Insomnia

Insomnia is a common disorder with a prevalence of about 10% in the general population. The most common complaints related to insomnia are difficulty initiating sleep (sleep-onset insomnia), difficulty maintaining sleep due to prolonged nocturnal awakenings (sleep-maintenance insomnia), early morning awakenings, and excessive daytime sleepiness resulting from lack of sleep. Furthermore, insomnia is associated with an increased risk of anxiety and depression, suicidality, and cardiovascular diseases. Currently, cognitive behavioral therapy for insomnia (CBT-I) is recommended as first-line therapy. While behavioral therapies are effective for chronic insomnia in some patients, pharmacotherapy is frequently used when immediate short-term symptom relief is needed. The most effective pharmacologic therapies for insomnia are benzodiazepines, benzodiazepine-receptor agonists, melatonin-receptor agonists, and antidepressants.