Insomnia drugs
Insomnia drugs have become hugely popular these days, and there is a good reason for that. Sleep-related complaints such as insomnia impairs the lives of many Americans. Sleep problems have been associated with decreased work
productivity, absenteeism, and short-term memory impairment. An estimated 200,000 car accidents each year are caused by excessive drowsiness or falling asleep at the wheel.
Statistics suggest that Some 70 million Americans suffer from chronic or occasional insomnia. The market for insomnia drugs in the U.S. is growing at a phenomenal rate of 29 percent per year, reaching $4.6 billion in 2006 and attracting the attention of a wide range of drug manufacturers.
Insomnia drugs are medications that help people who have difficulty falling asleep, staying asleep, awakening early, or who have disturbed sleep patterns. Physicians prescribe these types of insomnia drugs for short-term or intermittent treatment of insomnia. All insomnia medications should be taken shortly before going to bed.
Treatment for insomnia depends on the underlying cause. For individuals with insomnia due to emotional disturbance other than depression and for those suffering from chronic insomnia, a hypnotic drug may be required. The hypnotic is usually prescribed for short-term usage. Depressed individuals should be given limited amounts to reduce the risk of attempting suicide with the hypnotic..
Before taking insomnia drugs, it is important to let the physician know about any allergies; pregnancy or breast-feeding; chronic lung diseases, asthma, or chronic bronchitis; liver or kidney disease; current or past alcohol or drug abuse; depression; or sleep apnea. Alcohol intensifies the side effects of all sleeping medication and should be avoided.
After using insomnia drugs, individuals should avoid activities requiring mental alertness, and physical coordination, for example, driving, operating machinery. Hypnotics should also be used with caution in patients with respiratory problems. In the elderly, due to a slower metabolism and decreased tolerance for medications, any hypnotic can cause restlessness, excitement, or exacerbation of delirium and dementia.
In addition to drug treatment, there are specific behavioral strategies that can break the vicious cycle of insomnia. Although these strategies take time and patience to implement, they can provide long-term benefit, and are therefore highly recommended.
Over-the-counter sleep aids are possibly used in greater proportions than prescribed hypnotics. The active ingredient in most OTC sleep aids is an antihistamine, due to its ability to induce sleep. However, such drugs should not be taken by individuals using alcohol or other drugs with sedating effects. They should also be avoided by people with breathing problems, glaucoma, chronic bronchitis, or difficulty urinating because of an enlarged prostate gland.
Melatonin is a hormone that has become increasingly popular OTC sleep aid. It is released by the pineal gland at night, but its quantity decreases with age. Because melatonin can reset circadian rhythms, it has been tested as treatment for initial insomnia and jet lag. Melatonin is the most studied natural remedy for insomnia. It appears to reduce the time to fall asleep and the time spent asleep. However, there are no consistent standards on melatonin doses.
Barbiturates consist of a group of organic compounds. All barbiturates depress the central nervous system (CNS) and depress respiration, affect heart rate, liver enzymes, and decrease blood pressure and temperature. These drugs can be habit forming and are not recommended as hypnotics. For insomnia treatment, these drugs have been replaced by safer drugs such as the benzodiazepines and the newer non-benzodiazepine compounds.
Benzodiazepines were once the most commonly prescribed sedative drug. Originally developed in the 1960s, these drugs target receptor sites in the brain that modulate the effects of the neurotransmitter gamma-aminobutyric acid (GABA). They decrease the time taken to fall asleep, decrease the number and duration of nighttime awakenings, and increase total sleep time. All benzodiazepine hypnotics are effective in the short-term management of insomnia. Selecting a particular agent depends on the particular nature of the insomnia. From which the patient suffers.
Long-acting benzodiazepines include flurazepam (Dalmane), clonazepam (Klonopin), and quazepam (Doral). Medium- to short-acting benzodiazepines include triazolam (Halcion), lorazepam (Ativan), alprazolam (Xanax), temazepam (Restoril), oxazepam (Serax), prazepam (Centrax), estazolam (ProSom), and flunitrazepam (Rohypnol). Short-acting benzodiazepines may be helpful for reducing the jet lag effects.
Newer short-acting non-benzodiazepines can induce sleep with fewer side effects than benzodiazepines. Non-benzodiazepine hypnotics currently approved in the United States include: zolpidem (Ambien, Ambien CR), zaleplon (Sonata), eszopiclone (Lunesta), and ramelteon (Rozerem). All of these drugs have fewer morning side effects than the benzodiazepines. These new hypnotic medications are generally well-tolerated and have little risk of abuse. Developed in the 1980s, these drugs are currently the preferred sedative drugs for insomnia treatment.
Tricyclic antidepressants with sedative effects are usually recommended when insomnia is associated with a mood disorder. Tricyclic antidepressants are probably a good choice among patients with suicidal risk.
An unpleasant phenomena might occur on discontinuing the insomnia drug treatment. Rebound insomnia takes place when an individual stops taking an anti-insomnia medication and experiences one or two nights of insomnia. This type of insomnia commonly occurs when drugs are withdrawn from an individual who regularly takes large doses. Rebound insomnia can be avoided by gradually decreasing the dose.
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