CCFP 105 Topics: Insomnia

The GenerEhlist - CCFP Exam Prep, Low Risk Obstetrics & Canadian Primary Care Medicine

• Written By: Shaila Gunn - PGY , Calgary AB

• Expert Review: Dr Darby Ewashina, ER Psychiatrist, Calgary AB @doc.darbs

It is important that as family physicians, we learn to not only diagnose insomnia but learn to counsel patients in the management, both behavioral and pharmacological.

Insomnia is a common problem, impacting 35-50% of adults. However, only 12-20% of patient with symptoms of insomnia meet the criteria for insomnia disorder.

Many other factors including other sleep related conditions, mental health concerns, and organic health problems may present with symptoms of insomnia.

Knowing what is causing the insomnia is an important step, as this will guide the most effective treatment strategies. Common, non-modifiable risk factors for insomnia include female gender and middle aged to older adults.

However, most patients with insomnia will have another treatable condition. It is important to note that the MOST COMMON CAUSE OF SLEEPINESS IS INADEQUATE SLEEP WITH LACK OF TIME SPENT IN BED AND POOR SLEEP QUALITY

Regardless of the cause of insomnia, there are some important, non-pharmacologic treatments that we will talk about that can be beneficial for all patients struggling (or not!) with sleep. The two main treatments are sleep hygiene techniques and Cognitive Behavioral therapy for insomnia (or CBT-I for short). We will get into this later in the episode.