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The following suggestions are intended to help overcome transient insomnia and maximize the chance of getting a healthy night’s sleep:

1. Make your bedroom an inviting place. Keep the room free of clutter and distractions. Be sure you have the right bed and mattress for your needs. The wrong mattress can lead to musculoskeletal problems and sleep disturbances.


2. Use the bed only for sleeping and sex. Avoid use of the bed for watching TV, eating, working, or any other activities. If you do wish to use the bed for a bit of nighttime reading, read only pleasure books in bed.


3. Therapists often use "reconditioning" as part of a treatment plan for insomnia. With this method, people are "reconditioned" to associate the bed with sleep. If you find yourself unable to sleep at all, get out of bed and move to another room, so that you only associate the bed with sleep and not with wakefulness


4. Establish a regular sleep-wake cycle. Your body will learn to set its internal clock to your schedule and will eventually respond to internal cues to become sleepy at a given time and to awaken at a given time. A good way to begin this is by getting up at the same time every morning, even on weekends.


5. Don't nap. No matter how tempting it may be, an afternoon nap can make falling asleep at night even harder. "Extra" sleep on weekends can also throw off your sleep schedule and worsen midweek insomnia.


6. Limit your consumption of caffeine in the afternoon and evening. Remember that eating chocolates and drinking cocoa and colas also are sources of caffeine.


7. Watch your alcohol intake. Don’t drink any alcoholic beverages in the few hours prior to going to bed. Excessive amounts of alcohol at any time in the day can also disrupt sleep patterns and lead to unsatisfying sleep. Cigarette smoking can also worsen insomnia.


8. Fit in some exercise during the day, but don’t exercise strenuously right before bedtime.


9. Eat light meals in the evening. Eating heavily in the evening or eating just prior to going to bed can disrupt your sleep.


10. Establish a “winding down” period in the evenings just prior to bedtime. Try to free your mind of distracting or troublesome thoughts and engage in a relaxing, enjoyable activity like reading, listening to music, or watching a pleasant film.

Insomnia is the most common sleep complaint. It is a perception that sleep quality is inadequate or nonrestorative, despite the adequate opportunity to sleep. That insomnia is a symptom, not a disease, is important to note; it is associated with a variety of medical, psychiatric, and sleep disorders . A comprehensive history and physical examination are essential to determine the etiology of the insomnia.
The complaint of insomnia encompasses many sleep problems. These include difficulty falling asleep, sleeping too lightly, being easily disrupted with multiple spontaneous awakenings, or early morning awakenings with inability to fall back asleep. The timing of insomnia is important in determining its etiology. Therefore, having each patient define what he or she means by insomnia is essential.
To be considered a disorder, the complaint of insomnia should be accompanied by distress and/or impairment in daytime functioning.
On the basis of duration, insomnia is commonly divided into the following 3 types:
Transient insomnia lasts up to 1 week and often is referred to as adjustment sleep disorder because it most often is caused by an acute situational stress, such as a new job, upcoming deadline, or exam. It often recurs with new or similar stresses.
Short-term insomnia lasts for 1-6 months and is usually associated with more persistent stressful situational (death or illness of a loved one) or environmental (noise) factors.
Chronic insomnia is any insomnia lasting more than 6 months and is associated with a wide variety of disorders (to be discussed later).
Pathophysiology: Insomnia usually results from an interaction of biological, physical, psychological, and environmental factors.
Although transient insomnia can occur in any person, chronic insomnia appears to develop only in a subset of patients who may have predisposing factors. Evidence for this theory includes the following:
When compared to control subjects, individual with insomnia (1) have higher rates of depression and anxiety, (2) score higher on scales of arousal, (3) have longer daytime sleep latency, (4) have an increased 24-hour metabolic rate, (5) have more night-to-night variability in their sleep, and (6) may have more beta EEG activity (an EEG pattern seen during memory processing/performing tasks) at sleep onset.
In experimental models of insomnia, control subjects deprived of sleep do not demonstrate the same abnormalities in metabolism, daytime sleepiness, and personality as persons with insomnia.
In an experimental model of giving control subjects caffeine, causing a state of hyperarousal, the control subjects did have changes in metabolism, daytime sleepiness, and personality similar to those seen in individuals with insomnia.
These results support a theory that insomnia is a manifestation of hyperarousal. In other words, the poor sleep may not itself be the cause of the daytime dysfunction but merely the nocturnal manifestation of a general disorder of hyperarousability.
Therefore, chronic insomnia is believed to primarily occur in patients with predisposing factors. These factors may cause the occasional night of poor sleep, but in general, the patient sleeps well until the occurrence of a precipitating event, such as death or other life stress. Then, acute insomnia develops. If poor sleep habits or other perpetuating factors occur, chronic insomnia develops despite the removal of the precipitating factor.
Frequency:
In the US: In a 1991 survey, 30-35% of adult Americans reported difficulty sleeping in the past year and 10% reported the insomnia to be chronic and/or severe. Despite the high prevalence, only 5% of persons with chronic insomnia visited their physician specifically to discuss their insomnia. Only 26% discussed their insomnia during a visit made for another problem.
Internationally: A study from Quebec indicated an overall prevalence of insomnia of approximately 20% of French Canadians. A study of young adults in Switzerland indicated a 9% prevalence of chronic insomnia. A World Health Organization (WHO) study conducted in 15 centers found a prevalence of approximately 27% for the complaint "difficulty sleeping."
Mortality/Morbidity: Insomnia is associated with a variety of complaints in daytime functioning.
Insomniacs complain of impaired ability to concentrate, poor memory, difficulty coping with minor irritations, and decreased ability to enjoy family and social relationships.
Insomniacs are more than twice as likely as the general population to have a fatigue-related motor vehicle accident.
The mortality rate appears to be higher in patients who get less than 5 hours of sleep per night than in the general population.
Sex: The prevalence of the complaint of insomnia is higher in women—approximately 40% as against 30% in men.
Age: The frequency of the complaint of insomnia increases with age.

