Help-Seeking for Insomnia among Adult Patients in Primary Care

Abstract

Objective: To clarify the patient characteristics associated with seeking medical help for insomnia.Methods: A consecutive sample (n ‫؍‬ 700) of adults attending a nonurgent primary care appointment was screened for sleep problems. A follow-up mailed survey then assessed insomnia symptoms, daytime impairment, beliefs about sleep, medication use, sleepiness and fatigue, and medical help-seeking.Results: Fifty-two percent of patients with probable insomnia reported discussing this with a physician. Multivariate logistic regression analyses indicated that discussing one's probable insomnia with a physician was independently associated with having a greater number of medical conditions ( Approximately 40% of community-dwelling adults and 69% of primary care patients report sleep problems in the form of difficulty falling asleep, discontinuous sleep, and/or nonrestorative sleep.

Primary health care practitioner perspectives on the management of insomnia: a pilot study

“…Although low rates of insomnia recognition can be a result of the inherent resistance among insomnia patients to seek professional help (Aikens and Rouse 2005;Stinson et al 2006;Angst et al 2010), the suboptimal management of insomnia might reflect a more complex problem in primary care practice. Drawing on exploratory studies there appears to be a gap between clinical definitions of insomnia and patient definitions of insomnia.…”

Epidemiology of Insomnia

“…Patients with more severe and more chronic insomnia, more comorbid medical or psychiatric disorders, and those who are better educated are more likely to seek treatment for insomnia [25].…”

Treatment of Insomnia with Comorbid Mental Illness

“…[32][33] A s t u d y o f p r i m a r y c a r e p a t i e n t s w i t h i n s o m n i a d e t e r m i n e d t h a t t h e principal motivator for seeking treatment after controlling for insomnia severity was found to be the negative impact on daytime functioning. 32 A community based study identified that daytime fatigue and psychological distress were the main predictors of treatment seeking behavior. 5 Moreover, when patients seek treatment for their insomnia symptoms, health care providers (HCPs) are significantly more prone to prescribe pharmacotherapy than to refer patients for behavioral interventions.…”

“…25 Unfortunately, clinicians are not routinely probing the level of sleep difficulties in their patients other than a simple identification (yes or no) of sleep disturbance. [32][33][34][35][36][37][38] Treatment seeking behavior for insomnia is based on disease severity, fatigue, daytime consequences and comorbidities. [32][33] A s t u d y o f p r i m a r y c a r e p a t i e n t s w i t h i n s o m n i a d e t e r m i n e d t h a t t h e principal motivator for seeking treatment after controlling for insomnia severity was found to be the negative impact on daytime functioning.…”