Management of insomnia

Article Abstract:

Chronic insomnia can be cured, although identifying the cause or causes and resolving the problem may take time. The diagnosis often depends on ruling out other factors. A history and a sleep log can help pinpoint contributing factors. Treatment consists of behavioral management such as using the bed only for sleep and avoiding naps, modifying environmental factors, improving health practices such as diet and exercise, and medication. Principles of drug therapy include prescribing low doses, intermittent use, short-term use, and gradual weaning. Medications can have side effects. Antidepressants and melatonin have shown benefits but need further research.

Sleep disorders

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Benzodiazepines and zolpidem for chronic insomnia: a meta-analysis of treatment efficacy

Article Abstract:

Benzodiazepines in combination with the antidepressant drug zolpidem appear to be effective in treating insomnia, but research is needed on the drugs' long-term effects. Researchers used a technique called meta-analysis to pool the results of 22 studies covering 1,894 patients who took a benzodiazepine and zolpidem for insomnia. The drugs were more effective than a placebo in improving the quality of sleep, prolonging sleep time and reducing the number of awakenings. However, the median treatment time was only seven days.

Evaluation, Drug therapy, Benzodiazepines, Zolpidem

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Treating Insomnia in Older Adults: Taking a Long-Term View

Article Abstract:

More research is needed to determine whether behavior therapy can be effective in the long-term treatment of insomnia in elderly people. Insomnia is a common complaint among the elderly. Sedatives such as benzodiazepines are very effective in treating insomnia, but most studies only treated patients for a few weeks. Insomnia is often a chronic condition and therefore long-term treatments are needed. A 1999 study found that behavior therapy was effective and lasted longer than drug treatment.

Editorial

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