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Pharmacotherapy of sleep disorders

Publication at First Faculty of Medicine |
2017

Abstract

Disorders associated with fragmentation or shortening of sleep and/or with excessive daytime sleepiness may have a serious health consequences, and significantly decrease quality of life. The growing prevalence of insomnia leads to frequent and irrational use of hypnotics instead of nonpharmacologic approaches which are considered as a first line treatment.

Pharmacotherapy is indicated in acute insomnia. In chronic insomnia, the short-term drug administration should supplement behavioral, and psychotherapeutic methods.

Nonbenzodiazepine hypnotics are preferred drugs for treatment of insomnia. Benzodiazepines, antidepressants and melatonin are used as well.

Restless leg syndrome is a common neurological disease which can cause chronic insomnia and requires specific pharmacotherapy (dopaminergic drugs, calcium channel ligands, opioids). Central hypersomnias (narcolepsy and idiopathic hypersomnia) are rare disorders usually necessitating life-long therapy.

Stimulants and antidepressants are used in central hypersomnias to improve vigilance and supress cataplexy, respectively.