Sleep is essential for optimal health and the individual’s need for sleep is influenced by age, genetic, behavioural, medical and environmental factors.

For most adults, the recommended sleep duration is 7 to 9 hours per night, whereas babies, young children and teens need more sleep to enable their development and growth (Sleep Foundation).

Research found that 37% of New Zealand adults were short sleepers getting less than 7 hours of sleep per night.

The term insomnia is used to describe problems with sleep such as difficulty falling and staying asleep, short sleep duration, early awakenings, daytime sleepiness or the experience of poor sleep quality despite adequate opportunity for sleep. Health professionals distinguish between acute insomnia and chronic insomnia. Acute insomnia is short term and a common reaction to stressful life events. Prolonged and chronic insomnia problems persist for more than three months with disturbed sleep for more than three nights a week, and cause significant distress and impairment to daytime function.

Acute insomnia tends to resolve itself when the stressful situation passes and may not require any intervention or treatment. However, prolonged and chronic insomnia requires attention as can have adverse effects on your physical and mental health.

It is therefore important to consult your GP for an assessment if you have experienced problems with sleep for more than three months to identify the cause of your insomnia and the appropriate treatment.

Insomnia can be caused by a number of different factors including underlying medical and mental health issues, medications, stress, environmental factors, beliefs and attitudes about sleep as well as lifestyle factors and behaviours.

Insomnia can be a symptom or ‘by-product’ of medical and mental health conditions, but it can also be a condition on its own right happening at the same time. Therefore both conditions should be addressed in treatment.

To ensure you get the right treatment, it is therefore important to consult your GP to assess why you’re not sleeping well and rule out any medical and mental health conditions. Talk to your GP about drug-free treatments such as Cognitive Behavioural Therapy for insomnia (CBTi) for long-term improvements in sleep and without the risk of tolerance with pharmacologic approaches.

Sleep supports every system in the body including cardiovascular, metabolic, immune, hormonal, cognitive function and emotional regulation.

Some of the common health problems related to sleep deficiencies are:

• Fatigue and lack of energy

• Mood changes including feelings of stress, anxiety and irritability impacting personal and work relationships

• Poorer cognitive and physical performance

• Impaired memory and concentration

• Reduced attention and reaction time which increases the risk of injury and car accidents.

• Lower quality of life

However, prolonged and chronic sleep problems can pose more serious risk to physical and mental health. Research has found strong links between sleep deficiency and cardiovascular problems, worsened immune function, hormonal abnormalities, diabetes, obesity and increased risk of Alzheimer’s disease.

Chronic sleep problems have also been associated with greater risk of mental health conditions like anxiety, depression and substance use.

Cognitive behavioural therapy for insomnia (CBTi) is an evidence-based, gold standard treatment for insomnia recommended by the American Academy Of Sleep Medicine, BPAC (New Zealand GP education), and American College of Physicians.

CBTi is a multi-component treatment that targets the underlying issues contributing to insomnia, and your difficulties in falling asleep and/or maintaining sleep. Commonly, treatment is short-term, delivered face-to face in an individual or group setting for 6 to 8 sessions on a weekly or biweekly schedule.

The core treatment components of CBTi comprise of 5 elements that targets cognitive and behavioural:

• Sleep consolidation

• Stimulus control

• Sleep hygiene

• Cognitive therapy

• Relaxation

CBTi is a skill-based approach where you learn specific behavioural and cognitive approaches to manage your sleep difficulties for life. Keeping a daily sleep diary to track your sleep schedule is an integral part of treatment.

CBTi begins with a 60-90 minute pre-treatment session where the therapist collects comprehensive information on presenting sleep problems, baseline measurement and relevant physical or mental health history to get a clear picture of your sleep issues and to rule out other sleep disorders. The goal is to determine whether CBTi is the right treatment for your problems.

How effective is it?

The great news is, it works! Research shows CBTi has large effects in reducing insomnia severity, it enhances quality of life and it improves symptoms of co-occurring mental health conditions. Compared to other treatments, CBTi has long-term effects addressing the underlying causes of insomnia and does not have the negative side effects produced by medication.