June 2021 – The Big Topic of Sleep

Sleep is a really interesting topic, one which we stumbled into. Three years ago, we started collecting sleep data as part of our Psychosocial Questionnaires. We quickly saw that there was a huge correlation between lack of sleep and poor mental wellbeing. The inability to sleep is actually one of the determinant symptoms of major depression. Also, sleep is one of the first casualties of chronic pain, particularly with MSK claims. In addition, a recent study from Toronto University (click here) suggests that improved sleep reduces pain.
So, when we are looking at claims data at the start of the process to identify which claims are likely to be complex, sleep data is a great indicator, to help our clients determine where to apply their resources.
This really underscores the importance of looking at disability claimants’ experiences in a holistic manner and raises the question of what can be done to help? What kinds of interventions are most effective?
As we know, pain management can be a slippery slide into pain medication which may be over applied. We see the same thing happening with sleep medication. Yes, there may be a need to provide short term relief particularly where a few good night’s sleep may help with depression and anxiety. Again there is a temptation to over prescribe and create dependency. There are other paths available ….
In Canada, we are seeing that both cognitive behavioral therapy (CBT) and more recently CBT-I (CBT for insomnia) are being used to relieve this suffering in certain cases. CBT-I places a much greater emphasis on coaching individuals to have a different outlook on sleep through meditation and retraining their minds to block out the feelings and thoughts when sleep is most important. Now I’m not suggesting for one moment that a claimant who feels there is a red-hot poker pressing into their back can ‘just’ meditate the pain away, but if we can help educate those suffering from pain to use other techniques aside from strong prescription drugs, then maybe their levels of medication can be lowered, and their side effects can be reduced?
We are working closely with one of our Canadian clients, who are using CBT-I. We are taking the results from a short sleep questionnaire, combined with the other data we collect to drive selection for this intervention. We would love to share the results as we collect more data!
Quoting from the University of Toronto paper, their study saw significant improvements in sleep, pain, and depression, with the use of CBT-I programs.
The data is telling us that sleep, or lack thereof, plays a huge part in prolonging recovery. We need to bring more attention to this and make effective interventions available. This is another great example where the data is showing us a clear way forward, yet the current claims process is lagging behind!

For more information on how we can help your claims operation understand the influence of sleep, please email us at info@claimlab.org.

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