Hypnotic

Hypnotic (also called soporific ) drugs are a class of psychoactives whose primary function is to induce sleep and to be used in the treatment of insomnia , and in surgical anesthesia . When used in anesthesia to produce and maintain unconsciousness, sleep is metaphorical as there are no regular sleep stages or cyclical natural states; patients rarely recover from anesthesia feeling refreshed and with renewed energy. Because drugs in this class generally produce dose-dependent effects, ranging from anxiolysis to production of unconsciousness, they are often referred to collectively as sedative-hypnotic drugs. Hypnotic drugs are regularly prescribed for insomnia and other sleep disorders, with over 95% of insomnia patients being prescribed hypnotics in some countries. Many hypnotic drugs are habit-forming and, due to a large number of factors known to disturb the human sleep pattern, a physician may instead recommend alternative sleeping patterns, sleep hygiene , and exercise, before prescribing medication for sleep. Hypnotic medication when prescribed should be used for the shortest period of time possible. The benzodiazepine and nonbenzodiazepine hypnotic medications also have a number of side effects such as daytime fatigue, motor vehicle crashes, cognitive impairments, and falls and fractures. In children, prescribing hypnotics is not yet acceptable unless if used to treat night terrors or somnambulism . Elderly people are more sensitive to these side effects and a meta analysis found that the risks generally outweigh any marginal benefits of hypnotics in the elderly. A review of the literature regarding benzodiazepine hypnotic and Z drugs concluded that these drugs caused an unjustifiable risk to the individual and to public health, and lack evidence of long-term effectiveness due to tolerance . The risks include dependence , accidents, and other adverse effects. Gradual discontinuation of hypnotics leads to improved health without worsening of sleep. Preferably they should be prescribed for only a few days at the lowest effective dose, and avoided altogether wherever possible in the elderly.

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