Tratamiento farmacológico del insomnio 2A parte

Sleep disorders are a frequent pathology. Nearly 35% Colombians will have a sleep disorder at any time in their lives. Insomnia is the main complaint in adults and the elderly. The prevalence of insomnia in women is 40%, in men 30% and goes up to 50% in people over 50 years of age. The more frequently associated factors are female gendre, mental disorders, general medical conditions, substance abuse and advanced age. An adequate intervention needs careful diagnosis and etiological treatment. There is a direct relationship between insomnia and medical, neurological, pneumological and psychiatric conditions. The sleep expert goes through these pathologies with the ananmesis, physical exam, sleep agenda, psychological exams and occasionally polysomnography. Current treatment of insomnia entails a comprehensive and etiological approach. Predisposing, precipitating and perpetuating factors are evaluated. Sleep hygiene, hypnotics, CPAP, BiPAP, lumino therapy, chronotherapy and melatonin are used. This article considers the mechanisms of action of hypnotic drugs upon GABA A receptors, chloride channels and omega sites. Nowadays we have a wide variety of old and new hypnotics, the latter, quite selective sleep inducers, with fewer side effects, Iike zolpidem, zopielone and zaleplon.