What is the most effective therapy for insomnia?

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Avoid large meals and drinks before bed. No next-day sedation or rebound insomnia was documented when zaleplon was used at the recommended dose (5-10 mg). Ramelteon (Rozerem) is an insomnia medication that works differently than other sedatives. If stress is the primary cause of sleep disorders, any treatment must address the stress issue in your life.

Some people with sleep disorders sleep better after changing their behavior during the day and night. Or they may benefit from medication or cognitive behavioral therapy.

What medications are used for long-term insomnia?

Dual orexin receptor antagonists (DORAs) are newer drugs that limit the effects of orexin to reduce wakefulness. 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. A healthcare professional who treats sleep disorders can determine whether an underlying condition, such as hypothyroidism, obstructive sleep apnea, or restless legs syndrome, could be causing the person’s sleep problems. Benzodiazepine receptor agonists (BZRAs) target a specific part of the brain and can increase a neurotransmitter called gamma-aminobutyric acid (GABA).

Gregory Tino, MD, Director of Outpatient Pulmonary Practices, Associate Professor, School of Medicine, Department of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Medical Center and Hospital.

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