[Drug for the treatment of sleep disorders--review]

For the treatment of insomnia/sleep disturbances, drugs are indicated only if non-drug-procedures alone are not sufficiently successful or not successful at all. To facilitate sleep, sedative-hypnotic agents are used clinically. Because of favorable risk-benefit ratio, non-benzodiazepines with benzodiazepine-like action (zolpidem, zopiclon) or benzodiazepines themselves (dependent on their pharmacokinetic profil) are administered in the most cases. Sedative-hypnotic drugs reducing the electric activity of the CNS sufficiently to produce coma and even death are not recommended at present. To assess the clinical relevance of amino acid L-tryptophan for the treatment of insomnia/sleep disturbances, more controlled clinical studies are necessary. The nonprescription antihistamines (Doxylamin, Diphenhydramin) are only suitable for short-term administration in adults. Under certain conditions, antidepressant and antipsychotic drugs can be taken. Because of potential risks, the intake demands caution. Different herbal remedies are recommended, but only for extracts of valerian a sleep-inducing effect can be assumed. Melatonin, an endogenous hormone and tryptophan-metabolite is thought to be involved with the sleep-wake cycle. Therefore the exogenous intake of melatonin may influence vigilance and sleep. This is particularly true for patients with jet-lag symptoms.