The treatment of insomnia

About one in five adults does not get as much sleep as he or she would like.1,2 The amount of time people sleep varies from 3–10 hours a night, with an average of 7–8 hours; the elderly often sleep less.2 Insomnia, the feeling of excessive night-time wakefulness, is thus a very subjective complaint. It is more common in women and is often long-standing when medical help is sought.2 It is often treated with a hypnotic drug, and in recent surveys 4% of adults,3 and 16% of the over 65s4 had taken a benzodiazepine hypnotic in the previous year. We review how best to help insomniacs, when to prescribe a ‘sleeping pill’, and which one to use.