Funding refusal hits those who need a good night’s sleep

The shelves of pharmacies and health food shops groan under the weight of sleep “remedies” and alternative therapists offering techniques such as hypnotherapy and acupuncture are in great demand. Sufferers often turn to alternative products and therapies when prescription medicines don’t work, but doctors still write 10 million prescriptions a year in the UK to those who are desperate for a decent night’s rest.

Most of these are either sleeping pills or anti-depressants that generally don’t cure the condition. Some drugs can have debilitating side effects and they don’t deal with the cause of the patient’s inability to drop off or stay asleep.

As in previous economic downturns, with more stress and panic about jobs, household income, children and the future, it wouldn’t be surprising if more people were experiencing sleep disturbances. Worry about lack of sleep can add to the woe, especially as long-term sleep deficit has been associated with a host of mental and physiological problems that include anxiety, depression, diabetes, heart failure, cancer and premature death. Poor sleep has also been linked to relationship problems, low energy and an inability to concentrate.

Chris Harvey, a researcher at Glasgow University’s Sleep Centre, says he and colleagues are receiving a constant stream of calls from people desperate to find a cure for insomnia.

“Many feel their GP does not take the problem seriously. They’re seen for a very short time, given a prescription for anti-depressants or sleeping pills and sent away.

“Many don’t want to take medication or they take it for a short time and find that it might help them to sleep a bit more but it also knocks them out during the day. Psychological treatments like cognitive behavioural therapy are more expensive but work so much better. There is one cost-effective model that is successful therapeutically and involves training someone like a community nurse for two days to give group CBT sessions for sleep problems, in which treatment includes talking about worries, learning relaxation techniques and teaching good sleep practice.

“We want NHS funding for the staff training courses, but funding has been refused. As far as I’m aware no-one has succeeded in getting the money.

“At the same time the bill to the NHS for insomnia, both directly and indirectly, is massive. In the most comprehensive study we’ve seen, the cost was $10bn a year for just one Canadian province, including days off and loss of productivity at work as well as expenditure on associated health problems.

“CBT in the group model is well within a reasonable budget, and at a time when we see the problem escalating the Government should think again. Medication will always have a place but longer-term, drugs are not the answer. My message to the Government is that it is both naive and uneconomical to ignore both the scale of need and this cost-effective treatment.”

Jim Horne, head of Loughborough University’s Sleep Research Centre, is not sure that more of us are suffering insomnia than ever before – it could be just that we are more open about at talking about our health these days, and therefore sleep disorders are reported more – but he agrees that talking therapy is more effective than medication.

“It’s really not clear what effect the stresses of modern life are on sleep, and you have to wonder what damage is being done by fear-mongering about the other health problems that chronic lack of sleep may contribute to. I’m not dismissing people’s problems, but many people who think they’re barely sleeping are probably sleeping more than they realise.

“The acid test of insufficient sleep is whether you feel sleepy during the day – not just a short slump in the afternoon, which many people experience. If you are pretty alert during the day then you are getting enough sleep for you.

@We know that sleeping tablets only extend the amount of sleep someone gets by about 20 minutes, and there is no evidence that a person who has taken a sleeping pill is any more alert the next day.

“Sleeping tablets are a good crutch for a short time, but there’s no doubt that CBT is the way forward and is the most cost-effective treatment. Alternative therapies, if they work, do so probably because the patient finds someone they can really talk to about their problem and the worries that may be causing it.”