Hypnotics and Sedatives

Sleep is an active physiological process which harmonizes the brain function. A sedative is a drug which reduces activity and alertness by producing a calming effect on the subject, whereas a hypnotic induces drowsiness and promotes sleep onset and maintenance. With the various therapeutic options available, treating sleep disorders is becoming a challenging task to physicians. This chapter provides a brief review of classification, mechanism of action, pharmacological actions, pharmacokinetics, adverse effects, and uses of various drugs which are used as sedative and hypnotics. This chapter also highlights the drawbacks of the outdated sedative and hypnotics like barbiturates and the advantages of newer sedative and hypnotics like the melatonin receptor agonists and orexin receptor antagonists. An outline of management of insomnia has also been discussed in this chapter based on the current guidelines for treatment of insomnia [American Academy of Sleep Medicine Clinical Practice Guideline for Chronic Insomnia in Adults (2017), European Sleep Research Society guideline for the diagnosis and treatment of insomnia (2017), Indian Psychiatric Society Clinical Practice Guidelines for Sleep Disorders (2017)]. An update of newer drugs and molecular targets being evaluated for treatment of insomnia is also provided here.