Benzodiazepines increase the effects of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) by increasing GABA’s affinity for its receptor. However, if insomnia is severe or long-lasting, a thorough examination is required to reveal co-existing medical, neurological, or psychiatric conditions. Benzodiazepines do not selectively bind to an allosteric site and influence the GABA-A receptor complex so that a larger number of chloride ions can enter the cell when GABA interacts with the receptor, and thus increase the inhibitory effect of GABA. The lowest effective dose should be used to minimize side effects, and long-acting benzodiazepines with active metabolites should be avoided in elderly patients.
The treatment of sleep disorders consists of improving sleep habits, behavioral therapy, and identifying and treating the underlying causes.
What can you do about severe sleep disorders?
If an illness such as diabetes or menopause is causing your insomnia, treating those conditions may help. Treatment for sleep disorders may include nonmedical therapy, such as developing better sleep habits or psychotherapy, and sometimes medication. If sleep problems are a side effect of a medication, it may be helpful to change the medication, change its timing, or reduce the dose.