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Management of insomnia.

C K Kirkwood1

  • 1School of Pharmacy, Virginia Commonwealth University, Richmond 23298-0533, USA. cynthia.kirkwood@vcu.edu

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)
|October 26, 1999
PubMed
Summary

Nonpharmacologic insomnia treatments offer sustained benefits over hypnotics, which can cause tolerance and side effects. Behavioral interventions and sleep hygiene are key for long-term insomnia management.

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Area of Science:

  • Sleep Medicine
  • Pharmacology

Background:

  • Insomnia is a prevalent and often undertreated sleep disorder.
  • Current management approaches include pharmacologic and nonpharmacologic strategies.

Purpose of the Study:

  • To review current issues in the pharmacologic and nonpharmacologic management of insomnia.

Main Methods:

  • A literature search was conducted using MEDLINE (1990-1999).
  • Keywords included insomnia, various hypnotics (e.g., benzodiazepines, zolpidem, zaleplon), melatonin, and valerian.
  • Controlled trials and case studies were identified.

Main Results:

  • Nonpharmacologic strategies like stimulus control and sleep hygiene provide more sustained effects than medications.
  • Commonly prescribed hypnotics (benzodiazepines, zolpidem) carry risks of tolerance and adverse effects.
  • Zaleplon, a new nonbenzodiazepine, offers potential benefits for sleep-onset and sleep-maintenance insomnia due to its short half-life.

Conclusions:

  • Pharmacotherapy is common but long-term hypnotic use can lead to tolerance, dependence, or rebound insomnia.
  • Nonpharmacologic options, including behavioral interventions and patient education, offer longer-lasting benefits for insomnia management.

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