Getting a Good Night's Sleep, Without Medication

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Most of us know the difference between a good night's sleep and a poor one. Having an occasional sleepless night is not necessarily cause for concern. However, sleep troubles (e.g., difficulty falling asleep or staying asleep) that persist and cause distress and/or impair daily functioning may indicate insomnia, a clinical sleep disorder.

Insomnia is a chronic condition in about 50% of sufferers and is a risk factor for physical and mental health conditions (1). According to a Canadian Study of 2000 adults published in 2011, insomnia is prevalent: about 40% have trouble falling asleep or early morning awakenings three or more nights per week in the previous month, about 20% were dissatisfied with their sleep, and 13.4% met full criteria for insomnia (one symptom of insomnia plus distress or disruption to daily function as a result of the insomnia) (2).  Females, older adults, and individuals with poorer physical and mental health were more likely to report insomnia. Regarding treatments, 10% had used prescription medication in the past year to manage their sleep, 9% used natural remedies, about 6% used over the counter products, and about 5% used alcohol (2).

Concerns about psychological dependency on sleep medication to fall asleep is an often cited reason for not wanting to start a sleep medication.  For individuals who are not keen on taking sleep medication to manage their insomnia, Cognitive Behavioural Therapy for Insomnia (CBT-I) is an excellent alternative.  CBT-I has been shown to be effective for improving sleep and it has been shown to reduce healthcare visits and costs (3).  In CBT-I, patients work with a trained therapist to build awareness of their sleep patterns and behaviours, learn to eliminate sleep disruptive behaviours and activities (e.g., watching tv in bed, not keeping a regular sleep schedule, worrying in bed), and implement sleep promoting behaviours (e.g., regular exercise, learning strategies to manage worries, re-establishing a regular sleep routine).

For further information about CBT-I, consult a trained health professional.  NPR also published a short health blog article last week on CBT-I: