2012 Volume 71 Issue 6 Pages 396-400
Recent epidemiol ogic studies have clearly shown that sleep problems are common in industrial countries, as well as developing ones. A survey conducted in Japan reported that 21.4% of adults had complaints of insomnia, which were frequently associated with other psychological and somatic symptoms. Insomnia is clinically defined as sleep difficulty despite adequate opportunity and circumstance for sleep associated with daytime impairment in quality of life, and requires appropriate therapeutic interventions because it is likely to cause several serious mental and physical disorders including hypertension, diabetes, heart diseases and depression. Here I reviewed recent articles on epidemiology, pathogenesis, diagnosis and treatment of insomnia, and found the following documented facts. Pathophysiologic mechanism of insomnia seems to be multifactorial and needs further study. Diagnosis of insomnia in clinical settings is carried out mainly by excluding mental or physical diseases that are possibly cause symptoms of insomnia, as well as other primary sleep disorders. Current progress in sleep medicine has proposed that pharmacological and non-pharmacological interventions should be combined in the treatment of insomnia. New generation hypnotics that act through mechanisms other than central GABAnergic ones, i.e., melatonin receptor agonists, orexin receptor antagonists, are expected to play an important roll in future sleep medicine practice.