If you suspect that a patient’s stress problems are connected to his or her sleeping habits, this article from The Globe and Mail might point out the extent of the problem and help with some suggestions.

A new study in the journal Sleep identifies “cognitive intrusion” – the pesky, persistent and unwanted thoughts about stressors – as a key antecedent to sleep problems. Cognitive intrusion has features that are similar to those tasks that require effort and attention, thereby promoting wakefulness. While perfectly appropriate when you’re navigating work deadlines or presenting ideas to colleagues, this isn’t ideal if it leaves you frustratingly wide-awake at 1:13 a.m.

Our interviews with Canadian workers reveal the triggers of cognitive intrusion. Role-blurring activities – especially “after-hours” e-mail – is a main culprit. Can you clear the decks if you check e-mail before bed, and worse, open an angry one? An executive director described the fallout from doing just that: “I get an angry e-mail before bed and then I have trouble sleeping. That’s the problem with e-mail. They’ll write it in the heat of the moment being upset, and I’m home and it’s late.”

Why not simply shut down? Expectations. “It’s part of the field we’re in,” she explains. As the director, she views after-hours availability as part of her job – and believes others expect it too.