Re: “Sleepless in Canada” (August 2008) (letter)

This letter to the editor of  “Canadian Psychiatry Aujourd’hui” , a newspaper published by the Canadian Psychiatric Association, appeared in the October 2008 issue (volume 4, no. 5)

While I enjoyed the articles on sleep in your August 2008 issue, I felt that the headlines were misleading. For example, the front page had the catchy “Sleepless in Canada” while the page 8 headline was “Sleep-starved can say goodnight to insomnia with CBT”. The caption for the photo of Dr. Charles Morin on page 8 also reported “Lack of sleep linked to many physical and mental health problems, says insomnia expert.” The casual reader, scanning these eye-catching bits of text, would be tempted to conclude that the articles were focused on not getting enough sleep and the consequences of that behaviour pattern.

I was not able to find any mention of not getting enough sleep in either the article reporting the interview with Dr. Morin, nor in the report by Dr. Alan Douglass on the latest research in sleep and psychiatry. Similarly, the article on medication for sleep problems, based on an interview with Dr. Wende Wood, pharmacist, also does not refer to lack of sleep.

In addition, the editorial by Dr. Fabien Gagnon (p6) states “…studies are now suggesting that too little sleep may actually increase your risk of developing a new depression or symptoms of anxiety.” I have not come across these studies, but I am aware of several articles which suggest insomnia may be a causative factor for depression or anxiety.

All this suggests to me that your headline writers and editorialist may be equating insomnia with lack of sleep. While this is indeed a popular idea, an alternative hypothesis, that attempting to sleep more than required may cause psychophysiologic insomnia, may be more consistent with the available evidence. I direct your readers to a brief review posted at http://henry.olders.ca/iweb/Insomnia.html .

Sincerely,

Henry Olders, MD, FRCPC
Assistant Professor, Department of Psychiatry, McGill University

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