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Ontario Health’s Insomnia Disorder quality standard addresses care for adults aged 18 years or older who have insomnia disorder (also known as chronic insomnia). Insomnia disorder is defined as distress or daytime impairment that lasts 3 or more months, and that is associated with 1 or more of the following: difficulty initiating sleep, difficulty maintaining sleep, or early morning waking with difficulty returning to sleep, despite adequate opportunity for sleep. This quality standard applies to all health care settings. It does not include care for people whose sleeping difficulty is better explained by a different sleep disorder.

People with insomnia disorder experience numerous adverse effects related to their functional ability, personal life, social life, health, and quality of life. Insomnia is a common sleep disorder: according to the Canadian Community Health Survey, just over 20% of adults in Ontario reported having trouble going to sleep or staying asleep. Insomnia symptoms were also more prevalent among women than men.

To improve care for people with insomnia disorder, Ontario Health assembled an advisory committee comprised of people with lived experience and clinical leaders to develop the Insomnia Disorder quality standard. Drawing from clinical guidelines and expert consensus, the quality standard includes 5 quality statements that address areas with high potential to improve care for people with insomnia disorder: comprehensive assessment; individualized, person-centred, comprehensive care plans; management of insomnia disorder in people with comorbidities; cognitive behavioural therapy for insomnia; and pharmacotherapy.

Below are some tools and resources that may help you implement the Insomnia Disorder quality statements in your practice, organized by purpose. Many of these tools can be used to support multiple quality statements.

This list is not exhaustive, and these resources may have shortcomings—some of which are noted here. Are there other tools or resources you use? Do you have experience implementing these or other tools? If so, please share your thoughts in the comments section below.

Educational Resources for Clinicians

• Insomnia Interventions: First-Line Treatment for Insomnia in Primary Care (Queen’s University): an 8 module on-demand Continuing Professional Development course for clinicians on insomnia interventions. This practical program focuses on Cognitive Behavioral Therapy for Insomnia or CBT-I, the first line treatment of chronic insomnia, and safe and effective methods for deprescribing sedative hypnotics. Costs $245.00 per learner.
• Mastering Advanced CBT for Insomnia (CBT-I) With Colleen Carney (Leading Edge Seminars, 2024): a 6-houron-demand webinar on casual factors for chronic insomnia, using assessment to formulate client treatment targets, evidence-based treatment strategies and adapting treatment plans that factor in comorbidities. Costs $239.00 per learner.
• Modernizing Insomnia Care to Align With Practice Guidelines (Canadian Pharmacists Association, 2024): webinar on how the management of insomnia has been modernized. This session describes the current best practice for insomnia and introduces resources and tools to support patients transitioning from chronic sedatives use to a brief course in “CTB-I” for enduring relief of insomnia.

Tools and Resources to Support Clinical Practice

• Antipsychotic Deprescribing Algorithm (Bjerre et al, 2018; Deprescribing.org): an evidence-based algorithm providing recommendations for making decisions about when and how to reduce the dose of or stop antipsychotics. Recommendations are meant to assist with, not dictate, decision-making in conjunction with patients and families.
• Benzodiazepine Deprescribing Algorithm (Pottie et al, 2018; Deprescribing.org): an evidence-based algorithm providing recommendations for making decisions about when and how to reduce and stop benzodiazepine receptor agonists (BZRAs). Recommendations are meant to assist with, not dictate, decision making in conjunction with patients and families.
• Cognitive Behavioural Therapy for Insomnia (CBT-I) Across the Life Span Guidelines and Clinical Protocols for Health Professionals (Baglioni et al, 2022): a comprehensive exploration of various treatment protocols used by clinicians treating patients with insomnia from several different populations. The included treatment protocols are written by members of the European Academy for Cognitive-Behaviour Treatment for Insomnia and reflect current practice and theoretical models.
• Insomnia: Drug Information (GeriMedRisk, 2025): these are drug summaries and infographics for common medications used to manage insomnia disorder, including considerations for prescribing in older adults.
• Managing Benzodiazepine Use in Older Adults (Centre for Effective Practice, 2019): a tool designed to help primary care clinicians assess and discuss with their patients 65 years of age or older, the potential risks and benefits of benzodiazepines. It also contains steps to support primary care clinicians safely discontinue, start or continue prescribing benzodiazepines for older patients.
• Medication and Substance Use: Keeping Insomnia Treatment Safe (Sloan, 2013; Canadian Sleep Society): This issue of Insomnia Rounds addresses family physicians concern about patients becoming dependent on benzodiazepines or other hypnotic agents and discusses the use of other substances that patients often use to self-treat insomnia.
• Treating Chronic Insomnia in Primary Care – Early Recognition and Management (Davidson, 2012; Canadian Sleep Society): This issue of Insomnia Rounds outlines how to recognize and effectively treat chronic insomnia in adults.

Tools and Resources to Support People with Insomnia Disorder, their Families, and Care Partners

• Insomnia Disorder Quality Standard Patient Guide: This patient guide accompanies the quality standard on insomnia disorder. It outlines the top 5 areas where clinicians can take steps to improve care for people with insomnia disorder. The patient guide also includes suggestions on what to discuss with your clinicians, as well as links to helpful resources.
• A Patient’s Guide to Understanding Behavioral and Psychological Treatments for Chronic Insomnia Disorder in Adults (American Academy of Sleep Medicine): This patients’ guide summarizes the AASM’s recommendations for using behavioral and psychological (non-medication) treatments for chronic insomnia disorder in adults. This guide will help you know what to expect when talking with your clinician.
• CBT-i Coach (US Department of Veterans Affairs): CBT-i Coach is a free and publicly available mobile app for people who have trouble sleeping and are engaged in Cognitive Behavioral Therapy for Insomnia (CBT-I) with a clinician.
• Consensus Sleep Diary, free mobile app (also available as a PDF): This sleep diary is the result of collaboration with insomnia experts around the world and is the first standardized sleep diary. Sleep diaries are easy to apply and to fill out and not difficult to evaluate for the clinician who is administering it.
• Sleep EZ (US Department of Veterans Affairs): This online course can help those who struggle with insomnia, to can learn how to manage it with digital cognitive behavioral therapy for insomnia (dCBT-i).
• Sink Into Sleep: A Step-by-Step Guide for Reversing Insomnia (Davidson, 2020): This book breaks CBT-I down into a step-by-step, easy format, allowing the reader to follow the same effective program that patients in the clinic do. There is a cost associated with this resource.