Insomnia categories

Trade names Arvynol Nostel Indications Insomnia Category Sedative Half-life 10-20 hours... 

Indications Insomnia Category Barbiturate Half-life 15 40 hours... 

Trade names Dumozolam Halcion (Pfizer) Novo-Triolam Nu-Triazo Nuctane Somese Somniton Songar Trialam Indications Insomnia Category Benzodiazepine Half-life 1.5-5.5 hours... 

The sleep disorders fall into four main categories (1) insomnia, (2) hypersomnia, (3) parasomnias, and (4) sleep schedule disorders. Insomnia is the most common sleep problem. It is simply defined as poor sleep and can be manifested by difficulty falling asleep, difficulty staying asleep, waking up too early, or waking up in the morning without feeling refreshed. 

The National Institute of Mental Health Consensus Development Conference divided insomnia into three categories as follows ... 

Buysse DJ, Reynolds CF, Kupfer DJ, Thorpy MJ, Bixler E, Manfredi R, Kales A, Vgontzas A, Stepanski E, Roth T et al. (1994) Clinical diagnoses in 216 insomnia patients using the International Classification of Sleep Disorders, DSM-IV and ICD-10 categories A report from the APA/NIMH DSM-IV field trial. Sleep 17 630-637... 

Fig. 1. Schematized hypnogram demonstrating most of the sleep disorders described in the literature using laboratory recordings of untreated persons with schizophrenia. One category of sleep disorders in schizophrenia is the insomnia type , with long sleep latency, numerous and/or long awakenings, and short sleep duration. Another type of sleep disorders is more concerned with sleep organization, e.g.., short duration of SWS and/or short latency to the onset of REM sleep. Not all disorders are found in every study since variables such as symptoms or diagnosis subtype, severity and chronicity may influence the results (see text). REMS, REM sleep. A REM sleep period is defined as a succession of REM sleep epochs not interrupted for more than 15 min.

Secondary insomnia is the most frequent form of insomnia. The determinants of secondary insomnia can be grouped into the following categories (1) mental disorders (2) neurological diseases (3) medical conditions and (4) abuse of drug-or medication-induced sleep disorder [15]. A list of major factors is included as Tab. 1. 

Long-term insomnia. Studies suggest that insomnia in up to 50% of patients in this category is related to an underlying psychiatric illness. Of the remainder of the patients in this category, chronic alcohol or drug abuse may be the cause of the sleep disruption. 

CATEGORY ANTICHOL INERGIC EFFECT SEDATION HYPOTEN- SION GI DISTRESS CARDIO- TOXICITY SEIZURES INSOMNIA/ AGITATION... 

Trade names Amytal Amytal Sodium Isoamitil Sedante Neur-Amyl Novambarb Sodium Amytal Indications Insomnia, sedation Category Barbiturate... 

Trade names Medinox Mono Mintal Nova Rectal Pentobarbitone Prodromol Sombutol Indications Insomnia, sedation Category Barbiturate Half-life 15-50 hours... 

The names and formulae of some of the psycholeptic compounds which cannot be classified in the major chemical categories so far considered are set out in Table 5.3. Meprobamate VIII) was one of the earliest used tranquillizers. It was developed from mephenesin VII), which was introduced as a muscle relaxant and was soon seen to have a sedative action too. In small doses, meprobamate is a sedative. In larger doses, it causes muscle relaxation and has been classed, with similar compounds, as a tranquillo-sedative . Like the barbiturates, it produces no sign of extrapyramidal or central autonomic stimulation. Well-authenticated reports of addiction to meprobamate have appeared . Both mephenesin and meprobamate produce muscle relaxation by inhibiting interneurones—and hence polysynaptic reflexes—in the spinal cord. Though not described as a hypnotic, meprobamate has been successfully used in the treatment of insomnia, perhaps because it reduces tension. 

CATEGORIES OE INSOMNIA Like Gaul, insomnia may be divided into three categories ... 

Category Anticholinergic effect Sedation Hypotension GI distress Cardiotoxicity Seizures Insomnia/ Agitation... 

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