FDA-approved Nonbenzodiazepine Receptor Agonists for the Management of Insomnia

Jon P. Wietholter, PharmD, BCPS; Renier Coetzee, BPharm, MPharm, PharmD


US Pharmacist. 2017;42(1):29-32. 

In This Article


Several comorbid medical conditions may contribute to insomnia such as obstructive sleep apnea (OSA), fibromyalgia, and chronic pain. Treatment of these underlying conditions may or may not resolve insomnia. Of these concomitant disease states, insomnia is most strongly associated with neuropsychiatric illness, including mood disorders, posttraumatic stress disorder (PTSD), and anxiety. Additionally, insomnia is a strong predictor of relapsing depression and substance abuse. Smoking may lead to shortened sleep duration (<6 hours), while chronic alcohol consumption will most likely increase sleep disruption and ultimately have a negative effect on sleep initiation.[6]

Numerous epidemiologic studies have been conducted to determine the prevalence of insomnia with worldwide rates varying from 5% to 50%.[7] This variation may be due to different definitions being used for insomnia or various methods being used for assessing insomnia.[7] In population-based studies, about one-third of adults report at least one nocturnal insomnia symptom weekly.[8] When using the DSM-5 diagnostic criteria, insomnia prevalence rates from multiple countries have consistently been between 6% and 10%.[1,9] Insomnia is found to be more prevalent among women, older adults, shift workers, and those with aforementioned comorbid medical and/or psychiatric disorders.[7,9]