Where to get sleeping pills in singapore

The tribunal decided a fair penalty was 33 months suspension, but reduced it by a third because of the long delay in prosecuting the doctor. This means he will be suspended for a total of 22 months. He also has to pay the cost of the proceedings and give a written undertaking not to re-offend.

The tribunal said its decision was based on several factors, including the patients' advanced ages, with the youngest aged 57 and the oldest aged 81, at the time of the last prescription.

The tribunal said: "The elderly is an especially vulnerable class of persons for which the potential risks of drug tolerance and dependency would be amplified. It noted that "the numerous disciplinary cases involving the prescription of hypnotics underscores the urgent need to send a deterrent message to those who hold in low regard the safeguards imposed on the dispensation of medicine".

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If possible, a corroborative history from the partner, and the family members of the patient, should be obtained. Patients often report experiencing anxiety, associated with automatic negative thoughts, as the night falls. A mental state examination, a physical examination and appropriate investigations as guided by the history, should follow. Sleep logs or sleep diaries can give a clearer account, and may also be helpful for the monitoring of progress.

In a Sleep Centre, investigations such as polysomnography a type of sleep study , and multiple sleep latency tests, are ordered. This is to exclude the diagnosis of other sleep disorders such as OSA, a periodic limb movement disorder and narcolepsy , and are not used to diagnose insomnia. Cognitive-behavioural therapy, in the management of insomnia, is a first-line treatment, and it might be better than pharmacological treatment in the long-term 4. It consists of various techniques, that may target either the behavioural or cognitive aspects of insomnia.

Behavioural techniques include advice on sleep hygiene, relaxation techniques and stimulus control. Cognitive techniques focus on challenging the negative and distorted thoughts, and replacing it with helpful ones.

All these techniques take time to learn, more effort to execute and may not offer same-day results. However, they do not have the risk of a dependence, or the other side effects, of medications. Some patients may have already tried some of these methods with limited success. It takes patience to explain that the causes are multifactorial. Hence, the interventions should also have a multi-pronged approach, and should be persisted. Educating patients on good sleep hygiene is straightforward and essential.

This includes having a regular sleep-wake time even during the weekends, avoiding long naps and avoiding coffee, tea and drinks with stimulants. The information is easily accessible on the Internet, and can be printed out for the patients. Stimulus control is a type of conditioning, where the patient pairs the concept of sleepiness with the bed. They are told to go to the bed, only when feeling sleepy. If they are unable to sleep after 15 minutes, they are told to get out of bed, and to return again only when they feel sleepy.

Relaxation techniques , such as progressive muscle relaxation, deep breathing exercises, and mindfulness techniques, can help the patient achieve a state of relaxation. The instructional videos are easily found on the Internet. The patients who face stressors may benefit from counselling. The primary care doctor can also consider referring the patient to external agencies, such as to a nearby Family Service Centre.

The website of the Agency for Integrated Care carries a list of other counselling centres, that the doctors can refer to. All medications that are sedative may increase the risk of falls, especially in elderly patients, or in those with multiple medical problems. This can result in hip fractures and resulting consequences. It is important to discuss the pros and cons, and to make a joint decision with the patient. Medications should be started judiciously at low doses, and be carefully monitored.

Antihistamines are sedative, and it is commonly used by doctors for insomnia. It is safe, the least likely to cause a dependence, and inexpensive. The ones that are commonly prescribed, are hydroxyzine and chlorpheniramine. However, patients often report a drowsiness on the next day. As it antagonises the muscarinic cholinergic receptors, it may result in a urinary retention and an impaired cognitive function. Do consult your pharmacist before buying if you are taking other medications or if you have any medical conditions.

Prevention is better than cure — how true, especially for insomnia! You can avoid tossing and turning the entire night by cultivating good sleep hygiene. By clicking the "Subscribe" button above, you consent to our collection, use and disclosure of your personal data in accordance with our Privacy Policy.

Go to cart. Say Goodnight To Insomnia. Signs of insomnia Not sure if you are suffering from insomnia? Check if you have the following symptoms. Having difficulty falling asleep Having restless sleep or difficulty staying asleep Waking up frequently or early in the morning and having difficulty falling back to sleep Feeling tired, anxious, depressed or irritable Being unable to concentrate, remember things or make decisions Types of insomnia There are mainly three types of insomnia — transient, short-term and chronic.

Managing insomnia Setting yourself free from insomnia is not as tough as you think. Sign up or log in to read this article in full. Sign up. Already have an account? Log in. Resend verification e-mail. Subscribe now. Frequently asked questions. Good job, you've read 3 articles today! More on this topic.