Insomnia care vital to cut morbidity, says research

Doctors must do more to identify insomnia early to prevent patients from developing further illnesses, researchers have warned.

Insomniacs are more than five times as likely to suffer from anxiety and depression and are at higher risk of mortality, according to a review of the evidence published last week in The Lancet.

Those with problems sleeping are more than twice as likely to develop congestive heart disease and seven times more likely to abuse alcohol, it said.

Researchers suggested that the internet and other technologies should be used to deliver CBT to people with the condition.

Co-author Dr Charles Morin of Université Laval in Québec City, Canada said closer monitoring of patients was needed to avoid the harm caused by these common comorbidities.

‘In view of the high prevalence and substantial morbidities of insomnia, patients should routinely be asked about sleep problems by healthcare providers,’ he said.

The review also said there should be more research into the drugs used and which work best with different insomnia patients. ‘Some of the most commonly prescribed drugs - antidepressants and antihistamines - have yet to be approved for treating insomnia,’ authors advised.

In response, the US National Institutes of Health said only CBT and certain hypnotic drugs had enough evidence to support their use.

The authors said CBT could be made more widely available through technological innovation. ‘Although CBT is not readily available in most clinical settings, access and delivery can be made easier through the use of innovative methods such as telephone consultations, group therapy, and self-help approaches via the internet.’

They suggested doctors should be educated about the clinical guidelines for treating insomnia.

Authors also recommend better public education about sleep and greater use of proven therapies.

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