© New Zealand Broadcasting School 2022

Wide awake; the reality of insomnia

Emma Turton

Insomnia controls one in four New Zealander's lives, robbing them of sleep and impacting the quality of their day.

"You feel seconds away from sleep your whole life. It's like climbing a mountain and you've gotten 99% of the way up because you're so tired, but you just can't cross that final percentage in order to fall asleep."

"I went to bed around three [in the morning] and went to work but I couldn't stay awake, so I went home and slept for the whole day."

"I've just noticed how isolated I've become because I'm too tired to go anywhere."

These are just a some responses from people who regularly battle with insomnia. Annalice Rayner is 24 and has had the sleep disorder since she was 16.

"Sometimes I've gone without sleeping for a whole night and then I'll try and stay awake to reset myself the next day, and I fall asleep for a good 20 hours plus."

This is Annalice's story;

What is insomnia?

Insomnia is the inability to fall and stay asleep. While most people will suffer from sleeplessness at some point in their lives a number live with chronic insomnia. No-one talks about what happens if a person only sleeps three hours per night, but according to Alex Mortlock a clinical psychologist at Sleep Well Clinics it affects the whole body.

"People break down in almost every conceivable body system, our brains, immunity and even our ability to regulate our body temperature."

Marcus Ang is a general practitioner with a special interest in sleep and he stresses the importance of getting a good nights kip.

Marcus Ang believes sleep is crucial Emma Turton

Money matters

In New Zealand insomnia is not funded through the public health system.

If a person is seeking help they can go to their general practitioner (GP) but often they do not have the resources to help patients within the 15 minutes allocated. Other sleep disorders like sleep apnea and narcolepsy are funded for public health care and qualify for an overnight study.

Ang believes insomnia is the most common sleeping problem which presents itself to doctors in primary care, but due to time pressure it is hard to treat effectively.

"Insomnia is a specialised field, there's no funding beyond 15 minutes and you certainly can't treat someone for insomnia in 15 minutes, that's just impossible."

Richard Medlicott medical director of the Royal New Zealand College of General Practitioners believes tools are limited.

"The public system does not have the resources to see everyone, so they will decide whether to offer an appointment and at what level of urgency depending on severity."

After seeing their family doctor patients seriously affected are referred to specialists where they must pay. Private institutions like the Sleep Well Clinics utilise techniques such as cognitive behavioural therapy (CBT), before referring the patient elsewhere.

CBT addresses contributors like caffeine, alcohol, maintaining a sleep schedule and encouraging patients to get up if they are awake. This therapy takes multiple sessions at the expense of the patient.

Private appointments cost between $200 to $600, out of reach for many people like Annalice.

In Australia sleep disorders take a toll on resources, while no survey of this scale has been conducted in New Zealand, based on these figures insomnia would have an estimated 11-billion-dollar impact on the health sector.

A 2012 study in the New Zealand Medical Journal showed most providers believed there was an unmet need for insomnia treatment in New Zealand, and some of these health practitioners felt overwhelmed by the number of patients with insomnia problems. 

Doctor's training

Ang also explains doctor's lack of training for addressing sleep disorders.

"In general doctors would have received about four hours of education on sleeping problems in their entire six years of training at medical school." Although Medlicott disagrees stating GP's know what they are doing.

"It is a very common symptom and most GP's have experience and will be aware of treatment options beyond medications."

While sleeping pills can be provided as a quick fix Pharmac told Metro News the reason for prescribing a medication is not recorded, which means it can not be tracked as to how often this has been the remedy. The Ministry of Health says they also do not hold statistics on how many people were prescribed sleeping pills for insomnia.

Yet Mortlock says medication is often the first solution. While it may work in the short-term he does not recommend sleeping pills for people with chronic insomnia, as they can become a pathway to potential addiction.

He also emphasises sleep is essential saying people do not take it seriously. Because a sleep disorder is a chronic condition it can take weeks to remedy.

Alex believes doctors lack adequate training for sleep disorders Emma Turton

Insurance can not foot the bill

Insomnia is not covered by most health insurance companies, Sovereign, nib, Accuro and AA have all excluded insomnia from their health policies, stating it is a pre-existing health condition. However Sovereign does cover sleep apnea.

Anyone can suffer from the sleep disorder as it is caused by external influences, so classing it as a pre-existing health condition may not apply.

Southern Cross offers some cover for sleep disorders, but the extent depends on a member's policy.

Two of their plans cover specialist and GP consultations and Pharmac-approved prescriptions, while a third plan only covers specialist consultations unless the member adds day-to-day cover.