Objectives: Although insomnia is a common complaint in Primary Care, the patient's perception of the problem and the variables which affect his/her visit to the doctor have been little studied. In this study the Subjective Complaint of Insomnia (SCI) was evaluated. These data were then compared with those found in the clinical records and those contributed by the doctors at a Health Centre.
Design: An observational crossover study, using a structured personal interview based on Goldberg's Clinical Interview Schedule, was carried out. The clinical records of those interviewed were reviewed and a questionnaire aimed at the doctors was designed to determine their perception of insomnia from their consultations.
Results: The prevalence of SCI in the preceding week was 45.45%. 45.7% of patients with SCI attended for this reason. Those patients who did not declare SCI to their doctor often lacked psychiatric antecedents, attended because of acute (rather than chronic) pathology and scored lower on the subjective evaluation scale of the intensity of the insomnia. Quality of sleep was recorded in 58.7% of the clinical records, with 20.6% prevalence of insomnia. All the doctors interviewed thought that the prevalence of insomnia among their patients was below 40%.
Conclusions: The prevalence of insomnia in Primary Care is greater than doctors believe and than that recorded in the clinical notes. Patients who do not mention their problems are those who are less seriously ill.