clinical Research Coordinator in PTSD and Sleep at UCSF/ San Francisco VA Medical Center
The Stress and Resilience Research Program at the San Francisco VA Medical Center and UCSF We have an exciting opportunity to join our team as a clinical research coordinator in the Stress and Resilience Research program at the San Francisco VA Medical Center and UCSF. Research projects investigate pharmaceutical and behavioral treatments for Posttraumatic Stress Disorder (PTSD) and insomnia; fear conditioning; psychophysiological, endocrine, immune and -omic studies; digital health... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - August 12, 2023 Category: Universities & Medical Training Authors: TraumaDoctor Tags: Jobs and Help Wanted Board Source Type: forums

Cluster B:histrionic traits
I have a relatively new client of 3 months that I inherited from a retiring psychologist. No personality pathology, PTSD, OCD, and bipolar 1 disorder. Client has had middle insomnia since November 2022 and is often sleeping 2-4 hours a night. She once fell asleep during our session. This client also stopped her risperdal cold Turkey due to excessive weight gain. She has had a sleep study, seen a sleep psychologist and has tried every sleep medication. She is now on Belsomra and her sleep is... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - August 7, 2023 Category: Universities & Medical Training Authors: psychma Tags: Psychiatry Source Type: forums

Buspirone - a glorified placebo?
So, I know this question has come up many times before, but I was actually courious to know other psychiatrists opinion on augmentation for GAD after SSRIs/CBT. Sometimes, my patients still get residual symtomps that affect their quality of life, like insomnia or irritability even with behavioral interventions like sleep hygiene, and even after CBT and max-dose SSRIs. In these cases, if the patient had a good response to the SSRI for their anxiety, I'm always inclined to augment with a... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - July 14, 2023 Category: Universities & Medical Training Authors: thelastpsych Tags: Psychiatry Source Type: forums

Clinical Research Coordinator for PTSD and sleep studies - San Francisco VA Medical Center/UCSF
We are hiring! The Stress and Resilience Research Program at the San Francisco VA Medical Center and UCSF We have an exciting opportunity to join our team as a full-time clinical research coordinator in the Stress and Resilience Research program at the San Francisco VA Medical Center and UCSF. Research projects investigate pharmaceutical and behavioral treatments for Posttraumatic Stress Disorder (PTSD) and insomnia; fear conditioning; psychophysiological, endocrine, immune and... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - April 5, 2023 Category: Universities & Medical Training Authors: TraumaDoctor Tags: Jobs and Help Wanted Board Source Type: forums

Z drugs for chronic insomnia?
I am interested in surveying the collective wisdom about Z drugs for insomnia. My usual practice has been to approach them like benzodiazepines, basically avoiding their use for sleep aside from very brief prescriptions. Reading through guidelines (such as https://jcsm.aasm.org/doi/10.5664/jcsm.6470#d1e5029) and other literature (such as Pharmacological Treatment of Insomnia), I wonder if I am being too strict with my prescribing practices and denying patients a potentially... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - January 29, 2023 Category: Universities & Medical Training Authors: Bartelby Tags: Psychiatry Source Type: forums

Husband is MD, scripts controlled meds to Wife
You have a stable inherited outpatient, being seen primarily for ADHD, on Adderall 10 mg BID. She mentions her husband is a physician. After leaving the appointment, you check the PDMP again and realize that she's gotten a few scripts of Adderall and short-acting benzos for insomnia from him several times (field unrelated to psychiatry). Nothing majorly concerning from the fills, appears like it was bridging refills and/or sporadic, nothing majorly concerning for abuse. Clown ****. What... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - January 24, 2023 Category: Universities & Medical Training Authors: yoloswagpoop42069 Tags: Psychiatry Source Type: forums

Late onset bipolar
Patient in their 70s. Chronic cannabis user. Chronic depression, insomnia, anxiety, possible narcissistic personality traits. Over previous few months increased use of high potency cannabis products (e.g. 80% THC pen, flower marijuana soaked in cannabis oil). Manic episode emerges and leads to inpatient hospitalization. Dad had "bipolar", but best history I can get is dad was a heavy drinker and physically abusive, and had some good days. Where do you put your money? This person has new... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - January 3, 2023 Category: Universities & Medical Training Authors: nexus73 Tags: Psychiatry Source Type: forums

Non controlled sleep options?
What are the most potent non controlled sleep medication options, in your opinion? Assume primary insomnia in context of depression where sleep hygiene is optimized. (Source: Student Doctor Network)
Source: Student Doctor Network - October 6, 2022 Category: Universities & Medical Training Authors: lockian Tags: Psychiatry Source Type: forums

Thoughts on treating insomnia?
Im just curious about everyone's thoughts on treating sleep issues/what your general approach is as far as when you start controlled substances/overall treatment preference, if you use the z drugs, etc. (Source: Student Doctor Network)
Source: Student Doctor Network - July 15, 2022 Category: Universities & Medical Training Authors: DrAmazingishere Tags: Psychiatry Source Type: forums

Insomnia meds
PGY-1 (Europe) having difficulties with patients with insomnia in the depression ward. Currently I try with my patients the following order. 1) Sleep Hygiene 2) Baldrian and natural remedies 3) Zopiclon 3,75-7,5mg (only a few weeks) 4) Quetiapin (25mg) 4) Here is where I find it hard. Usually would go with Pipamperon 40mg. I've seen colleagues go with Agomelatin, Mirtazapin, Amitriptyline, Imipramine. Yesterday I had a Patient requesting Trazodon, because she had it prescribed in the... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - February 1, 2022 Category: Universities & Medical Training Authors: Tangerine123 Tags: Psychiatry Source Type: forums

Failing an elective
Hi Currently a sophomore at a state school and had a rough midterms week, dont know why but I cant really get any sleep either, at most 3ish consecutive hours. Doesn't help that for absolutely no reason I seem to want to cry every night. I submitted a midterm essay 2 days late for an elective history class and the professor emailed saying I am extremely disrespectful and indisciplined, the profs giving me a 0 and has more or less failed me even if I get 100s on everything else. I can... Read more (Source: Student Doctor Network)
Source: Student Doctor Network - November 7, 2021 Category: Universities & Medical Training Authors: sleepless headache Tags: Ask Your Confidential Question Here Source Type: forums

Long COVID for Patients with Chronic Pain?
Where should these patients be seen and by whom? Pain, ID, PM&R, ID, Neuro, or Psych? Stanford Medicine opens clinic for patients struggling with long COVID With research showing up to 30% of COVID-19 patients experiencing lingering symptoms, Stanford Health Care treats such “long haulers” with multidisciplinary teams. med.stanford.edu “As the pandemic progressed, we started seeing patients with all kinds of lingering symptoms after their initial COVID infection, includin...
Source: Student Doctor Network - August 2, 2021 Category: Universities & Medical Training Authors: drusso Tags: Pain Medicine Source Type: forums

Sedatives for insomnia should not be stopped prematurely
(Source: BMJ Comments)
Source: BMJ Comments - April 14, 2021 Category: General Medicine Source Type: forums

Re: Advise non-pharmacological therapy as first line treatment for chronic insomnia
(Source: BMJ Comments)
Source: BMJ Comments - April 4, 2021 Category: General Medicine Source Type: forums