Prevalent, Significant, Costly: The Chronic Inability to Sleep

Insomnia is a sleep disorder we cannot afford to trivialize. The National Sleep Foundation states around 1 in 3 people has at least mild insomnia. World renowned insomnia researcher, Charles Morin, PhD of Canada, puts the prevalence of chronic insomnia disorder in adults at around 10%. Considering the current global population, this means somewhere around 2 billion people are living with some form of insomnia. “It is a common assumption,” begins Dr. Morin, “that as we age, we have more sleep disturbances. And for the most part, that is true. But insomnia and chronic insomnia are most common in middle-aged patients, with a slightly higher prevalence among women.”

Dr. Morin is a professor of psychology and researcher at Université Laval in Quebec, Canada. With dozens of journal publications and awards behind him, currently, he is working to push insomnia into the spotlight. “Too often, insomnia is seen as trivial,” Dr. Morin states. “But we are able to show that the impact on individuals—as well as society—is quite profound.”

Recent research puts the individual economic burden of chronic insomnia at $5,000 per year, per patient, according to Dr. Morin. “This may sound like a large number,” Dr. Morin asserts, “Until you realize only 10 percent of that number is related to the individual’s cost of treating the sleep disorder. The remaining 90 percent is indirect costs.” The research sites indirect costs related to chronic insomnia as the frequency of being absent from work and decrease in productivity due to lower energy and memory function.

There is a familial aspect to chronic insomnia. If one or both parents have insomnia, the children are at a higher risk of developing the sleep disorder. But researchers are still looking at all of the variables. Could watching parents struggle with the inability to sleep make it a learned behavior? “What I like to offer,” Dr. Morin suggests, “is hope. If sleep difficulties are a learned behavior, that means you can unlearn them. And if you know you are at a higher risk, then when you face life stressors such as a death or divorce, you can hold out hope the issue is temporary.”

Though Dr. Morin has seen stressors strike high-risk patients and take insomnia from temporary to chronic. “Clinicians are now aware of the connection between depression and sleep disturbances. And where they were once told to treat the depression to relieve the insomnia, too often the sole treatment of depression did not stop the sleep disturbances. Today, we treat both health concerns, giving them equal significance. Sleep disorders such as insomnia need to be viewed as the high-level health factor that it is.”

Per World Sleep Society’s sleep talking points, chronic lack of sleep has not only been connected to an increased likelihood of mental disorders such as depression, anxiety and psychosis, but also a higher risk for heart disease, stroke and diabetes.

For the billions of people living with insomnia, what is the most recommended line of treatment? A form of therapy known as CBT-I. Cognitive Behavior Therapy for Insomnia (CBT-I) has been listed as the first-line of insomnia treatment for those with moderate to chronic insomnia by some of the top experts in the world. The American College of Physicians® published insomnia treatment guidelines that note CBT-I as “a strong recommendation” with “moderate-quality evidence.”

The European Sleep Research Society also has published guidelines on the positive outcomes of using CBT-I for the treatment of insomnia. So what is it, and why isn’t it a more well-known form of treatment? “I fear patients hear cognitive behavior therapy and assume it is a lengthy psychoanalytical process that can take years to work through, but it is not,” says Dr. Morin. “CBT-I is generally a 4-, 6- or 8-week process that puts the patient in the driver seat of the entire process. The healthcare professional is merely the coach encouraging the patient along the way. And when the program is followed, patients will likely see results because—as I want to reiterate—when dealing with a learned behavior, we can teach patients to unlearn it.”

The general idea of Cognitive Behavior Therapy for Insomnia is that personal feelings and attitudes affect everyday behavior. CBT-I teaches patients coping strategies and methods for dealing with life stressors. Dr. Morin adds, “However, if the insomnia is not yet chronic, or is triggered by one of those life stressors I mentioned, then one option is prescription medication. While medication should be seen as a temporary solution, I do want patients to be aware of all options, and know solutions are out there.”

World Sleep Society has found that most sleep disorders are preventable or treatable, yet less than one-third of sufferers seek professional help. For patients ready to be proactive about sleep health, the Society of Behavioral Sleep Medicine offers an online directory of providers who treat sleep disorders, including insomnia.


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