Insomnia Rounds

While persistent insomnia is a serious burden both for the individual and for society as a whole, it is too often unrecognized and untreated. The objective of this program is to provide concise perspectives on the most current scientific and clinical developments concerning the screening, diagnosis, and management of insomnia.

Please visit the website at: www.insomniarounds.ca for more information.

3.1 Insomnia and Performance – Helping Your Patients Remain Alert and Effective
By Colleen E. Carney, PhD
The personal cost to someone with insomnia – often a chronic condition – is considerable in terms of financial cost as well as with significant impediments to their sense of vitality, mood, perception of health, and the ability to carry out everyday activities. Impaired cognitive performance has been positively correlated with the severity of the insomnia complaint. People with insomnia who sleep for fewer than 6 hours show impairments on executive functioning tasks, significant increases in absenteeism and non-vehicle accidents, reduced productivity and even dubious ethical behaviour on the job. Challenges with performance and mood at work and socially as a consequence of insomnia are some of the many reasons why effective treatment of insomnia is imperative. This issue of Insomnia Rounds examines adverse consequences of insomnia on performance including subjective fatigue, which is a prominent feature that negatively impacts perceived functional capacity, mood problems, and cognitive decrements, and provides a brief overview of treatment strategies.

2.2 Medication and Substance Use: Keeping Insomnia Treatment Safe
By Eileen Sloan, MD, PhD, FRCPC
Previous issues of Insomnia Rounds have discussed approaches to pharmacological and nonpharmacological management of insomnia. Many family physicians are concerned about the possibility of their patient becoming dependent on benzodiazepines or the other hypnotic agents, in some cases refusing to prescribe them.

2.1 Psychiatric Disorders and Insomnia: Managing the Vicious Cycle
By Jonathan Fleming, MB, FRCPC, FABSM
Sleep problems and psychiatric disorders are independent conditions that exacerbate each other, impair quality of life, and increase disability. As most acute and many chronic psychiatric disorders are associated with delayed, disrupted, or nonrestorative sleep, normalizing sleep and its timing is essential to maximize recovery from severe and persistent mental illness.
CLICK HERE to download the PowerPoint presentation "Psychiatric Disorders and Insomnia: Managing the Vicious Cycle"

1.6 Sleepless Women: Insomnia from the Female Perspective
By HELEN S. DRIVER, PhD
Throughout the world, across cultures and all ages, more women than men have difficulty getting to sleep and staying asleep. Healthy women report longer sleep times (by 15–20 minutes) than men, suggesting a sex difference in sleep need.
CLICK HERE to download the PowerPoint presentation "Sleepless Women: Insomnia from the Female Perspective"

1.5 Pediatric Behavioural Insomnia: “Good Night, Sleep Tight” for Child and Parent
By SHELLY K. WEISS, MD, FRCPC, and PENNY CORKUM, PhD
Good sleep is important for optimal growth and development, with sleep duration changing from infancy to adulthood. Sleep problems during infancy and early childhood are among the most frequent complaints with which parents present to healthcare professionals.
CLICK HERE to download the PowerPoint presentation "Pediatric Behavioural Insomnia: “Good Night, Sleep Tight” for Child and Parent"

1.4 Sleep in the Elderly – When to Reassure, When to Intervene
By JULIE CARRIER, PhD, MARJOLAINE LAFORTUNE, BSc, and CAROLINE DRAPEAU, PhD
Sleep changes occur from the cradle to the grave with important modifications even in “optimal aging”. Gradual changes in sleep with aging lead to lighter sleep and more awakenings, especially in the second half of the night.
CLICK HERE to download the PowerPoint presentation "Sleep in the Elderly – When to Reassure, When to Intervene"

1.3 Treating Chronic Insomnia in Primary Care: Early Recognition and Management
By JUDITH R. DAVIDSON, PhD, CPsych
Chronic insomnia – ie, insomnia of at least 1 month’s duration – is a frequent problem in the primary-care office. Family physicians are best suited to identify the patient’s insomnia and initiate early treatment. This issue of Insomnia Rounds outlines how to recognize and effectively treat chronic insomnia in adults.
CLICK HERE to download the PowerPoint presentation "Treating Chronic Insomnia in Primary Care: Early Recognition and Management"

1.2 Taking Control of Acute Insomnia: Restoring Healthy Sleep Patterns
By JAMES MacFARLANE, PhD, DABSM
Acute insomnia is experienced by a significant proportion of the population, and may be a precursor of a more complex sleep-related syndrome. In some cases, insomnia may be related to the emergence of a specific medical or psychiatric disorder. There is often a combination of factors contributing to the patient’s disrupted sleep pattern, and thorough assessment for the 3 “P’s” (predisposing, precipitating, and perpetuating factors) is an essential part of effective management.
CLICK HERE to download the PowerPoint presentation "Taking Control of Acute Insomnia: Restoring Healthy Sleep Patterns"

1.1 Insomnia: Prevalence, Burden, and Consequences
By CHARLES M. MORIN, PhD
Insomnia is a significant and costly public health problem. It is among the most frequent complaints in primary-care medicine. Persistent insomnia represents an important health burden for the individual and for society at large, as evidenced by its adverse impact on quality of life, occupational functioning, and psychological and mental health.
CLICK HERE to download the PowerPoint presentation "Insomnia: Prevalence, Burden, and Consequences"