This study’s main strength lies in the quality and richness of the survey participants’ responses and comments. Participants were willing to share their reasons for choosing different insomnia therapies and their opinions on prescribing benzodiazepines and z-drugs.

This study’s limitations stem from the relatively small number of participants (particularly NPs and pharmacists) as well as inherent self-selection bias. Participants were invited and remunerated for their participation.

At the time of the survey, NPs in Ontario were not able to prescribe controlled substances, which may have influenced their responses.⁹ Pharmacists participating in the survey may not always be aware of the indication for a prescription for a drug or aware of non-drug therapies that may have been prescribed to patients. This survey did not include psychiatrists or psychologists, who may also prescribe drugs (e.g., benzodiazepines and z-drugs) or behavioural therapies for patients with insomnia-related disorders.

We also note that not all provinces were represented in the three sample groups, and there were no participants from Nunavut or the Territories. Practice and prescribing patterns may vary across regions for reasons such as access, age of population, prescribing, etc.

The literature search included the topics of insomnia and Canada, with retrieval limited to resources and studies published within Canada or regarding populations or situations within Canada.