General term insomnia includes such sleeping disorders as difficulty to fall asleep or stay asleep, frequent awakening or awakening early, disturbed sleep patterns.

Treatment for insomnia depends on underlying cause. Emotional disturbance is the main cause for initial insomnia (difficulty in falling asleep) and usually is cured with hypnotic (sedative) drugs.

Nonbenzodiazephine hypnotics are anti-insomnia drugs for short-term treatment – usually 1 – 2 weeks. Comparing to benzodiazephines this class of medicines may produce fewer side effects and are noted for rapid onset of action and short duration.

Common nonbenzodiazephine drugs (with brand names in brackets) are: zolpidem (Ambien, Stilnox, Stilnoct, Hypnogen, Myslee), zaleplon (Sonata, Starnos), zopiclone (Imovane), and stereoisomer of zopiclone – eszopiclone (Lunesta).

All of mentioned chemicals are CNS depressants and have the same mechanism of action. Being concurrent agonists of GABA – a chief inhibitory neurotransmitter in the human brain – nonbenzodiazephines bind with some GABA-receptor subunits and in this way slow down the nervous system.

The maximum dose for all of the medicines from this class is 10 mg per 24 hours, usually 7 – 7.5 mg, for older and more sensitive to compounds people – 5mg. The speed of action to average is 30 min, and the time of half-life varies from 1 hour for Sonata to 6 hours for Lunesta.

In case of overdose, incorrect or prolonged use of short-term anti-insomnia drugs, numerous and severe side effects may occur. Among them: hallucinations, day-time drowsiness, delusions, poor motor coordination, increased appetite and sex drive, bitter or metallic taste, bad breath, coated tongue, abnormal behavior, severe confusion, dizziness, double vision, agitation, headache, nausea, vomiting, diarrhea, abdominal pain, muscle weakness, tremor, vivid or abnormal dreams, extremely poor judgment, anterograde amnesia, asthenia, depression, suicidal thoughts.

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Some patients (usually young people) experienced vivid visuals, body high, mild to moderate euphoria and withdrawal symptoms like mood changes, anxiety and restlessness. Abuse of insomnia treatment may develop into deep addiction.

In view of listed possible side effects, after use of nonbenzodiazephines individuals should avoid driving, operating with complicated machinery, and minimize list of actions demanding high alertness.

Precautions and contraindications: -pregnancy -breastfeeding -alcohol abuse -depression -myasthenia gravis -sleep apnea syndrome -severe hepatic insufficiency -previous paradoxical reactions to alcohol and sedative medicines

Simultaneous use of other CNS depressants is highly undesirable as they may enhance the activity of nonbenzodiazephines. The consumption of alcohol while taking anti-insomnia drugs is also not recommended.

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