Primary care is the frontline for help-seeking insomnia patients

Eur J Gen Pract. 2021 Dec;27(1):286-293. doi: 10.1080/13814788.2021.1960308.

Abstract

Background: Although insomnia is a very common disorder, few people seek medical help.

Objectives: To determine the proportion of people who consult a healthcare professional about insomnia and examine reasons for help seeking.

Methods: Descriptive study of 99 patients diagnosed with insomnia following a telephone survey of 466 adults assigned to a primary healthcare unit in Majorca (Spain). Data were obtained from interviews and subsequent review of electronic medical records.

Results: Thirty-nine patients (39.8%) consulted at least once with one health care professional; 36(92.2%) consulted a general practitioner. Only 12.2% had an insomnia diagnosis registered in their medical record. Insomnia consultation was not associated with any sociodemographic variables analysed, anxiety, depression or comorbidities. Also, there was no association with sleep quality, duration, and sleep efficiency. Patients with clinical insomnia (OR, 2.48; 95% CI, 1.03-5.94), those who were more worried (OR, 2.93; 95% CI 1.08-7.95) or felt that others noticed the impact of insomnia on their quality of life (OR, 2.48; 95% CI, 1.02-19.08) are more likely to seek medical help. Patients taking sleep medication were 21.54 (95% CI, 7.34-63.20) times more likely to have asked for medical assistance.

Conclusion: Insomnia is an under-reported problem for both patients and doctors. When patients decide to consult for insomnia problems, they first go to the GP, and the vast majority take medications for their sleep problem. Those who consult most are people with more severe insomnia and those who are more worried.

Keywords: Insomnia; general practitioner; health care; help seek; nursing; primary care.

MeSH terms

  • Adult
  • Comorbidity
  • Humans
  • Primary Health Care
  • Quality of Life
  • Referral and Consultation
  • Sleep Initiation and Maintenance Disorders* / diagnosis
  • Sleep Initiation and Maintenance Disorders* / epidemiology
  • Sleep Initiation and Maintenance Disorders* / therapy

Grants and funding

This study received funding from the clinical and epidemiological projects grants fund of the Directorate General for Evaluation and Accreditation of the Ministry of Health and Consumption [DGAVAL PI11/10] (Dirección General d’Avaluación y Acreditación. Conselleria de Sanitat i Consum).