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Jan 2017

Chronic Insomnia


About one in every seven Canadians have difficulty going to sleep or staying asleep. Assess and manage insomnia in the general adult population through non-pharmacological and pharmacological options using the Management of Chronic Insomnia Tool.

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About the tool

Chronic insomnia can impact both daily functioning and quality of life. The Management of Chronic Insomnia Tool addresses what providers should do when a patient is concerned about their lack of sleep.

The tool also discusses appropriate management options, such as cognitive behaviour therapy for insomnia (CBT-I) and pharmacotherapy regimens to support primary care providers in their practice.

Divided into six sections, the tool highlights the following:

  1. Addressing and optimizing the management of any underlying medical, psychiatric or environmental causes.
  2. Considering pharmacological causes of insomnia.
  3. Non pharmacological options.
  4. Pharmacotherapy.
  5. Benzodiazepine or Z-drug Tapering.
  6. Special populations.

Clinical leads

  • Jose Silveira


    Dr. Jose Silveira is an Associate Professor in the Department of Psychiatry, Faculty of Medicine at the University of Toronto. Since 2001, Dr. Silveira has worked closely with the Ontario College of Family Physician’s Collaborative Mentoring Networks on the steering committee, as co-chair and as mentor. The networks support primary care providers in managing mental disorders, addictions and chronic pain. Dr. Silveira’s professional focus is to support the delivery of mental health and addiction care through primary care and community networks.

  • Deanna Telner


    Deanna Telner is a family physician at the community-based, academic teaching site, South East Toronto Family Health Team. She is involved in teaching medical students, residents and colleagues. She is an Assistant Professor and part-time researcher in the Department of Family and Community Medicine, University of Toronto. Her area of research interest is in postgraduate and continuing education. Dr. Telner has been extensively involved in the development of online clinical modules for primary care providers.

    Dr. Telner provided clinical leadership for the development of the Urinary incontinence topic and was offered compensation for her role. 

Clinical Working Group

A clinical working group comprised of a nurse practitioner and a family physician participated in the development of this tool. Members include:

  • Dana Newman, family physician
  • Claudia Mariano, nurse practitioner

Thank you to all providers involved for their time and expertise.

Conflict of interest

Clinical leads received compensation for their role. 

Focus group and usability participants received a small token of appreciation (e.g. gift certificate).

Expert Reviewers

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