Abstract：
This article reviews the history of insomnia pharmacotherapy, documenting the evolution that has occurred over time in the increasing availability of medications with novel mechanisms of action that more specifically target the neural systems that modulate sleep/wake function. This evolution provides an increasing capacity to improve the effectiveness of insomnia pharmacotherapy by allowing the selection of medications that specifically target the particular type of sleep difficulty present in each patient. As a result, they can achieve a therapeutic effect with fewer effects on aspects of brain function other than those needed to achieve benefit, thereby minimising adverse effects. The accumulated evidence-base is such that it can serve as the basis for a personalised insomnia pharmacotherapy paradigm. Here we outline a set of best-practice recommendations for how to carry out optimised personalised insomnia pharmacotherapy based on that evidence base in the hope that it will improve the treatment delivered to the many individuals suffering from insomnia.
摘要：
本文回顾了失眠的药物治疗史,记录随着时间的推移，随着药物可用性的增加，发生了新的作用机制，更具体地针对调节睡眠/觉醒功能的神经系统。通过允许选择专门针对每位患者中存在的特定类型的睡眠困难的药物，这种演变提供了提高失眠药物治疗有效性的能力。因此,它们可以达到治疗效果，对大脑功能方面的影响较小，而不是获得益处所需的影响，从而最大限度地减少不利影响。积累的证据基础可以作为个性化失眠药物治疗范式的基础。在这里，我们概述了一套最佳实践建议，以根据该证据基础进行优化的个性化失眠药物治疗，希望它能改善对许多失眠患者的治疗。
