World Sleep Day 2023

This World Sleep Day 2023, Dr Dimitri Gavriloff, Senior Clinical Psychologist and sleep medicine specialist, discusses insomnia – how it occurs, and what can help.

“I know I shouldn’t be using my phone .…” is something I often hear from the patients I see with insomnia. I wonder if in some sense my clinical consultations function a bit like a confessional for certain people, where through being honest about their perceived technological transgressions they may experience a brief catharsis. A sort of respite amid the unrelenting blame game that we invariably play as we navigate our complex relationship with the technology that now seems to be an inextricable part of our day to day (and night to night) lives. Although it’s becoming clearer that aspects of this relationship, such as our collective addiction to social media, and our smartphones can get in the way of sleep, and indeed probably gets in the way of a great deal of life in general, we should be careful not to tar all technology with the same brush.

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What is Insomnia?

Insomnia is a problem that affects around one in ten of us at a diagnostic level. The diagnosis here describes symptoms of difficulty falling asleep, staying asleep, or waking too early, happening chronically, consistently, and that are beginning to impact significantly the daytime function of the individual concerned. And although spending too much time on your smartphone or binge watching the latest Netflix series is unlikely to be helping you get back to sleep, it’s similarly unlikely to be the source of the insomnia.

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How does Insomnia Occur?

A relatively simple and easily intuited model for understanding how insomnia becomes a problem was developed in 1986 by Arthur Spielman. Known as the 3P Model, it represents the foundation, onset and course of insomnia using predisposing, precipitating and perpetuating factors. As a diathesis-stress model, it suggests that there are certain predispositions that those who go on to develop insomnia may exhibit, and that make an individual vulnerable to the development of the problem. When the touch paper is lit by a precipitant or trigger, a life-stressor perhaps, there is hypothesised to follow a period of acute sleep problems, which are then perpetuated, or kept in play, by changes to the way the individual thinks and feels about their sleep and the things they do in relation to their sleep problem.

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What is Cognitive Behavioural Therapy for Insomnia?The evidence-based treatment approach for this problem is Cognitive Behavioural Therapy (CBT) for Insomnia. The treatment approach sets out to help the individual unpick themselves from these perpetuating factors, often through a range of aligned but distinct modular treatments. As effective as the treatment approach is, and it certainly is effective for the majority of those with insomnia, it’s not often the case that someone experiencing sleep problems can pop down to see their GP and get ready access to this 1^st line recommended treatment.

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Is Technology Bad for Sleep?

Interestingly, here’s where technology may actually hold the answer to doing away with the postcode lottery limiting patients’ access to CBT for Insomnia and ensuring that everyone with insomnia can access the treatment that’s indicated for their problem. Sleepio, a digital CBT programme for insomnia that’s accessible via web-browser, phone and tablet, is available to all adults in Scotland for free. Sleepio delivers CBT in a fun and engaging manner, using voice and animation across six sessions of treatment, much like seeing a therapist face to face, to address sleep issues and Insomnia.

So far Sleepio has helped tens of thousands of people across Scotland with their Insomnia and poor sleep, from the Outer Hebrides to Dumfries and Galloway! Sleepio can be accessed by visiting www.sleepio.com/nhs and you can start the programme instantly and learn applied techniques that can put the problem to bed, once and for all!