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Sleep disorders

Sleep disorders encompass a wide range of conditions, including insomnia (the most common sleep disorder), abnormal behaviours that occur during sleep (such as sleepwalking, sleep-related eating, and sleep paralysis), sleep-related breathing disorders, disorders of excessive sleepiness (e.g. narcolepsy), and circadian rhythm disorders. Alarmingly, there is increasing evidence linking both insufficient and excessive sleep with increased mortality, high blood pressure, diabetes, obesity, and possibly later dementia.

Are medications helpful?

Most people who have taken medication for sleep have likely been advised that long-term use of sleep medication is not recommended. This is only partially true, as it depends on several factors: 1) the individual, 2) the nature of the problem, and 3) the medication used. Medication can certainly be effective, but is not without risks. It is untrue that all sleep medications are addictive. With benzodiazepines (the class of drugs that includes Valium), there are concerns regarding tolerance, loss of effect, and withdrawal; however, many other sleep medications do not pose this issue. Medication can often be a helpful addition to psychotherapy for sleep disorders, and therefore, an integrated approach may provide significant benefits.

Cognitive Behavioural Therapy for Insomnia (CBT-I)

CBT-I is a non-pharmacological treatment for insomnia disorder and is considered the gold-standard treatment for this condition. Numerous studies have demonstrated its efficacy, with short-term outcomes comparable to sleep medications and superior long-term results. However, it generally requires more time and effort than medication. On average, treatment consists of 6–8 sessions spaced fortnightly to monthly. CBT-I typically includes the following components:

sleep restriction,
stimulus control,
cognitive restructuring,
sleep hygiene, and
relaxation and/or mindfulness techniques.

To learn more about CBT-I, HERE is a useful article from the New York Times.