Poor quality, short sleep 'prevalent' among adults, StatsCan says

More than half of adults in Canada say their shuteye is fitful at times, according to a Statistics Canada report released Wednesday.

The federal agency's report on duration and quality of sleep focuses on people 18 to 79 years old during a six-year period. It provides recent estimates of the duration and quality of sleep, and the percentage of Canadians surveyed who adhere to these sleep guidelines:

• Seven to nine hours per night at 18 to 64.
• Seven to eight hours per night at 65 or older.

During the 2007 to 2013 study period, Canadians 18 to 64 averaged 7.12 hours of sleep per night. About 15 per cent of seniors slept longer than the recommended 8-hour maximum, which could be a signal of other medical conditions.

"Short sleep duration and poor sleep quality are prevalent among Canadian adults. About one-third sleep fewer hours per night than recommended for optimal physical and mental health.

"This group also experiences poor sleep quality more frequently than do those who sleep the recommended number of hours," the report's authors concluded. 

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The results suggested 43 per cent of men and 55 per cent of women in the 18 to 64 age group reported trouble going to sleep or staying asleep "sometimes/most of the time/all of the time." 

Lack of sleep (both duration and quality) are associated with obesity, Type 2 diabetes, cardiovascular disease, injuries, death from all causes, depression, irritability and reduced well-being, the researchers said. 

Colleen Carney is a professor at Ryerson University in Toronto, where she directs the sleep and depression laboratory. To Carney, the insomnia findings stand out, given its association with mental health conditions, damage to quality of life, lost productivity and cost.

Poor access to chronic insomnia treatment 

Insomnia is defined as difficulty falling asleep or staying asleep. The acute type is brief and occasional. The sleep disorder is considered chronic when it disrupts at least three nights per week and lasts at least three months.

The front-line treatment for the sleep disorder is cognitive behavioural therapy (CBT), a brief therapy that provides tailored advice for when and how long to be in bed, and challenges preoccupation and anxiety about sleep loss, she said.

CBT for insomnia can be provided in person, through self-help books and on the internet.

"Our research suggests patients aren't getting access to this treatment and instead get poor advice such as sleep hygiene, a treatment that is not effective for chronic insomnia," said Carney, who was not involved in the Statistics Canada report.

The findings show that a huge number of Canadians are not satisfied with their sleep, said Judith Davidson, a clinical psychologist at Queen's University in Kingston, Ont. Davidson is training graduate students on how to deliver CBT for insomnia, as well as giving workshops to family physicians, nurses and other health professionals. 

"If someone is under short-term stress and is not sleeping, then a sleeping pill will help and the problems will be minimal," Davidson said. "But over time, we know that medications are not the way to go."

Worrying about sleep 'a perpetuating factor'

There is a discrepancy between reported measures of sleep and actual sleep, said Luc Beaudoin, a professor of cognitive science and education at Simon Fraser University and developer of a sleep-aid app. Beaudoin wasn't involved in the report.

During the 2007 to 2013 study period, Canadians 18 to 64 averaged 7.12 hours of sleep per night.

"We've got time compression," said Beaudoin. "People have an enormous amount of activities that they need to do, or feel they need to do."

While awareness of the importance of getting enough rest is generally improving, Beaudoin said, it is important for people with insomnia not to focus too much on their sleep.

"You do the best that you can, but you don't want to start worrying about your lack of sleep, because it's been found that worrying about lack of sleep is one of the big causes of insomnia. It's a perpetuating factor, for sure."

For consumers, Beaudoin's app aims to help people try for adequate sleep, but develop a mindset to accept when they don't get it.

Researchers are learning about how different parts of the brain don't sleep at the same time, Beaudoin said. 

"People who meet the criteria for insomnia, what happens is that their brain is hyper-aroused." 

About two-thirds of survey respondents reported the recommended seven to nine hours, and the other third reported less than seven hours, with sleeping more than nine hours cited as being rare.