Lack of sleep can lead to premature death in long-term insomniacs, but is rarely treated, claim researchers.
At least 86 medical sleep disorders have been identified which if left untreated raise the risk of developing illnesses such as depression, diabetes and high blood pressure.
Doctors should routinely ask patients about their sleeping habits as they may be at the root of other disorders, says a review in Online First in The Lancet medical journal.
They should also be prepared to treat them with ‘talking’ therapies and drugs that haven’t necessarily been approved for sleep problems.
The review says millions of Britons – around one in four adults – have sleeping difficulties and up to one in 10 has an insomnia disorder that can affect their everyday lives through fatigue, trouble sleeping and mood disturbances.
Review authors Charles Morin from the Université Laval, Québec City, Canada and Ruth Benca from the University of Wisconsin, Madison, USA, said insomnia has ‘substantial long-term effects’ on people’s physical and psychological health.
They said ‘Despite advances in diagnosis and management insomnia is still under-recognised and often goes untreated.
‘In view of the high prevalence and substantial morbidities of insomnia, patients should routinely be asked about sleep problems by health-care providers.’
Research shows people who have between six and eight hours sleep a night are likely to live longer and have better health, while those getting less than six hours are more at risk of dying prematurely.
The optimum duration for sleep is around seven hours.
Currently around one third of the UK adult population regularly sleep five hours or fewer a night. The average night’s sleep is seven hours.
People with insomnia are more than five times as likely to experience anxiety and depression, are at more than double the risk of developing congestive heart failure and diabetes, and higher risk of premature death.
Insomnia also results in a substantial economic and societal burden through poor productivity, absence from work, and high health-care costs.
The review says some of the most commonly prescribed drugs such as antidepressants and antihistamines have yet to be approved for treating insomnia.
This has prompted the National Institutes of Health in the USA to state that only cognitive behavioural therapy [CBT] and approved hypnotic drugs have sufficient evidence to support their use for the treatment of insomnia.
CBT is a treatment that uses psychological and behavioural methods such as relaxation techniques, sleep restriction, stimulus control, and education about sleep hygiene (eg, diet, exercise, and the bedroom environment).
CBT has been shown to be highly effective at treating insomnia, does not carry risks of adverse side effects, and has long-lasting benefits, which is a clear advantage compared with drug treatment.
But at present there is a shortage of health-care professionals trained in these therapies.
The authors said it could be provided more widely through the use of innovative methods such as telephone consultations, group therapy, and self-help approaches via the internet.
Dr Neil Stanley, an independent sleep expert and ex-chairman of the British Sleep Society, said insomnia is ‘completely neglected’ by doctors, the NHS and the Government.
He said ‘Government policy makers always have something to say about diet and exercise, why don’t they get into the bedroom and tell people about the value of sleep.
‘We’ve all forgotten the importance of sleep – something our grannies took for granted.
‘But Britain is the worst country in Europe for sleep medical provision.
‘I’ve drawn up guidance on the 86 identifiable sleep disorders for use in specialist sleep centres. In Germany there are 350 to 400 centres that qualify, in Britain it’s between one and five – on a par with Estonia and Croatia.
‘We urgently need to pay more attention to sleep with clear advice to children in schools, parents and throughout adult life.’