Hypnotics

What are the current recommendations for treating insomnia?

Insomnia is a disorder that can have a primordial character. However, it often happens that we talk about it as a result of many diseases, be they somatic or psychological. She can also be a consequence of medication taken by a patient who is struggling with it. Currently, the guidelines for the use of sleeping pills are based on the agreed position of the participants in the 1996 conference organised under the auspices of the World Health Organisation. It was reminded, however, that the mechanisms of insomnia are still not fully understood, and therefore it is worth making room in the recommendations for new methods of pharmacotherapy. They most often appear in the company of behavioral methods and we can already say that they constitute a significant progress in treatment. The recommendations included in this article were developed as a result of the July 2009 workshop. The workshop took place in Brussels as part of the 22nd meeting of the Collegium Internationale Neuro-Psychopharmacologicum.

First, insomnia must be treated as a serious disorder, regardless of its nature.

Although insomnia may be a primary sleep disorder, it is also a symptom of a number of other diseases. Whatever its origin, there is no doubt that it not only worsens psychosocial functioning, but also has a negative impact on the quality of life of those struggling with the disease. Among other things, there are concentration and memory disorders and difficulties in performing daily tasks.

Secondly, insomnia is a disease that requires effective detection, diagnosis and treatment.

The results of research conducted all over the world confirm that although insomnia is an extremely common sleep disorder, we still have problems not only with detecting and diagnosing it, but also with treating it. It should therefore be remembered that the key role in her case seems to be played by a detailed interview, as well as accurate diagnosis of not only the somatic but also the mental state of the patient. The supplementary interview, which is collected from the patient's family members, is also valuable. They are the ones who inform about apnea, bruxism and restless legs syndrome. A fourteen-day diary can also help you determine the nature of your sleep disorders. The sick person is expected to keep a record of the time that elapses before he/she falls asleep, the time that he/she went to bed and the time of awakening, the number of awakenings at night, if any, and the length and quality of sleep.

Thirdly, the key to therapeutic management of insomnia is the detection and treatment of diseases that are responsible for sleep disorders.

Insomnia is primary, a consequence of other diseases, but can also coexist with other diseases. So if you want to treat insomnia effectively, you need to determine if you are not struggling with diseases that can cause or aggravate sleep disorders. Among the somatic diseases that can cause insomnia are diseases of the digestive system, musculoskeletal system, cardiovascular system and respiratory system. Insomnia is also an accompanying mental disorder. It occurs, among others, in patients with schizophrenia and depression.

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