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The challenge of chronic insomnia: is non-nightly hypnotic treatment a feasible alternative?

Published online by Cambridge University Press:  16 April 2020

G. Hajak ,
R. Cluydts ,
H. Allain ,
E. Estivill ,
L. Parrino ,
M.G. Terzano  and
J.K. Walsh
G. Hajak*
Affiliation:
Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
R. Cluydts
Affiliation:
Department of Psychology, Free University of Brussels, Belgium
H. Allain
Affiliation:
CHU de Rennes, Laboratoire de Pharmacologie Expérimentale et Clinique, Faculté de Medecine, Rennes, France
E. Estivill
Affiliation:
Institut Universitari Dexeus, Barcelona, Spain
L. Parrino
Affiliation:
Centro di Medicina del Sonno, Instituto di Neurologia, Università di Parma, Italy
M.G. Terzano
Affiliation:
Centro di Medicina del Sonno, Instituto di Neurologia, Università di Parma, Italy
J.K. Walsh
Affiliation:
Unity Sleep Medicine and Research Center, St. Luke’s Hospital, Chesterfield, MO, USA
*
2Corresponding author. Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität Regensburg, Universitätsstrasse 84, 93053 Regensburg, Germany. Goeran.Hajak@bkr-regensburg.de
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Abstract

The adverse effects of insomnia on health and quality of life are matters receiving increasing attention. Yet, surveys have consistently shown that most people suffering from insomnia do not seek medical help, perhaps, in part, because of a concern of becoming dependent on hypnotic medication. The treatment of chronic insomnia poses a particular dilemma in that continuous hypnotic treatment is restricted in many countries to a maximum of 4 weeks, and behavioural treatment is not readily available. Non-nightly hypnotic treatment of chronic insomnia offers a promising alternative option for the many patients whose symptoms do not necessitate nightly drug intake, allaying fears of psychological dependence on medication and respecting regulatory constraints on hypnotic use while providing patients with adequate symptom relief. The practical feasibility and efficacy of this approach has been demonstrated with zolpidem using various treatment regimens and study designs. So far, six clinical trials have been completed on over 4000 patients. Published results show effective treatment of insomnia without any evidence of either adverse event associated with a discontinuous regimen or increased hypnotic use over the treatment period.

Keywords

Chronic insomniaHypnotic medicationZolpidemPharmacological treatment
Type
Review article
Information
European Psychiatry , Volume 18 , Issue 5 , August 2003 , pp. 201 - 208
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

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