Dalhousie researchers study insomnia to address Canadian sleeping pill usage

Dalhousie University researchers are studying insomnia in response to sleeping pill usage in Canada.

Atlantic Canada has the highest rate of sleeping pill usage among older adults in the country.

In Canada, an average of 10 per cent of people 65 and older regularly use sleeping pills. In New Brunswick, that rate is 25 per cent; in Nova Scotia, it's 16 per cent.

“Our focus is on those who are most vulnerable to the plagues of sleep as well as the plagues of sleeping pills in terms of their side effects,” David Gardner, a professor in Dalhousie University’s department of psychiatry and college of pharmacy, told NEWS 95.7.

The research will be focused on people 65 and older because Gardner said the quality and quantity of people’s sleep reduces as we get older.

Gardner recently launched YAWNS NB, or Your Answers When Needing Sleep in New Brunswick, a project to help people become less reliant on sleeping pills and learn how to get a good night’s sleep.

The project will also test the effectiveness of sending packages in the mail with written information on sleep and sleeping pills.

Gardner said there have been many types of interventions, such as educational campaigns and policies, to reduce the use of sleeping pills in older adults. However, none have had a lasting impact.

A previous Montreal study showed that directly mailing information packages on sleep and sleeping pills to older adults was substantially effective.

YAWNS NB will compare the effects of no mailed information packages, packages used in the Montreal study and a new package that has information on cognitive-behavioural therapy for insomnia (CBTi).

It’s a method recommended by the Canadian Coalition for Seniors’ Mental Health, the American College of Physicians and the European Sleep Research Society.

Gardner said that a few years ago, a person would have to see a CBTi-trained therapist to receive the method.

Now, he said in the last decade, people can receive CBTi interactively through apps, virtual therapy or even by completing self-guided workbooks.

He said the workbooks — which are essentially step-by-step guides — are the most cost-effective with most costing under $50. People can also subscribe to apps such as Sleepio or Go! To Sleep or see a virtual therapist, through a clinic like Haleo, for a higher price.

CBTi’s purpose is to help people who are reliant on sleeping pills find an alternative that fits their lifestyle.

It has five components: relaxation therapy, cognitive therapy, time and bed therapy, stimulus control and sleep hygiene.

Some CBTi techniques that fall under these categories include meditation, breathing techniques and time in bed restrictions.

Gardner said it’s like giving people a list of optional techniques — meaning people don’t have to use each one — and people can implement which ones they think will be beneficial.

“It’s really making a new relationship, if you will, with your bed,” he said.

Gardner said there are different ways this relationship can be affected. For instance, someone who recently lost a loved one or a job might start taking medication and become reliant on it to fall asleep.

It could also be someone who may be creating a perpetuating sleep problem such as going to bed early in hopes of getting more sleep but not sleeping or taking naps throughout the day.

Gardner is working with colleagues from the University of New Brunswick and the University of Montreal to complete the YAWNS NB research.

The team hopes to recruit 500 to 600 participants by October 2021. While participants must be New Brunswick residents, all Canadians can find more information about sleep, sleeping pills and CBTi on the Sleepwell website.