Articles

For those people who believe that there is a chemical solution to every problem, I'm afraid I bear bad news: No pill yet invented will cure a case of chronic insomnia. Despite this Americans continue to spend millions of dollars on sleep remedies, both prescription and over-the-counter, in their quest for a good night's sleep. Over 20 million prescriptions for "sleeping pills" are written in the United States each year; an even larger number of over-the-counter sleep aids is sold. More drugs are used in connection with sleep than for any other therapeutic purpose. As we'll see, use of these drugs often fails to address the cause of the insomnia and can worsen the problem while preventing more effective therapies from being tried.

One point should be stressed about the treatment of sleep disorders. Insomnia, hypersomnia, and the other manifestations of disturbed sleep are not the exclusive province of any one medical discipline. Sleep disturbance may result from a neurological disorder or from some organic flaw in the cardiovascular or intestinal system. Conversely, the core of insomnia may lie buried within a traumatic emotional experience suffered by the victim years before its symptoms become manifest. The patient may confess to feelings of anxiety or excessive worry, but analysis conducted in a sleep laboratory may reveal the presence of severely disordered nocturnal breathing. Thus treatment of serious sleep disruption may require the services of many branches of medicine—internal, neurologic, and psychiatric; forms of therapy may range from psychological counseling to behavior modification, from drugs to surgery. For particularly recalcitrant cases, several approaches may need to be tried sequentially or simultaneously. I say this not to frighten but to reassure: for those who seek it, help—effective, methodical, multifaceted help—is available.

Let's look more closely now at the different common causes of insomnia—psychological, medical, and lifestyle.

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Antidepressants-Sleeping Aid