Insomnia
Management
Non pharm:
Sleep–wake activity regulation
Sleep setting and influences
Sleep-promoting adjuvants
Pharm
Temazepam (benzo)
Zolpidem/ Zolpiclone (hypnotics)
Melatonin (indicated for age >55)
NOTE: benzo and hypnotics may result in daytime somnolence
Source
Australian Therapeutic Guidelines 2013
Non pharm:
Sleep–wake activity regulation
- go to bed at the same time each day
- arise at a regular time
- avoid lying in bed for long periods of time worrying about sleeping
- avoid oversleeping
- avoid napping (if necessary, limit to afternoon 'powernap' of 10 to 15 minutes)
Sleep setting and influences
- avoid bright light exposure in late evening or night
- seek exposure to bright light after rising
- avoid heavy meals within 3 hours of bedtime
- undertake regular daily exercise but avoid vigorous physical activity within 3 hours of bedtime
- ensure a quiet, dark room for sleeping (remove TV, music player, laptop, mobile phone)
- avoid having pets and highly illuminated digital clocks in the bedroom
- use a suitable mattress and pillow for comfort and support
- reserve bedroom for sleep and intimacy
- avoid alerting, stressful ruminations before bedtime. Allocate time earlier in the evening to go through worrying issues
- avoid caffeine after midday
- reduce excessive alcohol intake
- avoid tobacco, especially in the evening
- avoid illicit drugs
Sleep-promoting adjuvants
- have a light snack or a warm milk drink before bed
- have a warm bath before bed
- ensure a comfortable temperature for sleep and maximal darkness
Pharm
Temazepam (benzo)
Zolpidem/ Zolpiclone (hypnotics)
Melatonin (indicated for age >55)
NOTE: benzo and hypnotics may result in daytime somnolence
Source
Australian Therapeutic Guidelines 2013