SYMPTOMS OF INSONMIA
Insomnia is described as the disturbance of sleep,
either by delay in falling asleep, failure to maintain
sleep, early waking, or in some extreme cases total
absence of sleep.
Why does it happen
Insomnia is a common complaint, and can occur with
almost anybody. Onset of insomnia can be triggered by
depression, pain, chronic illness, stress or a
disturbance in sleeping routine.
Treatments
Herbal remedies
Herbal remedies can sometimes help, such as Nytol
herbal, or Badger's sleep balm.
OTC Medication
OTC medication available include Sominex and Nytol. OTC
sleeping aids should be for short term use only as
dependance can occur. OTC treatment for insomnia usually
contains sedating antihistamines, therefore any other
antihistamines should not be taken at the same time e.g
for allergy chlorpheniramine, loratidine etc.
Prescription medications
Benzodiazepines
Benzodiaepines cause drowsiness and aid sleep. They
also have the added benifit of reducing aggression and
anxiety. They also reduce muscle tone and act as a
muscle relaxant, which can help if the insomnia is
caused by pain due to tight muscle spasms.
Benzodiazepines act on GABA receptors in the brain. One
common side-effect is a hangover effect the next
morning, due to long duration of action of some
benzodiazepines.
Z-drugs: zopiclone, zolpidem
The Z-drugs are a new class of hypnotics which are
non-benzodiazepines. They are design to reduce
sideeffects caused by benzodiazepines. Common
sideeffects include metallic taste, and hangover
effects.
Barbiturates
Barbiturates are not commonly used as hypnotics
anymore due to the high chance of drug interactions (due
to induction of hepatic cytochrome P450 enzymes), high
risk of tolerance and dependence, and they are highly
toxic on overdose.
OTHER USEFUL INFORMATION FOR THE EXAM
Short-acting benzodiazepines
temazepam, loprazolam, and lormetazepam
Long acting benzodiazepines
Flurazepam, flunitrazepam, nitrazepam.
