Insomnia: A New World Nightmare (original) (raw)

Special Considerations for Treatment of Insomnia

Several of the preceding chapters have already raised important issues that require consideration when treating patients with insomnia. The aim of this chapter is to address a number of additional special considerations including side effects, gender, age, comorbidity, reasons insomnia may be treatment resistant (e.g., presence of unhelpful beliefs or worry, daytime distress), and legal issues.

Cognitive-Behavioral and Pharmacological Treatments for Insomnia: A Combined Approach

2020

Insomnia is the most prevalent sleep disorder (10-40%). It is defined as the subjective perception of difficulty with sleep initiation, duration, consolidation, or quality that occurs despite adequate opportunity for sleep and that results in some form of daytime impairment. Among the typical symptoms, there are fatigue, decreased mood or irritability, general malaise, and cognitive impairment. According to the International Classification of Sleep Disorders 3 rd edition, ICSD-3, it has been defined as chronic (lasting more than three months) or short-term insomnia (less than three months). In clinical practice, the usual therapeutic approach is pharmacological (benzodiazepines, z drugs, slow wave sleep enhancers), even if the American Academy of Sleep Medicine (AASM), the American College of Physicians (ACP), and the European Sleep Research Society (ESRS) guidelines suggest that the first clinical choice should be non-pharmacological (cognitive behavioral therapy). A combined (non...

Insomnia and its management in Unani medicine *Author for correspondence

2014

CASE REPORT ABSTRACT ARTICLE INFORMATION According to Unani system of medicine, health is attributed to the equilibrium of akhlat (humors), besides this there is asbab-e-sittah zarooriya (six essential factors). These are air, food and drinks, bodily movements and repose (harkat-wa-sakoon badni), mental activity and repose (harkat-wa-sakoon nafsani), sleep and wakefulness (naum wa yaqza) and retention and excretion (ahtibas wa istifiragh). Any imbalance in any of the above factors is likely to cause disease. Normal sleep is thought to be because of ratoobat wa baroodat i.e. wetness and cold in our body and if there is derailment of balance in sleep and wakefulness, it implies the predominance of yuboosat wa hararat i.e. dryness and hotness widespread in the brain. Insomniacs complain of difficulty falling asleep, difficulty staying asleep, poor quality sleep, or inadequate sleep despite adequate opportunity. In addition, the sleep disturbance causes clinically significant distress o...

What’s new in insomnia? Diagnosis and treatment

Arquivos de Neuro-Psiquiatria

Although, insomnia is one of the most common diseases that health professionals face in their practice, it receives little attention in medical training. Diagnosis is based on a careful history taking, and physicians must be aware of the diagnostic criteria. Insomnia should not be considered a symptom, but a comorbid condition. Although cognitive behavioral therapy (CBT) has been the mainstay treatment for insomnia for many years, it is usually regarded as a novel therapeutic strategy, both because of scarcity of qualified psychologists and of limited knowledge about insomnia among physicians. GABA receptor acting drugs are being abandoned in the treatment of insomnia because of abuse and dependence potential and accident risk. Two main current therapeutic options with the best scientific evidence are the tricyclic antidepressant, doxepin, and a new melatoninergic receptor agonist, ramelteon. Newer drugs to treat insomnia are in the pipeline. Hypocretine blocking agents will be mark...

Current Patterns and Future Directions in the Treatment of Insomnia

Annals of Clinical Psychiatry, 2005

Background. Despite the high prevalence and the high burden associated with chronic insomnia, it remains largely unrecognized and often inadequately treated by physicians. Methods. A review was undertaken of the literature on barriers to both acute and chronic treatment of insomnia, as well as recent trials of pharmacologic and nonpharmacologic agents for insomnia. Results. Obstacles to appropriate treatment of the condition include outdated insomnia management guidelines, which have contributed to US Food and Drug Administration restrictions on longer-term prescription of hypnotic agents; lack of research demonstrating the benefit of treating insomnia; and fears of tolerance and withdrawal effects of long-term use of hypnotic agents, as well as an absence of longer-term, randomized, controlled, double-blind trials of existing agents used to treat insomnia. Conclusions. There is evidence that improved sleep may improve outcome in some medical and psychiatric illnesses. Both behavioral and pharmacologic therapies have shown efficacy in chronic insomnia. In addition, a recent 6-month, randomized, controlled study has demonstrated that at least one agent may be safe and effective in longer-term use.

Insomnia and its management: A systemic review

IP international journal of comprehensive and advanced pharmacology, 2021

Insomnia Disorder is one of the most prevalent sleep disorders, and it involves both sleep complications and daytime complaints. Adequate quality sleep is crucial for good health and high quality of life. Despite this, the high prevalence and burden of insomnia disorder, which may be acute (short-term) or chronic, is growing globally. This systemic review focuses on insomnia and its management. The main causes and risk factors for insomnia are discussed, as well as the diagnostic criteria for a correct diagnosis. The treatment of insomnia, which is typically a mixture of cognitive-behavioral therapy and pharmacological treatment, is addressed, as well as the vital role pharmacists may play in not just treating insomnia but also determining the root cause/s of sleep disruptions.