For persistent unexplained insomnia, evaluation in a sleep laboratory may help. Treatment Treatment depends on the underlying cause. Many patients respond to reassurance that their sleeplessness is a result of normal anxieties or is secondary to a treatable physical disorder. Discussing anxieties with the patient often eases distress and helps reestablish normal sleep patterns. Elderly patients experiencing normal changes in sleep patterns should be reassured, instructed in relaxation, and encouraged to exercise more during the day and to avoid daytime naps.
Warm milk helps some patients sleep.
For insomnia due to emotional disturbance other than depression and for refractory cases, a hypnotic drug may be temporarily required, especially if sleeplessness impairs the patient's efficiency and sense of well-being. Depressed patients should be given limited amounts to reduce the risk of attempting suicide with the hypnotic. Patients who awaken because of pain should receive analgesics at bedtime as the mainstay of treatment. Terms such as hypnotic, sedative, antianxiety drug, minor tranquilizer, and anxiolytic are often used interchangeably. The best term for drugs used primarily to induce sleep is hypnotic.