Reversing chronic insomnia without meds: On-demand course teaches use of CBT

A new on-demand course offered through Queen’s University is designed so pharmacists and primary care providers can help their patients conquer insomnia and get off harmful sleep medications. It teaches cognitive behavioural therapy for insomnia (CBT-i), considered first-line therapy for treating insomnia. The unique course was developed by an interprofessional team of experts in CBTi and is designed for the busy clinician. The role of pharmacists is specifically mentioned in the modules, including what is within a pharmacist’s scope of practice, said Stephanie Lynch, a pharmacist with the Queen’s Family Health Team in Belleville, Ont., and an instructor in the course. Lynch said that it’s immensely rewarding to work with patients “to help them come off medications that are very dangerous that we know don’t have evidence for long-term efficacy.” In her practice, Lynch has helped seniors who have been taking sedative hypnotic medications like benzodiazepine receptor antagonists for 20 years, even though there is no evidence supporting the use of these medications for long-term therapy. “While we’re taking something harmful away, we’re adding something that’s very beneficial, and actually addressing the root of their sleep problem,” she said. Younger patients have also benefited from CBTi, she said. “We want to target these patients before they become long-term users of these medications.” Read: With melatonin supplement use on the rise, experts ask if it should be prescription-only While community pharmacists may not directly deliver CBTi, knowing the non-pharmaceutical treatment of insomnia lets pharmacists work with patients to increase their chances for a successful discontinuation of sleep medications. “I think taking this training and understanding the whole core components around how to manage sleep without using medications is really key to supporting patients in their journey and helping facilitate deprescribing,” Lynch said. One element of CBTi is sleep diaries, and pharmacists who are well-versed in their use can more effectively support patients. “A pharmacist who is familiar with CBTi can encourage, review progress, provide clarifications or offer advice, not unlike how they support people living with diabetes with regards to their medications, testing, meal planning, exercise, and more,” David Gardner, professor of psychiatry and pharmacy at Dalhousie University and an instructor in the CBTi course, wrote in an email. Healthcare professionals who have taken the course include pharmacists, family physicians, medical residents, nurses, nurse practitioner, occupational therapists, psychiatrists, psychologists, occupational therapists. Gardner said that any healthcare professional who cares for patients with chronic insomnia would benefit from the course. The course is made up of eight sequential modules that take a minimum of ten hours to complete, Lynch said. Specific modules focus on deprescribing and how to support patients transitioning away from sleep medications. The accredited course costs $250.00 and is run through Queen’s University’s Continuing Professional Development department. It will be available until April 2024. Read: New training course for pharmacists seeking to learn Non-Medication Therapy for Insomnia

Reversing chronic insomnia without meds: On-demand course teaches use of CBT

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