Insomnia is a common sleep problem. More than 1 in 10 people suffer from insomnia and every year, many of these people discuss their poor sleep with their family doctor. Often, these people are given a prescription for insomnia medication and sent on their way.
In fact, a recent survey of family physicians has shown that pharmacotherapy is by far the most common treatment of insomnia. Sleep medications are prescribed in about 90% of insomnia cases, typically benzodiazepines like Temazepam or ‘z-drugs’ like Zolpidem.
But, insomnia medications are not the best treatment for insomnia. The side effects of these medications can be very serious. Benzodiazepines are associated with excessive drowsiness during the day, headaches, dizziness, depressive mood and impaired coordination. People on z-drugs can perform complex behaviours in their sleep, such as sleep-driving, sleep-eating or even sleep-emailing. While it is recommended that these medications are only used in the short-term, people can rely on them for long-term relief which often leads to addiction.
Insomnia medications may provide short-term relief, but they don’t treat the underlying causes of the insomnia. Using prescription medications for insomnia is like taking pain killers for a broken arm: the drugs alleviate the symptoms, but they don’t fix the break. The American Academy of Sleep Medicine recommend cognitive behaviour therapies (CBT) as the first-line treatment for insomnia because they actually treat the causes of the condition, not just the symptoms.
This all begs the question: why are sleep medications prescribed so often for insomnia? Undoubtedly one of the biggest factors is a lack of resources. Family doctors attempt to treat their patients’ sleep problems in just a 10-15 minute consultation, which is not enough time to convey even the most important aspects of CBT. Our public health system also does not have the resources to provide CBT for everyone with insomnia, as is evident in the ever-growing waitlists for sleep psychologists.
People may also be attracted to prescription medication because they provide immediate relief and are the ‘quick-fix solution’. This may be true for those who are struggling to sleep only in the short-term, but for those with persistent insomnia, are the serious consequences of long-term insomnia medication use really worth it?
This is why home behavioural treatment options like THIM’s Intensive Sleep Retraining are sorely needed. Using evidence-based behaviour therapy to rapidly treat poor sleep will hopefully become common practice and bring people the relief that they desperately seek.
By Hannah Scott
Hannah is a PhD (Research) Candidate from Flinders University