The Molecular Basis of Insomnia: Implication for Therapeutic Approaches

ABSTRACT Insomnia is one of the most common sleep disorders that is characterized by difficulty in sleep initiation, sleep maintenance, and/or poor sleep quality. Treatment for insomnia includes both pharmacological and non‐pharmacological interventions. Recently, the development of pharmacological treatment for insomnia has been prompted by the understanding of the molecular neurobiology of sleep‐wake regulation. For pharmacological treatment, benzodiazepines that target GABAergic system are the most widely used hypnotics. Besides GABA, the hypocretin/orexin system, and the hypothalamic–pituitary–adrenal (HPA) axis are involved in sleep‐wake regulation and may also play important role in the pathogenesis of insomnia. Genetic studies have revealed the critical role of several important genes related to the above‐mentioned systems in the regulation and function of sleep, suggesting the genetic/epigenetic factors could also contribute to the development and regulation of insomnia. Non‐pharmacological interventions include cognitive behavioral therapy for insomnia (CBT‐I) that is an effective insomnia treatment with less risk and side effects of drug therapy. Here the current treatments for insomnia based on the molecular mechanisms underlying sleep‐wake regulation, were reviewed and some newer targets that may be beneficial in the development of new treatments for insomnia were discussed.
Source: Drug Development Research - Category: Drugs & Pharmacology Authors: Tags: Research Overview Source Type: research