These are drugs that induce SLEEP. Before a hypnotic is prescribed, standard care is to establish – and, where possible, treat – the cause of the insomnia (see under SLEEP, DISORDERS OF). Hypnotics are most often needed to help an acutely distressed person (for example, following bereavement), or are requested for those with jet lag, or working unsociable hours.
If requested in states of chronic distress, whether induced by disease or environment, prescribers believe it is especially important to limit use to a short period to prevent undue reliance on them, and to prevent them becoming a means of avoiding the patient's real problem. In many cases, such as chronic depression, overwork, and alcohol abuse, hypnotics are inappropriate, and some form of counselling or other psychological therapy is preferable.
Hypnotics are generally best avoided, if possible, in the elderly (confusion is a common problem), and in children. The most commonly used hypnotics are the BENZODIAZEPINES such as nitrazepam and temazepam; chloral derivatives, while safer for the few children who merit them, are generally second choice and should be used in the lowest possible dose for the minimum period. Zolpidem and zopiclone are two drugs similar to the benzodiazepines, indicated for short-term treatment of insomnia in the elderly. Adverse effects include confusion, incoordination and unsteadiness, and falls have been reported
Side-effects include daytime drowsiness – which may interfere with driving and other skilled tasks; insomnia following withdrawal, especially after prolonged use, is a hazard. Occasionally benzodiazepines will trigger hostility and aggression.
A group of drugs that produce sleep by a general (i.e. nonselective) depression of the central nervous system. Some of these drugs are also...
This article is a revision of the previous edition article by Daniel J Buyusse, Charles M Morin, volume 2, pp 612–614, © 2003, Elsevier Inc. Abstr
Drugs that cause sleep. Ideally hypnotics should produce natural sleep without hangover effects on awakening. Some benzodiazepines and newer...