[Insomnia and hypnotics]

This article outlines some of the new developments in the field of insomnia. To obtain a better understanding of insomnia and avoid the diversities of impractical diagnosis, the medical profession must universally agree on the classification of insomnia. This knowledge has to be available to all levels of the medical community, especially general practitioners. The article reviews some new data about classification, diagnosis, and treatment of insomnia. It discusses the definition of insomnia and sets up the accepted criteria for the severity of its various forms. The policy of using hypnotics in Norway is fairly restrictive. Only three hypnotics are available, two benzodiazepins (nitrazepam and flunitrazepam) and the newly introduced cyclopyrrolone (zopiclone). The mechanisms of action of various hypnotics on the gamma-aminobutyric acid system are briefly discussed, and guidelines are given for use and choice of hypnotics, their indications and contraindications. In any modern society like Norway, there should be a clear awareness of the impact of insomnia on the quality of life and the seriousness of the effects it can have on the everyday activities of subjects suffering from this disorder.