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Management of insomnia: treatments and mechanisms

  • Sue Wilson (a1) and David Nutt (a1)

Summary

Management of insomnia is an interesting subject at present. New drug treatments are now becoming available after a relatively static period since the development of the Z-drugs in the 1990s. Moreover, more evidence is coming to light about the length of drug treatment and the effectiveness of psychological therapies. This article briefly describes current treatments, both evidence-based and common practice, and goes on to describe some emerging approaches.

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Copyright

Corresponding author

Dr David Nutt, Psychopharmacology Unit, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol BSI 3NY, UK. Email: david.j.nutt@bristol.ac.uk

Footnotes

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Declaration of interest

S.W. A. and D.N. have received funding from several pharmaceutical companies with an interest in the drug treatment of sleep disorder.

Footnotes

References

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Management of insomnia: treatments and mechanisms

  • Sue Wilson (a1) and David Nutt (a1)
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eLetters

Insomnia: how to lower the costs for society?

Peggy Bosch, Clinical Psychologist
06 December 2007

We read the article on management of insomnia (Wilson & Nutt, 2007) with great interest. Although prevalence estimates of insomnia vary depending on the definitions and criteria used, epidemiologic studies indicate that approximately 30% to 35% of the general population experience at least occasional or intermittent sleep disturbances (Ohayon,2002). However, the prevalence, burden, and management of sleep disorders are often ignored or overlooked by individuals and society in general. This leads to an under-appreciation and under-treatment of sleep disorders, making this group of illnesses a serious health concern (Hossain & Shapiro, 2002). The overall costs of insomnia for the society are extremely high (Bosch & Van den Noort, 2008; Walsh, 2004).For instance, costs associated with insomnia can include related medical expenses, more frequent use of healthcare resources, a higher rate of absenteeism, reduced subjective productivity, and an increased risk of accidents relative to those without insomnia (Walsh, 2004).

Wilson and Nutt (2007) give a good overview of the current treatmentsand developments. Moreover, we agree with them that insomnia is often persistent and disabling and contributes to poorer treatment outcomes and lower quality of life. Therefore, more (clinical) research on pharmacological and non-pharmacological interventions, and its combinations, is needed to make further progress. This can result in a better understanding of the underlying mechanisms and lower the overall costs of insomnia for the society. Finally, in order to achieve this, perhaps even less traditional non-pharmacological interventions must be more seriously investigated according to Western standards (Bosch & Van den Noort, 2008)?

References

Bosch, M. P. C. & Van den Noort, M. W. M. L. (2008) Schizophrenia, Sleep, and Acupuncture. Göttingen: Hogrefe & Huber.

Hossain, J. L. & Shapiro, C. M. (2002) The prevalence, cost implications, and management of sleep disorders: an overview. Sleep and Breathing, 6(2), 85-102.

Ohayon, M. M. (2002) Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Reviews, 6(2), 97-111.

Walsh, J. K. (2004) Clinical and socioeconomic correlates of insomnia. The Journal of Clinical Psychiatry, 65(S8), 13-19.

Wilson, S. & Nutt, D. (2007) Management of insomnia: treatments and mechanisms. British Journal of Psychiatry, 191(3), 195-197.
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Conflict of interest: None Declared

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