Health problems - pain, depression, or a sleep disorder such as sleep apnea - may be part of the picture as well. Midlife is often a time of psychological stress: children may be leaving home, a partner may be lost through death or divorce, and roles may be changing at home and work. Who does sleep-maintenance insomnia affect?įor many reasons, women transitioning through midlife may be more vulnerable to sleep disturbances. Like difficulty falling asleep at the beginning of the night, called sleep-onset insomnia, sleep-maintenance insomnia is more common in women than in men. It often takes the form of sleep-maintenance insomnia - that is, difficulty staying asleep, and in particular, waking too early and struggling to get back to sleep. Insomnia - inability to get the sleep you need to wake up refreshed - is the most common sleep complaint in the United States.
Maybe you doze off for an hour or so, but when the alarm clock gets you up for the day, you're far from rested. You toss and turn and worry about not getting enough sleep. You tell yourself you've got to get back to sleep, but thoughts about yesterday's troubles, the coming day's challenges, and all those "must-do's" race through your mind. You wake up and look at the clock: it's 3 a.m. Several compounds currently under development may offer clinicians a more effective and safer treatment for this common disorder.Sleep-maintenance insomnia common complaint among women at midlife New agents that offer relief of sleep maintenance insomnia without residual next day impairment while improving next day function are needed. Furthermore, the benzodiazepines with established sleep maintenance efficacy are associated with next-day sedation, the risk of tolerance and dependence, or both. Many of the currently available agents used to treat insomnia, including the antidepressant trazodone, the non-benzodiazepine hypnotics zolpidem and zaleplon, and some of the benzodiazepines, have not consistently demonstrated effectiveness in promoting sleep maintenance. In all publications, impact of treatment on sleep maintenance parameters (wake time after sleep onset, number of awakenings) and measures of next-day functioning were evaluated, in addition to sleep onset parameters (sleep latency, time to sleep onset/induction) and sleep duration data (total sleep time). Relevant texts and other articles that evaluated side effect profiles of these agents were also included, one of which was published in January of 2005.
SLEEP MAINTENANCE INSOMNIA TRIAL
As only one randomized placebo-controlled trial evaluated trazodone use in primary insomnia, the trazodone search was expanded to include all clinical trials that evaluated trazodone use in insomnia. Sleep efficacy endpoints from randomized, placebo-controlled clinical trials in adult populations and key review articles published between 19 were included in this review.
A literature search using the terms "trazodone" and "insomnia" was also performed, as this is the second-most commonly prescribed agent for treating insomnia. Per reviewer comments, the search criteria was later expanded to include lorazepam. When insomnia is recognized, considerable emphasis has been placed on improving sleep onset however, there is growing evidence that improving sleep maintenance is an equally important treatment goal.Ī MEDLINE literature search was performed using the search parameters "insomnia," "zolpidem," "zaleplon," "flurazepam," "estazolam," "quazepam," "triazolam," and "temazepam," as these agents are FDA-approved for the treatment of insomnia. Although insomnia is highly prevalent, sleep disturbances often go unrecognized and untreated.
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