![]() ![]() (Suvorexant, zaleplon and ramelteon are not currently available in Canada, but zaleplon is available through compounding pharmacies.) Trazodone, melatonin, tryptophan, tiagabine and valerian are not recommended for treating insomnia ( Sateia et al., 2017).Īll of the newest hypnotics (eszopiclone, ramelteon, zaleplon, zolpidem) have been shown to be safe and effective in older adults. ![]() Some sedating agents have the potential for physical or psychological dependence and there are limited studies on the effects of long-term hypnotic use.Īccording to the most recent American Academy of Sleep Medicine clinical practice guidelines, the following medications can be used to treat insomnia: suvorexant, eszopiclone, zaleplon, zolpidem, temazepam, ramelteon and doxepin. You might benefit from having a sleep study done. But recently I was looking at my medical info online and saw I was diagnosed with sleep apnea, which partly explains why I wake up at night and feel tired during the day. Difficulty staying asleep often gives rise to worry over not getting enough sleep, which further interferes with sleep, creating a vicious cycle. Do you have sleep apnea I had a sleep study done two years ago and they didnt tell me I had it. One form of it, called sleep-maintenance insomnia, is difficulty staying asleep, or waking too early and struggling to get back to sleep. Id be very cautious but you should do whats best for you. Been struggling on and off for 2 years now with insomnia. Took xanax lowest dose for 2 months after getting covid and never at bedtime. Sleep-promoting agents (hypnotics or sedatives) are generally recommended for short-term treatment of insomnia if CBT is not available or accepted by the patient. Insomnia is often thought of as trouble falling asleep. Benzos for anxiety are what caused my insomnia. Use with caution in children and in patients with lung diseaseĬaution with renal impairment and alcohol use Temazepam (Restoril): Benzodiazepine (GABA agonist) Cognitive Behavioural Therapy: An information guide for families.Psychiatry in Primary Care: A Concise Canadian Pocket Guide 2019.The efficacy of hypnotics is comparable to that of CBT-I for the acute treatment of insomnia however, the effects dissipate after the hypnotic is discontinued, whereas improvements made through CBT-I are maintained after the patient completes treatment. Consider pharmacotherapy for chronic insomnia when CBT-I is not available, when treatment was not effective or when the patient prefers pharmacotherapy.Įvidence suggests that insomnia with objective short sleep duration has primarily biological roots (e.g., genetics and physiological hyperarousal) and may respond better to biological treatments, whereas insomnia with objective normal sleep duration has primarily psychological roots and may respond better to psychological interventions alone (CBT techniques). Pharmacotherapyįor pharmacotherapies used in Canada to treat sleep disorders, see table below. I actually started Gabapentin 300mg for sleep last night. Goolam Hussain and Colin Shapiro (CAMH, 2019). Pregabalin may be more likely than Gabapentin to cause tolerance and cognitive side effects but the difference is probably pretty minor and it should work the same way on slow wave sleep. Text adapted from: "The adult patient with a sleep disorder," in Psychiatry in primary care by Dora Zalai, M.R.
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