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Insomnia is defined as a disorder in which patients have difficulty falling or staying asleep. An insomniac often wakes up early in the morning and remains groggy throughout the day because of lack of sleep.

Insomnia can be classified in various ways. It can be:

  • Primary insomnia: In this condition the lack of sleep is not associated with any other health problem.

  • Secondary insomnia: The lack of sleep can be attributed to some other underlying medical condition like asthma, acidity, arthritis, some kind of chronic pain or substance abuse.

Insomnia can also be classified as:

  • Acute insomnia: In this type of insomnia, the patient is unable to sleep for a few nights.

  • Chronic insomnia: A condition where the patient is unable to sleep for at least three nights every week for at least one month.

Causes of insomnia

Acute insomnia can be a result of:

  • Some stressful condition in personal life.

  • Sudden illness.

  • Environmental factors that disturb sleep. Examples are extreme hot or cold, excessive sound, and light.

  • Certain medications which may interfere with sleep.

  • A sudden disturbance in the normal circadian rhythm because of a change in shifts at work or because of jet lag.

Causes of chronic insomnia include:

  • Depression

  • Anxiety

  • Chronic pain

Symptoms of insomnia

These may include exhaustion upon waking in the morning, sleepiness during the daytime, irritability, difficulty remembering things and being unable to concentrate.

Chronic insomnia treatment

In case there is an underlying pathology that leads to lack of sleep, physicians try to treat that. Patients are encouraged to practice good sleeping habits. Behavioral therapy is tried in certain patients. However, if the insomnia is not relieved with these measures, then your doctor may prescribe some short-acting sleeping pills. Some commonly prescribed sleeping pills include:

  • Triazolam (Halcion): It is believed to be the strongest sleeping pill available. It belongs to the benzodiazepine group of medicines. Halcion is very effective in inducing sleep but it is highly addictive in nature. Stopping it suddenly produces severe withdrawal symptoms and that is why it is generally not prescribed by physicians.

  • Zolpidem (Ambien): This medicine can induce sleep within 15 to 30 minutes, but its effect wears off by the middle of the night and the patient then tends to awaken. To counter this problem, Ambien CR is now available on the market. This is an extended-release formula which helps the patient to sleep for at least 7 to 8 hours. As the medicine is metabolized more slowly in women, women are advised to take a lower dose to avoid a hangover effect.

  • Eszopiclone (Lunesta): This is the most commonly used sleeping pill. However, it is important to take a full night's sleep after taking the medicine or else it can cause grogginess the next day.

  • Ramelteon (Rozerem): Instead of depressing the central nervous system like other sleeping pills, Ramelteon acts on the sleep-wake cycle. This medicine is very effective and can be taken for a long time as it does not produce dependence.

  • Zaleplon (Sonata): This sleeping pill is metabolized in the body faster than any other sleeping pill. Patients are advised to fall asleep on their own. If they are unable to fall asleep by the middle of the night, they can take Sonata without fearing any hangover effect the next morning.

  • Antidepressants: Certain antidepressants are also being tried as sleeping aids as they help the patients in overcoming their anxiety.

  • Antihistamines: They are easily available as OTC medicines but patients soon develop tolerance to them.

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