Vancouver (Rajeev Sharma): Health professionals are sounding the alarm over what they describe as a widening gap in support for British Columbians living with chronic insomnia — a condition affecting hundreds of thousands across the province and significantly straining both personal well-being and the broader economy.
Chronic insomnia is recognized as a neurological disorder that can intensify risks for heart disease, obesity, depression, anxiety and even suicide. While up to 15 per cent of adults in Canada are estimated to experience persistent sleep problems, clinicians say access to effective, evidence-based treatment in B.C. remains limited.
High Personal and Economic Toll
Beyond its medical consequences, untreated insomnia quietly undermines workplaces and communities. Research links long-standing insomnia to a 40–75 per cent rise in long-term disability claims, alongside mounting productivity losses and increased safety risks in sectors that rely on alertness.
Clinicians say that despite the prevalence of the disorder, many British Columbians relying on public drug benefit programs continue to face barriers to care. “We’re dealing with a condition that affects virtually every aspect of health, yet many patients have no access to the treatments recommended in national guidelines,” one specialist noted.
Therapies Out of Reach
Current clinical guidelines promote cognitive behavioural therapy for insomnia (CBT-I) as the first and most effective treatment option. But access through the public system is sparse, leaving most patients to rely on medications that come with well-known drawbacks.
Commonly prescribed sedatives — including benzodiazepines and Z-drugs — carry risks such as dependence, falls and significant next-day drowsiness. Physicians say these medications require careful monitoring, adding pressure to an already stretched health-care network. Some patients, in frustration, turn to alcohol, cannabis or over-the-counter remedies, which offer little relief and can worsen health outcomes.
Call for Access to Safer Alternatives
Sleep specialists argue that the province should expand access to a newer class of medications known as dual orexin receptor antagonists (DORAs). These drugs have been shown to treat chronic insomnia with far lower risks of dependence and next-day impairment.
Several B.C. hospitals that have added DORAs to their formularies report clear benefits — including a 40 per cent decline in patient falls, a critical safety improvement for older adults and people with mobility issues. Medical teams also note reduced grogginess the next day, aiding recovery and overall well-being.
Despite their use internationally — in countries such as Japan, Italy, France and Germany — DORAs are not covered by provincial drug plans in Canada. A recent assessment by Canada’s Drug Agency advised against public reimbursement, citing cost concerns and limited long-term data. Clinicians argue the recommendation overlooks real-world outcomes, including quality of life, workplace functioning and reduced strain on the health-care system.
‘Years Behind’ in Medication Access
Advocates say the decision highlights a broader trend: Canada’s public drug programs lag far behind global standards for mental-health treatments. A 2023 report from the Mood Disorders Society of Canada found that provinces fund only about a quarter of approved psychiatric medications, and patients typically wait more than two years after federal approval before they can access publicly covered treatments.
Specialists contend that adding DORAs to B.C.’s PharmaCare formulary would not only align the province with international best practices but would also reduce long-term disability, boost workforce productivity and lower health-care spending tied to preventable complications.
Sleep as a Public Health Priority
Sleep experts stress that sufficient rest is not a luxury — it is foundational to physical health, emotional stability and day-to-day functioning. With so many residents left without safe, effective care, they say action from provincial leaders is overdue.
“Restorative sleep is essential for every British Columbian,” one clinician said. “Access shouldn’t depend on whether someone has private insurance. It’s time to treat insomnia as the serious public health issue it is.”
