Queen’s University Team Unveils Innovative Model for Insomnia Care

A research team at Queen’s University has developed a new model aimed at improving care for individuals suffering from insomnia, potentially reducing reliance on prescription medications. Led by sleep expert Dr. Judith Davidson, the team introduced a stepped care model that prioritizes access to cognitive behavioral therapy (CBT) as the first line of treatment for sleep disorders. This innovative approach emphasizes self-guided methods to manage insomnia effectively.

The study, published in March 2023, highlights the limited and inequitable access to CBT for insomnia, despite its recognition as an effective treatment. According to Katherine Fretz, a postdoctoral fellow at Queen’s and a registered psychologist, most individuals facing insomnia are commonly prescribed medication without exploring simpler and more cost-effective interventions. Fretz stresses that many patients are left waiting for specialized care, even when self-guided treatments might suffice.

“Right now, the way insomnia care is often administered in Canada is that people are waiting for these more specialized treatments that they may not actually need,” Fretz noted. “This model really emphasizes self-care and self-guided approaches for the treatment of insomnia, which are shown to be effective for many individuals.”

Statistics indicate a growing concern over sleep issues in Canada, with nearly half of Canadians reporting difficulties in falling or staying asleep, and one in six meeting the criteria for insomnia disorder. Fretz argues that in a healthcare environment where many lack access to primary care providers, increasing the availability of self-delivered treatments is crucial.

“We have this safe and effective treatment, CBT-I, that is recommended as a first-line intervention, yet it is not widely known,” Fretz explained. “Even when it is acknowledged, access to care remains inequitable. Many people struggle to find a primary care provider, and not all practitioners are trained in first-line insomnia treatments.”

One key objective of the model is to encourage healthcare professionals to inform patients about CBT as an effective initial treatment option. There is a common misconception that people prefer medication when, in reality, they may not be aware of alternative approaches. Fretz emphasized that the benefits of CBT can become apparent quickly if patients engage with the process.

“Changes that significantly impact sleep often extend beyond basic sleep hygiene,” she stated. “While these changes require effort and attention, they can be implemented independently.”

Despite the growing discourse around sleep optimization and the various supplements available, Fretz cautioned that excessive focus on perfecting sleep routines can lead to increased anxiety. “We often see individuals preoccupied with their sleep patterns and the consequences of insufficient sleep, which can backfire,” she said. “While I might not know the specifics of every supplement, as a sleep practitioner, I do not recommend them.”

The findings of this research were published in collaboration with the Canadian Sleep Research Consortium. The team’s emphasis on CBT and self-guided treatments aims to reshape the conversation around insomnia care, increasing awareness and accessibility for those in need. By addressing the current gaps in treatment options, this model has the potential to transform the way insomnia is managed across Canada and beyond.