Insomnia is a symptom and its proper treatment depends on finding the cause of sleeplessness and treating the underlying etiology. Transient insomnia is most commonly caused by psychiatric disorders such as substance abuse.

The aim of this study was to investigate the hypnotic effectiveness of different classes of sedative-hypnotic medications in treating opiate-withdrawal insomnia.

A total of 40 patients with opiate withdrawal were given a four groups of drugs 1.bezodizepines with a short (brotizolam and midazolam) or 2.intermediate (nitrazepam) elimination half-life,3.non-benzo hypnotics (zolpidem) and 4.antidepresants (mianserin or trazodone) in a randomized prospective trial.The efficacy for sleep inducing and prologed sleeping were clinical monitiroing. Sleep was assessed by means of the Sleep Evaluation Questionnaire and three insomnia items of the Hamilton Depression Rating Scale.

Results the scores of two sleep measures showed that all aspects of sleep, except the time it takes to fall a sleep, were not significantly different.The result demosntrated highest range of sleep inducing effects in the frist days of administration for nitrazepam 49,5 % and slight for zolpidem 15,3%, midazolam 12,2%, brotizolam 7,5% and low for mianserin 10%, trazodine 5,5%.In contrast, zolpidem and trazodine show effeciveness not only as a sleep inducer but also after prolged unsuccessful attempt to sleep.

In Conclusion, apart from the initial efficacy and development of tolerance, dependence and rebound insomnia the benzodiazepines are no longer the "first line" medication for tretment of opiate-withdrawal insomnia. Non -benzo hypnotics and antidepresants can be used rationaly to consolidate sleep with a less side effects.