Most insomniacs don’t seek professional help until they’ve endured months or years of chronic sleeplessness. By then, they’re reliant on over-the-counter medications or alcohol—or both—but nothing really does the trick anymore.
Only a minority of insomniacs ever mentions sleep loss to a doctor, though, and then it’s only in the context of other problems more likely to get addressed. Despite the ubiquity of sleep problems, physicians often haven’t been taught how to handle them.
University of Rochester sleep expert Michael Perlis cites a “pharmacologic renaissance” in the management of sleep problems. Newer drugs like Ambien (zolpiden) and Sonata (zaleplon), so-called nonbenzodiazepene hypnotics, improve the quality of sleep without destroying sleep architecture. People wake up feeling refreshed. “But most drugs are in fact underused,” he argues. Perlis blames what he calls “pharmacologic Calvinism”—fears that some pleasurable aspect of these drugs will lead to addiction.