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What is the first line medication treatment for insomnia?

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Selective, non-benzodiazepine-sedative “Z-drug hypnotics,” the melatonin receptor agonist Ramelteon, and low-dose doxepin are the drugs of choice for treating primary and comorbid insomnia. It is a good first choice for treating sleep disorders and does not result in significant residual sedation in the morning. The incidence of sleep disorders and the extent to which insomnia significantly affects daytime function determine the need for examination and treatment. Zolpidem, an imidazopyridine class tranquilizer, has a rapid onset of action and a short duration of action.

Competing arguments over whether fixed or intermittent dosing strategies to treat chronic insomnia continue to dominate sleep literature, and other than a randomized controlled trial, there is no sign that the matter will be resolved anytime soon.

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