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AASM statement on use of sleep medications

January 24, 2008

INSOMNIA AND SLEEP MEDICATIONS

Insomnia occurs when people have trouble falling asleep or staying asleep, and it is a common sleep compliant. While a brief case of insomnia can arise due to temporary stress, excitement or other emotion, more than 20 million Americans report having a chronic form of insomnia that keeps them from sleeping well nearly every night. As a result, the insomnia, which is a serious and often debilitating condition, can lead to severe daytime fatigue, poor performance at school and work, physical symptoms such as headaches, and in some cases depression.

People suffering from insomnia need to know that there are effective treatments and their sleep can improve. The American Academy of Sleep Medicine recommends that people who experience insomnia see a sleep medicine specialist or primary care physician for proper diagnosis and to discuss treatment options before treatment with medications is undertaken. This evaluation should also look for specific causes of insomnia such as restless legs syndrome or depression.

Sleep medications are often used for the short-term treatment of insomnia and, on occasion, for more chronic insomnia. Medications that currently are available by prescription are known to improve sleep by reducing the amount of time it takes to fall asleep, increasing sleep duration and/or reducing the number of awakenings during sleep. While modern hypnotics are considered safe, individuals should be aware that, like all medications, side effects may occur in a minority of patients. These side effects can include sleep walking, sleep eating and other complex sleep behaviors as well as difficulty with memory.

RECOMMENDATIONS FOR PATIENTS

Behavioral therapies and medications have been shown to be effective therapies for insomnia. Behavioral therapies use nonpharmacologic methods to improve sleep and are effective and long lasting. Sleep medications are effective and safe treatments for insomnia when used properly and judiciously by a patient who is under the supervision of a sleep medicine or primary care physician.

The American Academy of Sleep Medicine offers the following recommendations for individuals who use sleep medications:

* Read carefully the package insert and all information provided by your physician and pharmacist for your sleep medication. This information will help guide you in the safe use of the medication.

* Especially read the package insert and all information to learn the side effects of the medication.

* Adhere strictly to the indicated use of your sleep medication. Do not take it for purposes other than to sleep.

* Follow the prescription carefully and do not take more than the dosage your doctor prescribes.

* Allow time for a full night of sleep when using sleep medication to avoid morning or daytime drowsiness.

* Avoid combining sleep medication with alcohol.

* Ask your doctor any questions you have about the intended use, dosage and side effects. Communication with your physician will help ensure safe use of the medication.

* Inform your doctor right away of any problems you have while taking a sleep medication.

* Make your doctor aware of any other medications, prescriptions or over-the-counter, that you use. Mixing medications may cause adverse effects.

* Make your doctor aware of other medical conditions, including other sleep disorders, you may have. Sleep medications can be dangerous when treating sleep disruption that may arise from another disorder.

* Visit www.SleepEducation.com for more information about insomnia, treatment options and to find a sleep center.

RECOMMENDATIONS FOR PHYSICIANS

The American Academy of Sleep Medicine is committed to educating sleep medicine and primary care physicians about treatment options for insomnia. Behavioral therapies and medications have been shown to be effective therapies for insomnia. The American Academy of Sleep Medicine offers the following recommendations for primary care physicians who see patients with insomnia:

* Read the practice guidelines for chronic insomnia created by the American Academy of Sleep Medicine: http://www.aasmnet.org/Resources/PracticeParameters/PP_ChronicInsomnia.pdf

* Become intimately familiar with sleep medications you prescribe, including the indications for use and side effects.

* Educate your patients about the sleep medicine you are prescribing to them, including the indications for use, dosage and side effects. Ensure your patients fully understand the intended use and potential effects.

American Academy of Sleep Medicine