Untreated insomnia risks other health woes

Insomnia is the most common sleep disorder but it often goes untreated, which increases the risk for anxiety, depression and heart failure, a review concludes.

Doctors and other health-care providers should routinely ask patients about sleep problems, said the paper's co-author, Charles Morin from Laval University in Quebec City.

About a quarter of adults have sleeping problems and an estimated six per cent to 10 per cent have an insomnia disorder, Morin and Ruth Benca from the University of Wisconsin, Madison, said.

People withinsomniaexperience:

• Difficulty falling or staying asleep.
• A lack of restorative sleep.
• Daytime symptoms such as fatigue, trouble concentrating, and mood disturbances.

People with insomnia are more than five times as likely to experience anxiety and depression, are at more than double the risk of developing congestive heart failure and diabetes, and have an elevated risk of death, the researchers said.

Insomnia can occur on its own or with another medical disorder such as pain or a psychiatric disorder like depression.

The authors said more needs to be done todiagnoseand treat sleep problems early on.

But some of the most commonly prescribed drugs such as antidepressants and antihistamines have yet to be approved for treating insomnia, and there's little evidence about which drugs work best, they noted.

Combining approved hypnotic drugs with cognitive behavioural therapya treatment that uses psychological and behavioural methods such as relaxation techniques and education can be highly effective in treating insomnia safely with long-term benefits, the authors said.

"Although cognitive behavioural therapy is not readily available in most clinical settings, access and delivery can bemade easier through the use of innovative methods such as telephone consultations, group therapy, and self-helpapproaches via the internet," Morin and Bencaconcluded in their paper, which appears in Friday's Lancet.

"There is an urgent need for more public education about sleep and broader dissemination of evidence-based therapies for insomnia."

The authors have worked as consultants for pharmaceutical companies.