Insomnia-pharmacotherapy

CBTi is the preferred treatment for both acute and chronic insomnia and is backed by evidence , both short and long term Pharmacological treatment can be considered as an adjunctive therapy to CBTi / other behavioral therapies in the comprehensive management of insomnia for both acute and chronic insomnia In the acute phase of CBTi adding a medication to alleviate insomnia may have a slightly better effect compared to CBT-i alone

Decide which agent based on predominant symptom pattern what is the goal of the treatment previous treatment trials/ response patient preference , circumstances cost of treatment comorbidities contraindications/interactions potential adverse effects- sedation is among the most common effects and / or SE of prescription medications

Neurotransmitters and sleep -Sleep is regulated by a variety of neurotransmitters for e.g in forebrain and hypothalamus- gamma-aminobutyric acid ( GABA ) and histamine- these have opposing action on the sleep-awake cycle GABA is the most important and copious inhibitory neurotransmitter in the nervous system GABA controls the state of excitability in all brain areas and the balance between excitatory inputs and inhibitory GABAergic activity decides the prevailing level of neuronal activity Increased GABA and decreased histamine release induce NREM sleep by deactivating the...