Sleepless in South Africa: insomnia is not just a night-time problem

Abstract

Sleep is necessary for normal growth and development. Lack of sleep causes considerable personal impairment that may impose a substantial societal burden on productivity and quality of life. Insomnia, whether transient or chronic, responds to both pharmacological and non-pharmacological interventions. Cognitive behaviour therapy can effect sustained improvement in insomnia but requires motivation and commitment on the part of the patient and a trained therapist to guide the process. Benzodiazepine receptor agonists and benzodiazepines reduce sleep latency and increase total sleep time in insomniacs. However, their effects are not sustained after stopping the medication. Long-term safety of these medications has not been formally established. Combination of psychological and pharmacological therapies reduces the effect of psychological interventions. Thus, in determined patients psychological therapy should precede drug therapy.