Pharmacotherapy of Insomnia

Abstract

A s insomnia is a common symptom caused by diverse disorders, treatment tools for the insomnia differ depending on the underlying cause. Hypnotics can be used for primary insomnia. As hypnotics show excellent short-term efficacy, they would be useful as short-term (< 4 weeks) treatments for transient insomnia. There has been much controversy over long-term hypnotic use for chronic insomnia. Evidence supporting safety and efficacy of the long-term hypnotic use is insufficient. Therefore, rather than using hypnotics alone, non-pharmacological treatments are recommended more for chronic primary insomnia. Although various benzodiazepines have widely been used as hypnotics, there have been concerns over tolerance, rebound insomnia, dependency, cognitive decline and psychomotor slowness. In efforts to relieve these concerns, selective benzodiazepine agonists like zolpidem have been introduced as novel hypnotics. Sedating antidepressants, melatonin and anti-histamine have also been used in order to manage insomnia. However, their efficacy for primary insomnia has yet to be proven.Keywords: Insomnia; Benzodiazepine; Zolpidem; Pharmacotherapy Abstract

Effects of Audio Brain Entrainment on Korean People with Mild Insomnia

“…The timing, duration, and quality of sleep are important indicators of health, and this is further emphasized during the Covid-19 pandemic (Chaput et al, 2018 ; Xiao et al, 2020a , b ). While a good night’s sleep may provide mental and physical recovery (Bonnar et al, 2018 ; Kim, 2009 ), sleep disorders are associated with significant medical, psychological, and social disturbances (Cho et al, 2019 ; Leggett et al, 2017 ; Vgontzas & Kales, 1999 ). Different studies had associated people with sleeping disorders with a higher risk of mortality, diabetes mellitus, hypertension, cardiovascular disease, coronary heart disease, and obesity (Im & Kim, 2017 ; Itani et al, 2017 ; Jike et al, 2018 ).…”

Is Hand Massage with the Preferred Aroma Oil better than Lavender on Stress and Sleep for Long-term Care Facility Residents?

“…To improve stress and sleeping among residents at LTC facilities, medications are often provided, but they bring negative effects such as the possibility of drug abuse, medication dependence, cognition deficit, and so on so that the non-pharmacological methods need to be provided preferentially [8]. Among the non-pharmacological methods, hand massage with aroma oil helps relaxation [9].…”

The Effect of Sayeok-san for Insomnia: A Systematic Review and Meta-Analysis

“…불면증에 사용되 는 대표 처방인 산조인탕 5 , 귀비탕 6 등에서는 항우 울 효과가 있다는 연구결과가 있으며, 항우울효과 가 여러 번 밝혀진 시호소간산에서도 불면증에 효 과가 있다는 연구결과가 보고된 바 있다 7 . 서양의 학에서도 항우울제를 불면증 치료에 사용하고 있 으며 대표적으로 Trazodone은 serotoine의 재흡수 억제 효과와 서파 수면을 항진시키는 효과를 동시 에 가지고 있어 항우울효과와 수면유도 효과를 같 이 가져올 수 있고, Mirtazapine 또한 항우율효과 및 수면유도 효과를 같이 가져올 수 있다 8 . 사역산(四逆散)은 ≪傷寒論≫의 <辨少陰病>편에 수록된 처방으로, 疏肝理氣作用과 邪解작용을 하여 手足厥冷(四逆)과 脘腹疼痛 혹은 咳, 心悸 등의 질 환에 사용되었다 9,29 .…”