Grant: Foundation Grant

Sleep problems are among the most common health complaints, with insomnia affecting 20% of adults at least occasionally and 10% on a chronic basis. Insomnia is characterized by difficulties initiating or maintaining sleep associated with distress and impairments of daytime functioning. Chronic insomnia produces significant psychological (increased risks of depression), physical (increased risk of hypertension), and economic burdens (reduced productivity and increased absenteeism). Despite some recent progress in insomnia research, there are still some major gaps in understanding and treating this sleep disorder. First, little is known about its risk factors and long-term consequences. Secondly, although chronic sleep disturbances are often associated with co-existing medical and psychiatric conditions, the specific role of psychological and biological factors in insomnia is still poorly understood. Thirdly, despite its high prevalence, insomnia often remains untreated and when treatment is initiated, it is usually limited to prescribed or over-the-counter drugs. Long-term use of sleep medications is often problematic due to their adverse effects and risks of tolerance and dependency. Behavioural therapies for insomnia are effective and well accepted by patients, yet they are not readily available and are infrequently used in practice. The main objectives of this research proposal are to: a) document the natural history, risk factors, and long-term health consequences of insomnia; b) develop more efficient and cost-effective therapies; and c) examine how we can make these interventions more accessible to those who need it (i.e., patients and health care practitioners). This research program is likely to have practical implications by producing new knowledge that will improve our understanding of insomnia and how best to treat it in clinical practice, hence reducing the individual and societal burden of this important public health problem.