I am often consulted by patients who say, “I have been having serious insomnia recently, how should I treat it?” In fact, as long as people will always have the experience of insomnia, said to say: insomnia is a common thing, the mediocre people are disturbed, especially in the knowledgeable and educated groups are more so, the daytime head spinning, to the night still can not stop. So, what exactly causes insomnia? Strictly speaking, any kind of internal or external factors may be the cause of insomnia: for example, psychological insomnia caused by emotional conflicts, psychiatric insomnia caused by a series of emotional disorders such as depression, anxiety and panic, physical disease-related insomnia caused by asthma, pneumonia, gastric ulcer or degenerative brain disease, and so on. I believe that as long as people who have had insomnia will have a similar feeling, that is: the more you can’t sleep, the more you are afraid of not being able to sleep, the more you are afraid of not being able to sleep, the more you can’t sleep, which forms a vicious circle is also a paradox, the result often leads to the person more and more excessive entanglement in the “can’t sleep” emotions can not extricate themselves, this, I myself also I have experienced this myself. Insomnia can often take many forms, such as difficulty falling asleep, waking up easily during the night, trouble maintaining sleep, and early awakening. The treatment of insomnia requires, first of all, a correct attitude to clear the mind, to face the matter of insomnia, to establish correct sleep hygiene habits, and to create a good sleep environment: for example, to dim the indoor ambient light, to set the appropriate temperature and humidity, to choose a comfortable pillow and bedding, and to maintain a fixed circadian rhythm to prevent sleep rhythm disorders. Night insomniacs should try to avoid daytime naps or naps, reduce the time spent in bed during the day, improve sleep efficiency, during the day should be moderate exercise, night massage recommended to relax, these can enhance the desire to sleep at night; such as conditions can be a warm shower before bed, pay attention to regulating diet, avoid alcohol and caffeine and other stimulating drinks, before bedtime can drink a glass of milk. To sum up: no smoking, no alcohol, no all-nighters, less coffee, more milk, nothing to bed, and most importantly, remember: do not let your children watch horror films, because there will really be a psychological shadow. The next thing to say is that medication, according to the different forms of insomnia to choose the appropriate drugs. The treatment of insomnia mainly needs to rely on sedative-hypnotic drugs, such as those who have difficulty falling asleep, can consider the use of Sinox, Zopiclone, Midazolam and other drugs that can quickly induce sleep; such as those who are prone to wake up at night, it is recommended to use the medium and long-acting sedatives that can prolong the sleep time, such as Scholastin, nitroprusside, etc.; such as those who wake up early, the same should consider the use of medium and long-acting nitroprusside, clonidine, etc. For people with combined depression and anxiety, treatment of the primary disease is also very important. Consider using TCA drugs such as Enoxil, mirtazapine, trazodone, etc. You can also try SSRI antidepressants such as fluoxetine, paroxetine, sertraline, citalopram, etc. If you have combined anxiety symptoms, you can add Dextran. In clinical practice, my experience is: 1, may try the “wheel tactics”, that is, each kind of sedative sleeping drugs will exist the so-called “honeymoon” effect, if the use of alprazolam after a period of time found that the effect is not as good as before, you can consider replacing If you use alprazolam for a period of time and find that the effect is not as good as before, you can consider replacing it with Synthroid or Zopiclone to try, as the saying goes, “you sing, I’m on stage”, so there is enough lively. 2, you can also try “cocktail therapy”, that is, the use of different types of drugs together, especially for those who have a combination of depression and anxiety, consider the daytime low dose of Dexedrine with the evening Jiajing Valium; or a small dose of mirtazapine to combine with the application of diazepam drugs, will often bring twice the result with half the effort. It is important to note that the combination of Dexedrine with Diazepam in the evening and Mirtazapine in the daytime can be effective. It is important to point out that insomnia is not that terrible, many insomnia is often inextricably linked to stress, everyone will encounter something every day, there must be physical discomfort, insomnia should be regarded as a very common thing to play down, there is no need to feel nervous about a short period of insomnia at any time and anywhere. As a medical professional, no doctor’s work and sleep cycles are completely normal due to years and years of irregularities. I wish you all a good night’s sleep and good dreams in the future!