Use drugs to treat chronic insomnia

Sleep is a state of the body that balances the endogenous and exogenous factors, characterized by day and night rhythm oscillations, ensuring the restoration of the functions of the brain in the wake-sleep state.

Throughout life, each person sleeps an average of 220,000 hours and sleep disorders are often the earliest symptoms of mental illnesses.

(Photo: TTO)

Normally people sleep about 6-7 hours / night. The life cycle of sleep is 25 hours, but due to the influence of external factors, the sleep rate is only 24 hours. People sleep into two stages: slow sleep and fast sleep.

The slow sleep period accounts for about 75% of the sleep time, while the fast sleep period accounts for the remaining 25%. Movement from the fast sleep phase to the slow sleep phase and vice versa is generally very fast, in fact only clearly distinguishing these two periods when making EEGs in sleep.

Primary insomnia is a major complaint: difficulty falling asleep or having difficulty keeping sleep and lasting for at least a month. Primary insomnia occurs independently not related to any other physical or mental disorders. Patients increase activity at night and sleep less, feeling happy or too melancholy.

Primary insomnia leads to anxiety disorder, irritability, drowsiness, fatigue, reduced ability to work, difficulty concentrating, reducing memory . Primary insomnia is common in the elderly, popular among women than men. The disease is common in adults, rarely seen in children and adolescents. It is often difficult for a young person to go to sleep, while in the middle and the elderly people often complain that it is difficult to sleep and get up early.

The disease is very common, according to the American Psychiatric Association, in 40% of adults complain of insomnia and about 15-25% of people with primary insomnia. Most cases of primary insomnia appear after a psychological stress factor. But primary insomnia is very sustainable, when psychological stress factors are resolved, insomnia is not over.

However, primary insomnia is a chronic disease, usually lasting several months or even years. Therefore, the treatment also needs enough time, avoiding the use of drugs that can cause drug dependence.

Drugs used in primary insomnia

Some sedatives can be used to treat insomnia such as thioridazine, olanzapine. These drugs can be used long without fear of addiction. Peaceful antidepressants such as amitriptiline (elavil), mirtazapine (remeron), doxepine, and ludiomine are good for treating primary insomnia.

In addition, these drugs also work to treat anxiety, depression - very common causes of insomnia. Therefore, the use of these drugs is very convenient, giving good results even when diagnosis of primary insomnia or insomnia due to depression, anxiety is not clear. In these drugs, amitriptiline is the cheapest and the easiest to buy, but the drug has the most side effects, so when used, increase the dose slowly so that patients get used to it.

Remeron is currently available in the market, the drug has a good effect like amitriptiline, but very few side effects, convenient for patients, especially the elderly, but the drug price is still high. Some specific regimens:

- Regimen 1: Elavil 25mg, take 1 pill each night for 1 tablet, 2 for each night, 2 for a morning, 1 for the morning, 2 for the evening, from the 4th week onwards to drink 2 tablets, 2 tablets at night. Need to take medicine for 6-12 months.

- Regimen 2: Remeron 30mg, take half a tablet, if necessary, use 1 tablet, drink at night before going to bed. Need 6-12 months of medication.

- Regimen 3: Olanzapine 10mg orally half a tablet, if one tablet is needed. Need 6-12 months of medication. Olanzapine can be replaced by thioridazine 100mg.

In summary, primary sleep disorder is a very common, chronic, relatively complicated treatment. Therefore, patients should be consulted and treated carefully by a psychiatrist.