Insomnia in the community: The Better Sleep Programme
There's a ‘cleft-stick' of sleep problem management. When the diagnosis is insomnia not a physical sleep disorder, talking therapy should be used first line. However, drug treatments (hypnotics, antidepressants, anti-histamines, opiate analgesics) are valued as effective, quick to prescribe and encouraged by a culture increasingly regarding sleep as commodity, on demand and fitted around more interesting wakeful activities.
This leads to:-
- 1. Sleep Mythology - perpetuation in the community of the expectation of an externally derived "cure" for not getting enough sleep, under-use of sleep protection techniques or informed acceptance.
- 2. Increased sleep anxiety, sleep depravation, reduced function, low mood and impaired relationships.
- 3. Over-medicalisation of those sleep problems which are actually a disturbed or even normal body rhythm.
- 4. Increased risk of, and reduced recovery from, physical and mental co-morbidities. Obesity epidemic also connected to poor sleep.
- 5. Reassurance or "you should expect this" statements to sufferers and carers which can be interpreted by them as "being ignored".
- 6. High levels of hypnotic use in older persons and learning disability services contributing to falls, cognitive and functional impairment.
- 7. Benzodiazepine, opiate and Zed drug dependency issues.
- 8. Consumer spending on herbal or alternative cures.
- 9. Funding penalties incurred by practices with high levels of hypnotic use.
- 10. Under-detection of less familiar sleep disorders.
The Better Sleep Programme (BSP) is a talking therapy approach for treating sleep problems, incorporating both screening and sleep management tools. The purpose of the BSP is to integrate sleep education into the wellbeing initiatives delivered by Redcar and Cleveland Primary Care Trust and the programme will build on existing skills and systems to increase the capacity of frontline services to detect and manage sleep disorders, at a level appropriate to need.
The study is part of a Knowledge Transfer Partnership programme (KTP), the knowledge partner being Durham University and the business partner being Redcar and Cleveland PCT.
Colin Malloy is the project lead for the Better Sleep Programme (contact: firstname.lastname@example.org)