The incidence of sleep disorders and the extent to which insomnia significantly affects daytime function determine the need for examination and treatment. The American College of Physicians recommends cognitive behavioral therapy as a first-line treatment for sleep disorders. The American College of Physicians recommends cognitive behavioral therapy as a first-line treatment for sleep disorders. Physicians may initiate treatment for sleep disorders on a first visit; for patients with a clear acute stressor such as grief, further investigation may not be indicated.
The American College of Physicians recommends cognitive behavioral therapy as a first-line treatment for sleep disorders. 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. Avoid or limit caffeine and alcohol, and don’t use nicotine.
What is the drug of choice for sleep disorders?
When
taking the drug after a high-fat meal, the absorption of doxepin is increased by approximately 40% and the time to reach maximum plasma concentration is delayed by about three hours. On average, people who take one of these drugs only sleep a little longer and better than people who don’t take any medication. Patients have developed rapid tolerance to the sedative effects of BZDs, and long-term use of these drugs is therefore not recommended. A meta-analysis of 13 studies involving more than 4,000 subjects showed that the currently available Z drugs zolpidem, zaleplon and eszopiclone led to a small but statistically significant reduction in subjective and polysomnographic sleep latency compared to placebo.