Sedative-hypnotics are the most commonly prescribed drugs for insomnia.Though not usually curative, they can provide symptomatic relief when used alone or adjunctively.This insomnia typically resolves when the stressor is no longer present or the individual adapts to the stressor.Chronic insomnia lasting more than 1 month can be associated with a wide variety of medical and psychiatric conditions and typically involves conditioned sleep difficulty.Evaluation of insomnia primarily comes from a detailed clinical history that includes a medical, psychiatric, and sleep history.The sleep history should elucidate the type of insomnia (eg, sleep initiation, sleep maintenance), its duration (transient, acute, or chronic), and its course (recurrent, persistent), as well as exacerbating and alleviating factors.
A summary of this conference can be obtained at the NIH Consensus Development Program Web site.
Such agents include the following: Insomnia is defined as repeated difficulty with sleep initiation, maintenance, consolidation, or quality that occurs despite adequate time and opportunity for sleep and that results in some form of daytime impairment.
Specific criteria vary, but common ones include taking longer than 30 minutes to fall asleep, staying asleep for less than 6 hours, waking more than 3 times a night, or experiencing sleep that is chronically nonrestorative or poor in quality.
In fact, insomnia appears to be predictive of a number of disorders, including depression, anxiety, alcohol dependence, drug dependence, and suicide.
The annual cost of insomnia is not inconsequential, with the estimated annual costs for insomnia being billion for health care and billion for sleep-promoting agents.