More than 16% of Canadians are struggling with chronic insomnia disorder, yet most are receiving treatment that could be making their condition worse, according to leading sleep expert Rébecca Robillard.
The Problem with Popular Sleep Advice
Robillard, director of clinical sleep research at the University of Ottawa Institute of Mental Health Research at The Royal and co-chair of the Canadian Sleep Research Consortium, says approximately 98% of primary care providers in Canada recommend sleep hygiene as the first approach for insomnia patients.
Sleep hygiene includes maintaining consistent sleep schedules, limiting screen time before bed, and avoiding large meals and stimulants in the evening. While this advice is popular on social media and among the general public, Robillard emphasizes there is no evidence it works for chronic insomnia.
Why Sleep Hygiene Can Harm Insomnia Patients
Chronic insomnia differs significantly from occasional sleepless nights. The condition involves difficulty falling or staying asleep at least three times weekly for three months or longer, with serious consequences for health, safety, cognitive function, and interpersonal relationships.
Robillard explains that sleep hygiene recommendations can actually worsen insomnia by causing patients to blame themselves when the strategies fail. This creates additional stress and anxiety around sleep, reinforcing the negative thoughts and behaviors that perpetuate insomnia.
The Gold Standard Treatment Canadians Aren't Getting
Recent Ontario Health quality standards for insomnia disorder recommend cognitive behavioural therapy (CBT) as the first-line treatment. This psychotherapy approach focuses on changing the thoughts and behaviors that disrupt sleep and is considered the most effective and lasting treatment available.
Despite these evidence-based guidelines, CBT is not being widely recommended by primary caregivers across Canada. This creates a significant gap between recommended care and actual treatment received by the millions of Canadians living with chronic insomnia.
The disconnect persists even as insomnia's serious impacts on individuals and society become increasingly recognized. Robillard's work highlights the urgent need for better education about effective insomnia treatments among healthcare providers and the public.
