What is the drug of choice for insomnia?

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Hypnotics are recommended when an immediate response to symptoms is desired, when sleep disorders cause severe impairment, when nonpharmacological measures do not produce the desired improvement, or when insomnia persists after treatment of an underlying condition. A meta-analysis comparing pharmacological and nonpharmacological treatments found similar short-term effectiveness (two to four weeks) in patients with primary insomnia. Treatment for sleep disorders may include nonmedical therapy, such as developing better sleep habits or psychotherapy, and sometimes medication. The incidence of sleep disorders and the extent to which insomnia significantly affects daytime function determine the need for examination and treatment.

What is the safest treatment for sleep disorders?

Exercise, cognitive behavioral therapy, and relaxation therapy are recommended as effective, nonpharmacological treatments for chronic sleep disorders. Behavioral changes learned through cognitive behavioral therapy are generally the best treatment for persistent sleep disorders. For long-term insomnia, behavior changes learned in behavioral therapy are usually the best treatment. Melatonin is effective in patients with circadian rhythm sleep disorders and is safe when used in the short term.

The cornerstone of sleep disorder treatment is a treatment called cognitive behavioral therapy (CBT). All medications should be prescribed by a licensed physician who is familiar with their dosage and side effects.

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