Diagnosis:

Difficulty with sleep initiation or maintenance (staying asleep, waking early) inspite of adequate opportunity to sleep.

Treatment:

Non-pharmacological:

Improve sleep hygiene:

• Maintain regular sleep-wake cycle: Set to bed time, mid-day Nap less than 1 hour, don’t oversleep in the weekend.
• Reduce stimulants: no caffiene afternoon, noneducational reading at bed, avoid exercise alcohol & heavy meals close to bedtime. Minimise light, noise, excessive temperatures. Avoid working in the bed room. Remove clock from sight.
• Exercise but not withing 3 hours of bedtime
• Don’t lie in bed awake in the morning

Cognitive behavioural therapy CBT: for chronic insomnia

Pharmacological:

For acute insomnia:

• Melatonin receptor agonist: Ramelteon
• Benzodiazepine receptor BZR agonist: zolpidem, zopiclone, eszopiclone

For chronic insomnia:

• Esozopiclone. Ramelteon