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How should Sonata be used?

Sonata comes as a capsule to be taken orally. It is usually taken once a day at bedtime or after going to bed if you cannot sleep. This medication is usually taken for 7-10 days.

What about Sonata addiction?

The active ingredient in Sonata is zaleplon which can be habit-forming; do not take a larger dose, take it more often, or take it for a longer period than your doctor tells you to. Do not stop taking Zaleplon without talking to your doctor.

What about Sonata tolerance?

Generic Sonata can lose its effectiveness if used for long periods of time.

What special precautions should I follow?

Before taking zaleplon, tell your doctor if you are allergic to aspirin, tartarzine (a yellow dye in some processed foods and drugs), or any other drugs. tell your doctor what prescription and nonprescription medications you are taking, especially allergy medications; antihistamines; barbiturates; cimetidine (Tagamet); cold medicines; imipramine (Tofranil); medications for depression; medications for seizures such as phenytoin (Dilantin), carbamazepine (Eptitol, Tegretol, others), and phenobarbital (Solfoton); pain relievers; rifampin (Rifadin, Rimactane); thioridazine (Mellaril); tranquilizers; and vitamins and herbal products. tell your doctor if you have or have ever had kidney or liver disease, a history of alcohol or drug abuse or depression, asthma, breathing problems, or allergies. tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Sonata/Zaleplon, call your doctor. if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Sonata/Zaleplon.

What special dietary instructions should I follow?

Do not take Sonata with or right after a high-fat or heavy meal.

What should I do if I forget a dose?

Do not take a missed dose when you remember it. Skip the missed dose and take the next dose at the regularly scheduled time.

What about Sonata Side Effects?

Although zaleplon side effects are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away: drowsiness, dizziness, lightheadedness, lack of coordination, headache, constipation, dry mouth, muscle aches.

If you experience any of the following symptoms, call your doctor immediately:

skin rash, itching , fast or irregular heartbeat, chest pain, difficulty breathing, fever, behavior changes or acting differently, mental confusion, abnormal thinking or dreams, hallucinations, depression, worsening of insomnia, problems with memory



What storage conditions does Sonata require?

Keep this medication out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed.

 

Most adults have experienced insomnia or sleeplessness at one time or another in their lives. An estimated 30-50% of the general population are affected by insomnia, and 10% have chronic insomnia.
Insomnia is a symptom, not a stand-alone diagnosis. By definition, insomnia is "difficulty initiating or maintaining sleep, or both." Although most of us know what insomnia is and how we feel and perform after one or more sleepless nights, few seek medical advice. Many people remain unaware of the behavioral and medical options available to treat insomnia.
Insomnia affects all age groups. Among older adults, insomnia affects women more often than men. The incidence increases with age.
Stress most commonly triggers short-term or acute insomnia. If you do not address your insomnia, however, it may develop into chronic insomnia.

EGA WELCOMES PATENT DECISION

The EGA welcomes the decision of the Opposition Division of the European Patent Office, revoking "Citalopram crystalline base" patent EP 1 169 314 in its entirety due to the lack of inventive step. The decision, based on final proceedings in June this year, was taken on 19 July 2006, and became official with its publication this week.
Greg Perry, EGA Director General, said, "This decision highlights the need for a review of how patents are granted. In the light of this unequivocal decision, it is difficult to understand how such a patent could have ever been granted within 18 months, and why it took nearly three years to conclude the opposition procedure."
In the meantime the patent holder sued more than 35 generic medicines companies throughout Europe for "infringing" this so-called "patent". These cases, mostly unsuccessful, generated tremendous expenses in lawyers, patent attorneys and wasted time, and seriously threatened the companies concerned with being removed from the market.
Mr Perry reiterated his call for a review of the current patent regime. "Why waste resources", asked Mr Perry, "on fighting and defending illegitimate patents, when the time and money could be better employed to improve healthcare and lower costs? Indeed these added costs and time delays for market entry of competitive generic medicines will mean added costs for society. "
The necessary reform of the patent system should be part of a wider public policy approach including:
a global re-assessment of the use of IP laws relating to medicines, particularly when granting patent extensions, secondary patents and data exclusivity;
stronger enforcement of the criteria for granting patents, particularly the inventive step;
greater incentives to develop genuine innovative medicines and to discourage the generation and protection of marginal changes to products with no added value for patients;
the allocation of public funding to research into priority medicines; and
ensuring quick access to the post-patent market for generic equivalents.