Improving Treatment for Insomnia Sufferers Banner

Improving Treatment for Insomnia Sufferers

Research into insomnia carried out by a team from the University’s School of Health and Social Care has led to better provision for sufferers on a national scale.

Insomnia affects 30 to 40 per cent of adults in any one year with 10 per cent affected by chronic or recurrent symptoms, leading to impaired quality of life, work absence, poor work output and economic consequences.

There is longstanding evidence of inappropriate prescribing of hypnotic (sleep-inducing) drugs in primary care, which the research group, led by Professor Niroshan Siriwardena, aimed to tackle.

The members of the Community and Health Research Unit at the University of Lincoln used a range of methods, including systematic reviews, surveys, interviews and controlled clinical studies. They aimed to investigate aspects of the quality of care for insomnia to improve care provision through innovation, quality improvement and service redesign, and to evaluate the effects of interventions.

The research found that GPs frequently prescribed sleep-inducing drugs early on in treatment, despite hypnotics being known to do more harm than good, especially in the elderly. And despite practitioners’ reluctance to recommend psychological treatments for insomnia, patients were open and responsive to these approaches.

A novel approach to managing sleep problems in primary care was developed as part of the study, using careful assessment and patient-focused treatment, including cognitive behavioural therapy.

As a result, clinicians have moved away from prescribing drugs to using psychological therapies for insomnia, which is a cultural shift in clinical behaviour towards greater involvement of patients.

"The impact has been a change in the way general practitioners provide care for people with insomnia; a move toward providing psychological treatments rather than prescribing sleeping tablets, and a greater awareness among GPs and patients of psychological treatments."

The research has directly affected GPs’ and primary healthcare professionals’ practice, including changes in sleep management and reduced prescribing of hypnotic drugs. It has been disseminated through seminars, workshops, a national conference and an online learning programme developed by the research team.

The findings have led to national changes in health service policy and practice, and have been incorporated in policy information, educational resources and guidance to clinicians on hypnotics prescribing.

There is now greater public awareness of better sleep management nationally and internationally through media coverage, including a national UK television documentary in which the research team took part.

Initially, the work had local impact in Lincolnshire in 2009, where the team compared development of a new model of care for insomnia within 16 GP practices.

From 2011, the research began to have a wider regional impact on the NHS through seminars for GPs on management of insomnia in Lincolnshire, Chesterfield, Leicester, Nottingham and Derby.

The group also presented its findings at a national event run by the Royal Society of Medicine and the Mental Health Foundation.

The funding sources for the research programme on insomnia are all peer-reviewed competitive awards from organisations such as the Engineering and Physical Sciences Research Council (EPSRC), the Health Foundation and the East Midlands Health Innovation and Educational Cluster. These have collectively contributed to almost £1 million of investment.