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Review Article Open Access
Insomnia is defined as difficulty with the initiation, maintenance, duration or quality of sleep which affects daytime functioning. About one third of world population suffer from insomnia. It can be classified by various ways i.e. primary or secondary; transient, short term or chronic insomnia; or difficulty in onset or difficulties in maintaining sleep. The derangement of various neurotransmitters e.g. histamine, orexins, noradrenaline, acetylcholine and serotonin leads to insomnia. Predisposing conditions leading to insomnia are familial or genetic tendency, illness, stress and maladaptive sleep habits. Insomnia leads to chronic fatigue, inattention, irritability, emotional outbursts, absence from work, diminished productivity, risk of accidents and other health related problems. The treatment options for insomnia include cognitive behavioural therapy, pharmacological therapy and combined approach. Cognitive behavioural therapy includes stimulus control therapy, sleep restriction therapy, relaxation therapy, sleep hygiene and cognitive therapy. The pharmacological options currently widely in use are benzodiazepines and Z-drugs. Alternative drug delivery methods and innovative treatments hold promise for increasing access to care and accelerating improvement. The newer targets for treatment of insomnia are orexin receptors, melatonin receptors and serotonin receptors. A combined approach of pharmacological treatment, cognitive behavioural treatment and newer formulations for improving drug delivery is required to combat the problem of insomnia.
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Author(s): Dhiren M. Pranami, Jyoti Kaushal, Garima Bhutani
Cognitive behavioural therapy in insomnia, insomnia, new drugs for insomnia, orexin receptor antagonists, recent advances in insomnia, Pharmaceutical Technology,Biopharmaceutics,Insomnia