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19-01-2012 | Article

Treat insomnia early, doctors urged



2012; Advance online publication

More efforts are needed to identify and treat insomnia early, as sufferers are at high risk of recurrent episodes and, if left untreated, of developing long-term chronic conditions, say researchers in The Lancet.

Writing in a Seminar article, Dr Charles Morin, from the Université Laval, Québec City, Canada, and Dr Ruth Benca, from the University of Wisconsin, Madison, USA explain that around a quarter of the adult population has sleeping problems, while 10-15% report symptoms that impact on their daytime function, and 6-10% have an insomnia disorder.

Most people with the condition are vulnerable to recurrent episodes and nearly 70% continue to experience symptoms a year later, and half up to 3 years later. Sufferers are more than five times as likely to experience anxiety and depression as people with normal sleep, and are at more than double the risk of developing heart failure and diabetes, as well as at increased risk of death.

"In view of the high prevalence and substantial morbidities of insomnia, patients should routinely be asked about sleep problems by healthcare providers," say Dr Morin and Dr Benca.

Yet some of the most commonly prescribed drugs (antidepressants and antihistamines) have yet to be approved for treating insomnia. Of the two only approved treatments in the USA, cognitive behavioural therapy (CBT) is preferred over approved hypnotic drugs because it avoids the risk of adverse drug side effects, and has long-lasting benefits. But there is currently a shortage of healthcare professionals trained in this.

"Although CBT is not readily available in most clinical settings, access and delivery can be made easier through the use of innovative methods such as telephone consultations, group therapy, and self-help approaches via the internet," the authors note.

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price