Question 1

How much sleep do I really need?

Accepted Answer

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,(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434546/#:~:text=Adults%20should%20sleep%207%20or,and%20increased%20risk%20of%20deat) whereas babies, young children and teens need more sleep to enable their development and growth (Sleep Foundation)(https://www.sleepfoundation.org/how-sleep-works/how-much-sleep-do-we-really-need).

Research found that 37% of New Zealand adults were short sleepers getting less than 7 hours of sleep per night.(https://pubmed.ncbi.nlm.nih.gov/31377250/)

Question 2

What is insomnia?

Accepted Answer

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.

Question 3

What causes insomnia?

Accepted Answer

Insomnia can be caused by a number of different factors (https://www.sleepfoundation.org/insomnia/what-causes-insomnia) 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.

Question 4

What happens if I don't get enough sleep?

Accepted Answer

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 (https://www.sleepfoundation.org/sleep-deprivation)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 (https://www.sciencedirect.com/science/article/pii/S2666144623000084) 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.

Question 5

What is Cognitive Behavioral Therapy for Insomnia?

Accepted Answer

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 a(https://www.sciencedirect.com/science/article/pii/S1087079222000594)nd it improves symptoms of co-occurring mental health conditions.
(https://pubmed.ncbi.nlm.nih.gov/29455893)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.(https://pubmed.ncbi.nlm.nih.gov/28392168)

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