Self Assessment – Resources for Effective Sleep Treatment E-Learning

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Self Assessment

Background

Sequelae of insomnia – Which of the following conditions is the SINGLE LEAST likely to be a consequence of long term insomnia?

Benefits of effective sleep management – Which of the following is the SINGLE most likely effect of psychological treatment for insomnia?

Greater reliance on sleeping tablets

Improved quality of life

Increased help seeking behaviour

Dissatisfaction with clinical care

Reduced mortality

Long term treatment of insomnia – According to current evidence, which of the following is the SINGLE most effective treatment licensed long term for insomnia in adults?

Cognitive behavioural therapy for insomnia

Sedative antidepressant

Sedative antihistamine

Sleep hygiene

Z-drug or short acting benzodiazepine

Answer: Cognitive behavioural therapy for insomnia. Cognitive behavioural therapy for insomnia has been shown to be effective in improving sleep and reducing hypnotic drug use. Z-drug or short acting benzodiazepines are only licensed for short term use. There is less convincing evidence for sedative antidepressants or sedative antihistamines. Sleep hygiene, although a component of cognitive behavioural therapy for insomnia (CBTi) is ineffective on its own. References: Wang MY, Wang SY, Tsai PS. Cognitive behavioural therapy for primary insomnia: a systematic review. J Adv Nurs 2005; 50(5):553-564.Buscemi N, Vandermeer B, Friesen C, Bialy L, Tubman M, Ospina M et al. The efficacy and safety of drug treatments for chronic insomnia in adults: a meta-analysis of RCTs. J Gen Intern Med 2007; 22(9):1335-1350. Morin CM, Vallieres A, Guay B, Ivers H, Savard J, Merette C et al. Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial. JAMA 2009; 301(19):2005-2015.

Effects of hypnotic drugs – A 70-year old man has insomnia for the past 6 weeks. He has had sleeping tablets previously and asks you to prescribe sleep tablets on repeat prescription. Which is the SINGLE most appropriate advice to give when explaining the benefits versus harms of sleeping tablets compared with placebo?

1 in 100 suffer dependence

1 in 1000 suffer serious side effects

17 in 100 suffer side effects

7 in 100 people do not benefit

76 in 100 people sleep better

Treatment of comorbid insomnia – Which of the following conditions associated with sleep difficulty would you not consider treating with cognitive behavioural therapy for insomnia?

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