Sleep articles

Insomnia and CBT-I

• What is CBT-I? Cognitive behavioural therapy for insomnia, explainedCBT-I is the first-line treatment for chronic insomnia in major guidelines. What it includes, what trials found, and who should get medical advice first.Last reviewed 7 October 2026
• Chronic insomnia: when bad sleep becomes a disorderHow chronic insomnia is defined, how common it is in Canada, what links it to depression, how it is assessed, and what guidelines recommend.Last reviewed 7 October 2026
• Can't sleep? What to do in the middle of the nightAwake at 3am? What experiments on clock-watching and worry show, what CBT-I guidelines support, and when waking at night needs a doctor.Last reviewed 7 October 2026
• Are sleep trackers making your insomnia worse?Orthosomnia explained: what clinicians and a controlled experiment show about sleep-tracker scores, anxiety and insomnia, and how to use a tracker wisely.Last reviewed 7 October 2026
• Can you do CBT-I on your own? Apps, books and coursesWhat trials show about self-help books, web programs and digital CBT-I apps, how they compare with a therapist, and how to choose an option.Last reviewed 7 October 2026
• Is it normal to wake up at night?Brief night waking is part of healthy sleep. What sleep studies show about awakenings, age, 'segmented sleep', and when waking becomes insomnia.Last reviewed 7 October 2026

Sticking with CBT-I

• CBT-I feels worse before it gets better: what the research saysEarly weeks of CBT-I can bring daytime tiredness before sleep improves. What guidelines and trials report, why people stop, and where evidence is thin.Last reviewed 7 October 2026
• Sleep restriction making you more tired? Why it happens and how long it lastsSleep restriction in CBT-I can bring daytime sleepiness early on. What lab studies and guidelines found, how long it lasts, and who should take extra care.Last reviewed 7 October 2026
• Why sleep hygiene tips aren't enough for insomniaSleep hygiene tips are sensible, but guidelines advise against them as the only treatment for chronic insomnia. What trials and reviews found, and why.Last reviewed 7 October 2026

Sleeping pills

• CBT-I vs sleeping pills: what the research saysHow CBT-I and prescription sleep medication compare in trials and reviews: short-term results, lasting benefit, and what guidelines advise.Last reviewed 7 October 2026
• Cannabis, CBD and sleep: what the research saysSleep is the top reason Canadians give for medical cannabis. What the trials, the 2026 Cochrane review and withdrawal studies show about THC, CBD and insomnia.Last reviewed 14 October 2026
• Coming off sleeping pills, with your doctor: what the research saysWhat studies and the Canadian guideline found on stopping long-term sleeping pills with a prescriber, including CBT-I, rebound insomnia and withdrawal risks.Last reviewed 7 October 2026
• Sleeping pills, insomnia and dementia: what the research saysTwo separate questions: does insomnia raise dementia risk, and do sleeping pills? What the follow-up studies, meta-analyses and the Lancet Commission found.Last reviewed 14 October 2026
• The sleep-medication families: what the research says about eachBenzodiazepines, Z-drugs, trazodone, quetiapine, mirtazapine, Gravol and the newer orexin drugs: what trials and guidelines show, and the risks in older adults.Last reviewed 14 October 2026

Perimenopause and sleep

• Perimenopause insomnia: why sleep changes in midlife, and what helpsSleep trouble is common around menopause and linked to the transition itself. What the research shows about why it happens, and which treatments have evidence.Last reviewed 7 October 2026
• Does CBT-I work for menopause insomnia? What the trials showTrials in perimenopausal and postmenopausal women found CBT-I improved insomnia, even with hot flashes. The numbers, and where evidence is thin.Last reviewed 7 October 2026
• Hot flashes and night sweats waking you up?How hot flashes and night sweats disrupt sleep in the menopausal transition, options menopause societies list, and what trials show for the insomnia.Last reviewed 7 October 2026
• Waking at 3 a.m. in perimenopauseWhy many women wake in the small hours around menopause and struggle to fall back asleep: hot flashes, alertness and other causes, and what research says helps.Last reviewed 7 October 2026

Shift work

• Shift work sleep disorder: how it differs from ordinary shift work tirednessWorking nights makes most people tired. Shift work disorder is a specific diagnosis. Where the line sits, what the research says, and when to see a doctor.Last reviewed 7 October 2026
• Anchor sleep: what it is and what the evidence saysAnchor sleep means keeping one block of sleep at the same time while shifts change. Where the idea came from, and how little has been tested in shift workers.Last reviewed 7 October 2026
• Naps, caffeine and light on night shifts: what the research saysShould you nap before a night shift? When should you stop caffeine? What does light do? The evidence on three everyday tools, and the safety catches.Last reviewed 7 October 2026
• Rotating shifts and sleep: why your body clock cannot keep up, and what helpsFixed nights and rotating shifts call for different strategies. What the research says about adapting your body clock, and what to try instead.Last reviewed 7 October 2026

Sleep and everyday life

• Alcohol and sleep: what a nightcap really doesA drink can help you fall asleep faster but disturbs the second half of the night. What reviews and trials show, and what remains unproven.Last reviewed 7 October 2026
• Caffeine and sleep: how long it really lastsTrials show caffeine can cut sleep even when taken 6 hours before bed. What a half-life means, why people differ, and where the evidence is thin.Last reviewed 7 October 2026
• Melatonin: what it can and can't do for sleepMelatonin shortens time to fall asleep by a few minutes on average. What meta-analyses, a guideline and product testing show, and who should ask first.Last reviewed 7 October 2026
• Sleep and getting older: what changes and what doesn'tSleep changes with age, but insomnia is not a normal part of it. What research shows, why sleeping pills carry extra risk after 60, and what helps.Last reviewed 7 October 2026
• Tired all day? The common causes besides last night's sleepFatigue and sleepiness differ. What research shows about causes of daytime tiredness, from mood and movement to medical conditions, and when to see a doctor.Last reviewed 7 October 2026

Choosing a CBT-I option

• What makes Small Hours different, and why it works best alongside your clinicianHow Small Hours differs from other CBT-I apps, what the research says about using one with a clinician, and the limits of what we can claim.Last reviewed 7 October 2026
• CBT-I in Canada: your options comparedA plain guide to CBT-I options in Canada: therapists, primary care, free self-help, books, commercial apps and Small Hours, with cost and coverage facts.Last reviewed 7 October 2026
• Can you claim a sleep app through your benefits in Canada?How wellness and health spending accounts treat apps in Canada, what provincial plans and the CRA say, and what to send your plan administrator.Last reviewed 7 October 2026

For clinicians

Also for you: a one-page referral sheet and patient handout, to print or download, on the clinician page.

• Digital CBT-I for your patients: what the evidence showsGuidelines, meta-analyses and trials of digital CBT-I for chronic insomnia, plus dropout data, who to assess first, and how to support a patient using an app.Last reviewed 7 October 2026
• No CBT-I therapist nearby? A stepped-care route for primary careWhen CBT-I therapists are scarce: a stepped-care route for primary care with brief behavioural treatment, digital CBT-I, medication's place and referral.Last reviewed 7 October 2026