The Prevalence, Morbidities, and Treatments of Insomnia

Abstract

Insomnia is a common condition that often is co-morbid with other illnesses. It is associated with significant morbidities, including nighttime distress, impaired cognitive functioning, impaired daytime functioning, and increased risk of accidents. People with insomnia utilize healthcare services more often than those without insomnia, and they are at greater risk for the development of certain health problems; most notably psychiatric illness such as depression. It is now known that the significant impact of insomnia warrants diagnosis and treatment. Behavioral and psychopharmacological treatments have been available for some time. However, formerly common classes of therapeutics such as the barbiturates and benzodiazepines have been replaced by new allosteric modulators of the GABA(A) receptor and other therapeutics with novel mechanisms of action. This article presents existing approaches to insomnia treatment, and reviews new treatments, therapeutic targets, and treatment approaches to insomnia under development that may offer promise to practitioners and patients.

Magnolol, a major bioactive constituent of the bark of Magnolia officinalis, induces sleep via the benzodiazepine site of GABAA receptor in mice

“…It plays a key role in neuronal firing patterns and in the activity of neuronal networks. The modulators of GABA A receptors have been the focus of several therapies aimed at insomnia (Zammit, 2007). Several in vivo and in vitro studies support our findings that magnolol might elicit sleep-promoting effects by acting on the GABA A receptor.…”

Insomnia Treatment

“…CBT interventions combine empirically tested behavioral, cognitive, and educational procedures to alter faulty beliefs and attitudes, modify sleep habits, and regulate sleep-wake schedules (Whitworth, & Crownover, 2007). The efficacy of CBT has been well documented and it is recognized as an appropriate treatment for many people with insomnia (Whitworth, & Crownover, 2007, Zammit, 2007.…”

“…Another concern is that a number of the studies referenced in this paper were meta-analysis studies that were based on studies with small non-probability samples (Drake et al, 2003;Zammit, 2007). The use of small non-probability samples limits the external validity of the studies and thus their findings cannot be generalized to the wider population.…”

Effect of renal impairment on the pharmacokinetics of PD 0200390, a novel ligand for the voltage‐gated calcium channel alpha‐2‐delta subunit

“…Insomnia, which is characterized by difficulty falling asleep, difficulty staying asleep or nonrestorative sleep, can cause significant distress to those affected, impairing both social and occupational daytime functioning [1]. The disorder is relatively common, with over one-third of individuals surveyed in the UK reporting insomnia symptoms [2,3].…”

“…Compared with good sleepers, those with insomnia have lower productivity, increased utilization of medical care and increased medication usage [4,5], all of which pose a significant financial burden on society. In recent years several pharmacological agents have been used to treat insomnia, including the benzodiazepines, newer allosteric modulators of the GABAA receptor, antihistamines, antidepressants and antipsychotics [1].…”