On this page
About the project
Sedative-hypnotics, commonly known as "sleeping pills", are often prescribed to seniors for insomnia despite the risk of serious side effects (e.g., memory problems, mobility issues that could lead to falls).New Brunswick seniors use sleeping pills 2.5 times more regularly than the Canadian average of 8%. Cognitive-behavioural therapy for insomnia (CBTi) is recommended over medications. It improves sleep while reducing sleeping pill use. However, few seniors in New Brunswick know about CBTi. The Your Answers When Needing Sleep in New Brunswick (YAWNS NB) program aimed to reduce long-term sleeping pill use, promote CBTi, and improve sleep. The project compared the effectiveness of two mailed CBTi information packages with treatment-as-usual (TAU):
- EMPOWER: Shown to reduce sedative use in a previous study in Montreal, the EMPOWER package included 2 booklets: You may be at risk (sedative medications); and How to get a good night's sleep without medication.
- Sleepwell: The Sleepwell package included a cover letter and 2 booklets: How to stop sleeping pills; and How to get your sleep back (CBTi techniques and resources).
- TAU: No information package was sent.
565 adults (362 women, 203 men) aged 65+ (M = 72.1 ± 5.7 years) with long-term use of sleeping pills (M = 11.4 ± 9.1 years) participated in this study.
Participants’ first languages were English (75%), French (22.5%) or another language (2.5%).
Conclusions and lessons learned
- New Brunswick seniors who received behaviour change information packages by mail were less reliant on sleeping pills after 6 months. Stopping sleeping pills after an average of 11 years of use is feasible and unlikely to be associated with long-lasting or severe negative effects.
- Overall, Sleepwell was more effective than EMPOWER, which could be related to the greater number of CBTi resources and techniques used by Sleepwell recipients.
- Sleepwell is a low effort, effective and scalable intervention that can be used to help reduce or stop the use of sleeping pills among seniors. This can reduce the risk of serious side effects while improving daytime functioning and sleep outcomes for older adults experiencing insomnia.
Recommendations
- As first-line therapy for insomnia, CBTi should be promoted and access increased. This can be aligned with direct-to-patient interventions aimed at reducing sleeping pill use.
- The YAWNS project team recommends that the Sleepwell material be included as the center piece of a provincial sleep health promotion campaign for older adults in New Brunswick.
- Developing and promoting a sleep campaign will require support and facilitation from government, the health sector support, non-governmental groups, and health care provider organizations. Awareness of the campaign can mediated by traditional and social media.
To learn more read the complete project findings (PDF 150 KB)