Pharmacological Treatment of Insomnia

Abstract

About 35% of the American population complain of difficulty going to sleep or maintaining sleep, and perhaps half of this group consider it a major problem (Mellinger and Balter, 1983). As a consequence, many persons consult a physician, and 4.3% of them receive a prescription for a sleep medication each year. (About 60% of these persons receive a traditional hypnotic; the remainder receive anxiolytics and antidepressants.) Of those who obtain medication, roughly three-fourths take it for less than two weeks; 11%, however, use it nightly for over a year. Although the utilization of hypnotics is widespread, the total number of prescriptions is less than in past years. Since careful data were first collected in 1964, the number of prescriptions rose from 32.5 million to a peak of 42 million in 1971 and gradually declined to 23 million in 1982. In 1985, there were approximately 24 million prescriptions for barbiturates (excluding long-acting forms), chloral hydrate, and other nonbarbiturate hypnotics combined.* Of the nonbarbiturate prescriptions (21 million), 94% were for benzodiazepines.