Insomnia
What is Insomnia?
Insomnia is a persistent difficulty with falling asleep, staying asleep (sleep duration, consolidation or quality), that occurs despite adequate opportunity and circumstances for sleep, and results in some form of daytime impairment for. Insomnia itself can be a symptom of another medical disorder, such as chronic pain, sleep apnea, anxiety, and depression or its own disorder.⁷
In the 2018 Stats CAN health report on the prevalence of insomnia, 10% to 15% of Canadians reported symptoms of insomnia associated with daytime consequences, while 6% to 10% met the criteria for an insomnia disorder. To put this into perspective, from 2.2 million to 3.7 million Canadians could be struggling with a sleep disorder. These numbers have increased since the COVID-19 pandemic. ⁸⁻⁹
Diagnosis
Sleep specialists typically rely on the patient’s presentation to determine if the insomnia is a symptom resulting from another medical condition, or if the person meets the diagnostic criteria for insomnia. Sleep logs, validated sleep surveys and/or actigraphy may also be useful. Polysomnography is not required for diagnosis. ⁷
In chronic insomnia disorder, the sleep disturbance and associated daytime symptoms have been present for >3 months. When it has less than 3 months, it is considered to be short-term insomnia, and the presence of an identifiable cause triggering or precipitating the insomnia is common, such as a specific daytime stressor, jet-lag, altitude sickness, and/or inadequate sleep hygiene.
Management
The first-line treatment recommended for the treatment of chronic insomnia disorder is cognitive-behavioral therapy for insomnia (CBT-I). This is a personalized, non-pharmacological program that aims to change sleep habits and behaviors, and address misconceptions about sleep and insomnia that perpetuate sleep difficulties. ⁷
When left untreated, insomnia may lead to sleep deprivation and its associated consequences, such as: headaches, mental illnesses, difficulty with recall/memory, inability to concentrate on every day tasks, high blood pressure, heart or circulatory problems, stroke, diabetes, and even accidents from excessive daytime sleepiness.
For an additional resource on insomnia, please click here.