While persistent insomnia is a serious burden both for the individual and for society as a whole, it is too often unrecognized and untreated. The objective of this program is to provide concise perspectives on the most current scientific and clinical developments concerning the screening, diagnosis, and management of insomnia.

2.6

Pediatric Behavioural Insomnia in Children with Neurodevelopmental Disabilities – Strategies to Improve Sleep
By Penny Corkum, PhD, Shelly K. Weiss, MD, FRCPC, Kim Tan-MacNeill, BA, and Fiona Davidson, MA
Sleep problems in children with neurodevelopmental disorders (NDDs) such as autism spectrum disorder and attention deficit/hyperactivity disorder are more common than in typically developing children.

2.5

Pain, Analgesia, and Insomnia: Stopping the Cycle
By Florian Chouchou, PhD, and Gilles J. Lavigne, DMD, MSc, PhD
Poor sleep and pain form a vicious cycle: sleep deprivation can alter pain processing and cause hypersensitivity, and pain in turn typically reduces sleep duration, continuity, and architecture.

2.4

Circadian Rhythms and Insomnia – Approaching the Time Barrier
By Diane B. Boivin, MD, PhD, and Philippe Boudreau, BEng, PhD
Circadian rhythm disorders can occur either as the result of an externally imposed shifted sleep schedule (eg, shift work and rapid travel across time zones) or because of an intrinsic individual tendency to sleep at unusual times. Conditions such as delayed, advanced, or non-24-hour sleep-wake disorders have an intrinsic etiology, often aggravated by the patient’s sleep behaviour.

2.3

Insomnia and Performance – Helping Your Patients Remain Alert and Effective
By Colleen E. Carney, PhD
The personal cost to someone with insomnia – often a chronic condition – is considerable in terms of financial cost as well as with significant impediments to their sense of vitality, mood, perception of health, and the ability to carry out everyday activities. Impaired cognitive performance has been positively correlated with the severity of the insomnia complaint.

2.2

Medication and Substance Use: Keeping Insomnia Treatment Safe
By Eileen Sloan, MD, PhD, FRCPC
Previous issues of Insomnia Rounds have discussed approaches to pharmacological and nonpharmacological management of insomnia. Many family physicians are concerned about the possibility of their patient becoming dependent on benzodiazepines or the other hypnotic agents, in some cases refusing to prescribe them.

2.1

Psychiatric Disorders and Insomnia: Managing the Vicious Cycle

By Jonathan Fleming, MB, FRCPC, FABSM
Sleep problems and psychiatric disorders are independent conditions that exacerbate each other, impair quality of life, and increase disability. As most acute and many chronic psychiatric disorders are associated with delayed, disrupted, or nonrestorative sleep, normalizing sleep and its timing is essential to maximize recovery from severe and persistent mental illness.

Click here to download the PowerPoint presentation “Psychiatric Disorders and Insomnia: Managing the Vicious Cycle”

1.6

Sleepless Women: Insomnia from the Female Perspective

By Helen S. Driver, PhD
Throughout the world, across cultures and all ages, more women than men have difficulty getting to sleep and staying asleep. Healthy women report longer sleep times (by 15–20 minutes) than men, suggesting a sex difference in sleep need.

Click here to download the PowerPoint presentation “Sleepless Women: Insomnia from the Female Perspective”

1.5

Pediatric Behavioural Insomnia: “Good Night, Sleep Tight” for Child and Parent

By Shelly K. Weiss, MD, FRCPC, and Penny Corkum, PhD
Good sleep is important for optimal growth and development, with sleep duration changing from infancy to adulthood. Sleep problems during infancy and early childhood are among the most frequent complaints with which parents present to healthcare professionals.

Click here to download the PowerPoint presentation “Pediatric Behavioural Insomnia: “Good Night, Sleep Tight” for Child and Parent”

1.4

Sleep in the Elderly – When to Reassure, When to Intervene

By Julie Carrier, PhD, Marjolaine Lafortune, BSc, and Caroline Drapeau, PhD
Sleep changes occur from the cradle to the grave with important modifications even in “optimal aging”. Gradual changes in sleep with aging lead to lighter sleep and more awakenings, especially in the second half of the night.

Click here to download the PowerPoint presentation “Sleep in the Elderly – When to Reassure, When to Intervene

1.3

Treating Chronic Insomnia in Primary Care: Early Recognition and Management

By Judith R. Davidson, PhD, CPsych
Chronic insomnia – ie, insomnia of at least 1 month’s duration – is a frequent problem in the primary-care office. Family physicians are best suited to identify the patient’s insomnia and initiate early treatment. This issue of Insomnia Rounds outlines how to recognize and effectively treat chronic insomnia in adults.

Click here to download the PowerPoint presentation “Treating Chronic Insomnia in Primary Care: Early Recognition and Management”

1.2

Taking Control of Acute Insomnia: Restoring Healthy Sleep Patterns

By James MacFarlane, PhD, DABSM
Acute insomnia is experienced by a significant proportion of the population, and may be a precursor of a more complex sleep-related syndrome. In some cases, insomnia may be related to the emergence of a specific medical or psychiatric disorder. There is often a combination of factors contributing to the patient’s disrupted sleep pattern, and thorough assessment for the 3 “P’s” (predisposing, precipitating, and perpetuating factors) is an essential part of effective management.

Click here to download the PowerPoint presentation “Taking Control of Acute Insomnia: Restoring Healthy Sleep Patterns”

1.1

Insomnia: Prevalence, Burden, and Consequences

By Charles M. Morin, PhD
Insomnia is a significant and costly public health problem. It is among the most frequent complaints in primary-care medicine. Persistent insomnia represents an important health burden for the individual and for society at large, as evidenced by its adverse impact on quality of life, occupational functioning, and psychological and mental health.

Click here to download the PowerPoint presentation “Insomnia: Prevalence, Burden, and Consequences”