Medicating Insomnia by Targeting Underlying Neurological Deficiencies

Insomnia is more than a few bad nights. Modern research shows it reflects deeper changes in the brain’s chemical balance — and that the right treatments can begin restoring both sleep and brain health.

A new study by Kumar and other researchers offers an important clue. Participants treated with either the hypnotic medications zolpidem or clobazam for 12 weeks not only slept longer and better, they also showed increased levels of BDNF, a key brain-growth molecule. This matters because BDNF (Brain-Derived Neurotrophic Factor) supports learning, memory, emotional stability, and the brain’s ability to repair itself. Low BDNF has repeatedly been linked to chronic insomnia, anxiety, depression and long-term cognitive decline. Only in the last few years has the low levels of BDNF revealed itself as a key underlying target to treat chronic insomnia.

Your brain operates on a delicate balance between “go” signals (primarily glutamate) and “slow-down” signals (GABA).
In insomnia, this balance is tilted:

This is why insomnia often feels like the nervous system is stuck in “high alert,” even when you desperately want to rest.

Chronic insomnia increases vulnerability to depression, anxiety, and age-related cognitive decline. The likely path: years of night-time overarousal + low BDNF slowly strain the brain’s resilience and has been found to heighten your chance of developing neurodegenerative and psychiatric disorders. Early and effective treatment can help break this cycle.

(Evidence-based medications with behavioural therapy isn’t enough)

These switch off the brain’s wake-promoting orexin system.
Best for: staying asleep. Use if you wake up frequently throughout the night.
Low risk of dependence and minimal hangover.

Fast and effective for getting to sleep quicker.
The recent study mentioned earlier highlights zolpidem’s potential to restore BDNF, hinting at a biological benefit beyond sedation.
Must be used short term and under supervision.

Help realign the sleep–wake rhythm.
Very safe, non-habit forming.

High risk of dependence, tolerance, memory problems, and withdrawal.
Not suitable for chronic insomnia.

Cause grogginess, confusion, and anticholinergic side effects — especially risky for older adults. Common over-the-counter anti-insomnia medication.
Not recommended for long-term sleep.

Increasingly given for sleep but linked to weight gain, metabolic issues, daytime sedation, and serious long-term risks.

If your sleep has been poor for more than three months, or if you’re noticing changes in mood, concentration, or daytime functioning, a sleep specialist can assess the underlying causes and create a safe, effective plan — usually starting with cognitive behavioural therapy and adding medication only when beneficial.