Benzodiazepines and Non-benzodiazepines hypnotics
These primarily address insomnia related to quantitative sleep problems (long sleep latency, short sleep duration) but do not necessarily improve sleep quality. Furthermore, there is often no improvement and even impairment to daytime vigilance25 26. Hypnotics are also associated with ‘hangover effects’ such as drowsiness and diminished alertness and are further associated with the development of dependence and withdrawal symptoms 25 .
The serious potential safety concerns associated with benzodiazepine use are well known, and include addictive potential, cognitive impairment/confusion, impaired motor coordination (leading to falls and other accidents and injuries), and anterograde amnesia (inability to remember events that occurred under the influence of such drug)27 28.
The potential for inducing confusion and falls is of particular concern in the elderly. Cognitive decline is a natural accompaniment to the ageing process which may be further aggravated by the confusion evoked through treatment with benzodiazepines. The increased risk of falls and accidents associated with the use of benzodiazepines in the elderly often lead to fractures and hospitalisation29 30 31.
Unfortunately, for elderly patients, fractures can be a major cause of morbidity and mortality due to long hospital stays, operations, rehabilitation, and the risk of infections and other complications29 30 31.
Rebound insomnia and residual daytime effects are also known to occur in some cases of drug withdrawal, and are generally linked with short-acting and long-acting factors, respectively32.
There is now an increasing awareness that, since sleep quality is essential to daytime functioning, pharmacological treatments of insomnia must be evaluated with respect to effects on morning alertness and withdrawal symptoms23 25.
Melatonin 33 34 1
A sleep promoting hormone. It plays a role in regulating the circadian clock and has a strong association with sleep.
Circadin® is a prolonged release formulation of melatonin. Melatonin has been used for many years to treat sleep disorders, in particular jet lag and non-24 hours sleep wake disorders in the blind. For such uses regular melatonin preparations that are available in an unregulated fashion particularly in the USA, may be effective. However, in insomnia there is a need for melatonin to cover the entire night period. Circadin® is different as it gradually releases melatonin over an eight to ten hour period, mimicking your body’s normal sleep pattern.
Circadin® can help you fall asleep easily and sleep soundly, allowing you to wake feeling more refreshed and ready to face the day. Click here to read more about Circadin®
