Insomnia in primary care patients

Study Objectives: To determine the prevalence and characteristics of insomn ia in primary care patients, to examine patients' help-seeking behavior, an d to compare the frequency of insomnia in primary care patients to the gene ral population. Methods: 286 patients from primary care clinics in San Diego, California (n =96), and in Haleiwa and Honolulu, Hawaii (n=190) participated. Sleep study questionnaires were distributed by front desk receptionists to all patient s over 18 years of age upon arrival at the clinic for an appointment with t he physician. Completed questionnaires were collected at the clinic or retu rned by mail. Comparisons were made by using nonparametric statistics. A lo gistic regression analysis using backward elimination was done to develop a model showing predictors of who would consult with the physician about a s leep problem. Results: The prevalence of insomnia in primary care patients was 69%, with 50% reporting occasional insomnia and 19% reporting chronic insomnia. As ex pected, patients with chronic insomnia had the most severe sleep complaints as well as the poorest daytime functioning, and exhibited the most help-se eking behaviors. The four predictors of discussing insomnia with a physicia n were how patients felt physically, number of years of insomnia, age, and income. Conclusions: The primary care population has a higher prevalence of insomni a than the general population, probably because of concomitant psychiatric and medical illnesses. Although many of the characteristics of the sleep co mplaints are easily detected, most patients with insomnia are not treated e ffectively.