Insomnia Essay

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One third of the United States population complains of insomnia, with about one

More than 40% of those suffering from insomnia self- medicate with over the counter drugs (OTC) or with other substances such as alcohol. 2

half of those are saying it’s serious.1

Insomnia is defined by inability to initiate or maintain sleep despite of adequate

time and opportunity to sleep which results in daytime impairment.2

time it’s characterized as problems with either sleep onset, sleep maintenance, or non- restorative sleep. Impairments associated with insomnia can lead to: impaired cognitive

functioning, increased incidence of bodily pain, increased future risk of psychiatric

disorders, increased risk of accidents, and increased healthcare cost.3

also have negative health consequences on obesity, cardiovascular disease and diabetes.4

There are four different types of insomnia.2,5

3 days in duration, most likely cause is acute situational or environmental stressors.

Second is short term insomnia less than 3 weeks caused by personal stress of an ongoing

nature. Third type is chronic primary insomnia with duration of more than 3 weeks

not related to lifestyle may be due to medical causes. Finally the forth type is a chronic

secondary insomnia with duration of more than 3 weeks related to lifestyle likely caused

psychological illness, substance abuse, behavioral cause(poor sleep hygiene). Secondary

chronic insomnia may be caused by comorbid diseases such as: heart failure, depression,

anxiety, bipolar disorder, sleep apnea, medications, substance abuse, restless leg syndrome

or circadian rhythm sleep disorders. As far as the medications are concerned possible

medication classes that cause insomnia are antidepressant...

... middle of paper ...

... choice for sleep onset insomnia. Appropriate drugs may include

zaleplon, zolpidem IR, ramelteon and triazolam. However, rebound insomnia may be a

problem with short acting benzodiazepines like triazolam. Moreover, sleep maintenance

insomnia are most appropriately treated with drugs that have an intermediate duration

and no active metabolites to minimize daytime effects such as : zolpidem, eszopiclone,

temazepam, and estazolam may be appropriate choices. Also, zaleplon can be taken after

awakening in the night if > 4 hr left for sleep. Attached are the tables with drug treatment

options for insomnia, and questionnaires to assess the initial insomnia and post treatment.

Nevertheless sedative-hypnotics should only be used in the lowest effective dose (to

decrease the next day morning impairment) for a short duration of time in treatment of


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