Sleep Science Offers New Options
> 8/21/2006 3:14:49 PM

For centuries, insomniacs haven't had too many options in the struggle to catch some Z's. It has only been in the last several years that our knowledge of the workings of sleep have progressed by any considerable measure. Alcohol, maybe the world's first sleeping aid, works on virtually the same principle as modern sleep aids, which have been designed to ramp up effectiveness while trying to eliminate those pesky hangovers. This class of drugs are collectively called hypnotics and work by manipulating the neurotransmitter GABA.

Now, however, research has helped pharmaceutical companies begin to design and manufacture drugs that work on different parts of the sleep architecture. One of the most successful and interesting of these new developments is a drug known as ramelteon. This new drug, called a melatonin receptor agonist, acts on the areas of the brain that control our normal circadian rhythm. That way, they induce a sleepy state more "naturally," by getting our bodies to react as they would were the melatonin receptors were functioning properly.

Our circadian rhythms are still not understood in their entirety, but the daily passage from light into the darkness is intricately tied into our need to sleep and wake. In this day and age though, of offices and homes bathed in droning fluorescent light, our bodies don't always behave the way they might have in the past and often our circadian rhythms can get off track. Ramelteon and other drugs like it require continued research, but are putting us on a new and worthwhile path toward healthy sleep.

At the 58th Annual Meeting of the American Academy of Neurology, Dr. Sonia Ancoli-Israel, a professor at UC - San Diego pointed out that these new drugs, more than anything else give doctors and patients new options in treating insomnia.

"All these drugs work," she said. "They all help people fall asleep faster and/or help them stay asleep longer—so what does that tell us? It tells us that we as health care professionals need to ask our patients what their complaint is and then choose the appropriate agent, because not everyone responds to every drug. It is important to have multiple options about what to prescribe to different patients, as different patients have different problems and different needs."

Ramelteon may not completely revolutionize sleep science, but it is a worthy addition to any discussion and treatment of insomnia. Hypnotics like the popular Ambien that effect GABA can often have troublesome side effects such as amnesia or even more frightening sleep behaviors. Continued research will help us better understand the effects that these new drugs have in the long term, but the current outlook is good, and hopes should be high that ramelteon, et al. will help have those afflicted with insomnia sleeping more soundly in the future.

The New Scientist covers the future of sleep science.

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