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Areté in the News
NSF Statement on the NIH State of the Science Conference on Manifestations and Management of Chronic Insomnia in AdultsThe National Sleep Foundation (NSF) commends the National Institutes of Health for conducting a thorough and timely State of the Science review on "Manifestations and Management of Chronic Insomnia in Adults," which provided a much needed update and clarification regarding the definition, prevalence and morbid consequences of this common sleep problem, as well as a review of available treatment options and recommendations for future research directions.
Insomnia is a condition characterized by difficulty falling asleep, problems staying asleep and waking prematurely or feeling that the sleep was non-restorative; when insomnia is persistent, it is considered chronic. Data presented at the NIH conference suggest that about 30% of the general population has complaints of sleep disruption, while approximately 10% have associated symptoms of daytime functional impairment. Research presented at the conference showed that chronic insomnia is significantly associated with risks for poor physical and mental health, particularly with depression, has a negative effect on quality of life, and is costly not only to individuals but to our healthcare system and society as a whole.
Conference conclusions were developed by a panel of independent healthcare experts from a variety of fields and backgrounds who evaluated the evidence presented by sleep and insomnia experts. Among the panel's significant findings, conclusions and recommendations were:
- Most cases of insomnia are linked with co-morbid conditions including psychiatric diseases, particularly depression, cardiopulmonary disorders, and conditions resulting in chronic somatic or physical complaints that may disrupt sleep.
- Both cognitive behavioral therapy and pharmacotherapy with non-benzodiazepine medications are safe and effective means of managing chronic insomnia and its effects.
- The safety, appropriate dosage and effectiveness of other prescription medications, including those commonly prescribed for insomnia such as antidepressants, over-the-counter medications and botanical products, including melatonin and valerian, have not been established.
- The numerous risks of excess alcohol consumption, a commonly used self-medication for insomnia, greatly outweigh any benefits for therapeutic use.
- There is a need for a substantial public and private research effort to address the long-term consequences of chronic insomnia, to compare effective or promising treatments, and to focus on chronic insomnia in population sub-groups, including children, nursing home residents, and postmenopausal women.
- A call for major educational programs directed at physicians, healthcare providers and the public.
Despite the prevalence of chronic insomnia, too often America’s adults ignore this condition and other sleep problems and their consequences. They are not discussing these problems with their doctors and according to NSF's 2005 Sleep in America poll, 70% of respondents have never been asked by their doctor about their sleep. Instead of getting proper diagnoses for sleep problems and their causes, many people risk their health by self-treating with remedies that may be ineffective, allowing underlying conditions to persist or worsen. The same NSF poll found that 11% of Americans use alcohol as a sedative to promote sleep.
Insomnia symptoms should not be ignored. Whether it be primary (no known or underlying condition), or associated with co-morbid conditions, it is essential that the symptoms be recognized, discussed, diagnosed, and treated effectively, sometimes in tandem with associated medical problems.
NSF urges the public to recognize that good sleep is an integral part of good health. People must take sleep and sleep problems seriously; when sleep problems persist, they should be discussed with a healthcare professional.
In turn, healthcare providers must make sleep issues a patient care priority. Sleep habits should be discussed as part of a patients' overall health history, and a treatment plan should be discussed and implemented when symptoms of insomnia or other sleep problems are described.
The Conference statement is available at http://consensus.nih.gov.
For more information about insomnia and other sleep issues, visit NSF's Web site, http://www.sleepfoundation.org.
The National Sleep Foundation is an independent nonprofit organization dedicated to improving public health and safety by achieving greater understanding of sleep and sleep disorders, and by supporting sleep-related education, research and advocacy. NSF is based in Washington, DC. |