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.