Treatment preferences and help seeking experiences of Australian adults with insomnia

Objective: Evidence-based insomnia guidelines recommend Cognitive Behavioural Therapy for insomnia (CBTi) as the first-line treatment. However, many people with insomnia are prescribed sedative-hypnotic medications. To understand this gap between guidelines and practice, this study surveyed people seeking treatment for insomnia about their help-seeking experiences and treatment preferences. 

Methods: Australian adults who had previously expressed interest in a clinical trial of insomnia treatments were invited to complete a detailed online survey assessing their sleep difficulties, help seeking behaviours, and treatment preferences. 

Results: Among 745 adults responding to the survey (Mean±SD = 54 ± 13 years, 69% Female), 74.5% reported an Insomnia Severity Index (ISI) score ≥ 15 indicating clinical insomnia symptoms and only 3 people (0.4%) reported receiving CBTi which included behavioural components. Among respondents with clinical insomnia symptoms, 64% had discussed sleep with their general practitioner but only 16% saw a psychologist about their sleep. Lack of referral to a psychologist (44%) and concerns about costs associated with treatment (21%) were the main reasons for not seeing a psychologist. 

Conclusions: These findings highlight opportunities to directly address barriers in the management of insomnia. To improve access and use of CBTi it is important to increase public awareness and availability so more people with insomnia can access effective treatment.