Knowledge and Attitudes of Primary Care Physicians Toward Sleep and Sleep Disorders

Papp, Klara K.; Penrod, Carolyn E.; Strohl, Kingman P.

doi:10.1055/s-2002-34317

Cited by 77 publications

(25 citation statements)

References 15 publications

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“…The survey consisted of 5-point Likert type questions, and included original questions as well as questions adapted from prior studies. 27 We specifically examined 4 OSA screening-related questions from this survey. The survey was approved by the University of Chicago Institutional Review Board.…”

Section: Staff Surveysmentioning

confidence: 99%

Risk of Sleep Apnea in Hospitalized Older Patients

Shear

Balachandran

Mokhlesi

et al. 2014

Journal of Clinical Sleep Medicine

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Background/Objectives: To assess the prevalence of undiagnosed obstructive sleep apnea (OSA) among general medical inpatients and to investigate whether OSA risk is associated with in-hospital sleep quantity and quality. Design: Prospective cohort study. Setting: General medicine ward in academic medical center Participants: 424 hospitalized adult patients ≥ 50 years old without a sleep disorder diagnosis (mean age 65 years, 57% female, 72% African American). Main Measures: The Berlin questionnaire, a validated screen for determining risk of OSA, was administered to hospitalized medical patients. Sleep duration and effi ciency were measured via wrist actigraphy. Self-reported sleep quality was evaluated using Karolinska Sleep Quality Index (KSQI). Key Results: Two of every 5 inpatients ≥ 50 years old (39.5%, n = 168) were found to be at high risk for OSA. Mean in-hospital sleep duration was ~ 5 h and mean sleep effi ciency was 70%. Using random effects linear regression models, we found that patients who screened at high risk for OSA obtained ~ 40 min less sleep per night (-39.6 min [-66.5, -12.8], p = 0.004). These fi ndings remained signifi cant after controlling for African American race, sex, and age quartiles. In similar models, those patients who screened at high risk had ~ 5.5% less sleep effi ciency per night (-5.50 [-9.96 S C I E N T I F I C I N V E S T I G A T I O N SO bstructive sleep apnea (OSA) is a common sleep disorder that affects approximately 1 of every 4 adults in the United States.1,2 Unfortunately, up to 90% of people with OSA are undiagnosed.3 Without treatment, severe OSA is associated with increased risk of cardiovascular and cerebrovascular morbidity and mortality in both men and women.3-5 Early diagnosis and treatment of OSA have been recommended to improve patient health outcomes.Hospitalized patients are likely at high risk of OSA. One reason is that OSA is especially prevalent among patients with medical conditions that can result in hospitalization, such as congestive heart failure. [4][5][6][7] Hospitalized patients with OSA also have an increased risk of postoperative complications and exacerbations of chronic conditions. 8,9 Because hospitalization has been characterized as a period of acute sleep loss due to environmental factors, inpatients with undiagnosed OSA may experience even more sleep disruptions than their healthier counterparts.10 Despite these associations, in one study of inpatients, there was no documentation of sleep histories or any sleep-associated symptoms in their hospital charts.11 In addition, there is a high frequency of sleep disordered breathing in hospitalized patients referred for polysomnography, especially in patients with underlying cardiopulmonary disease. 12These fi ndings suggest that hospitalization may represent a missed opportunity to screen patients for sleep disorders. Risk of Sleep Apnea in Hospitalized Older Patients BRIEF SUMMARYCurrent Knowledge/Study Rationale: While the prevalence of OSA in the US is estimated at approximately 25%, it ...

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Section: Staff Surveysmentioning

confidence: 99%

Risk of Sleep Apnea in Hospitalized Older Patients

Shear

Balachandran

Mokhlesi

et al. 2014

Journal of Clinical Sleep Medicine

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“…Few generalists reported adequate knowledge in the area, characterizing care of patients with poor sleep as not urgent, frustrating, and de-motivating-attitudes that contributed to under-and misdiagnosis, under-and mistreatment, and stigmatization of patients with these low priority conditions. In 2002, 90% of generalists surveyed evaluated their knowledge of sleep disorders as fair or poor, 9 as compared to 5.5% in the OSA study and 35.2% in SWD study. This study also demonstrated a shift in this knowledge gap, as only 20% of generalists questioned sleep disorders as a real diagnosis, with large gaps identified not only by generalists but also by specialists.…”

Section: Discussionmentioning

confidence: 99%

“…Specialists reported that while some primary care physicians have been receptive to sleep education in the past, they were reluctant to take the responsibility for interpreting polysomnography results and for treatment. 9 Further, the healthcare system as a whole has not adapted to the care of sleep disorders patients and does not provide the resources or infrastructure needed to provide effective care across the continuum of the patient experience for sleep disorders. 9 In light of these and related data, the Institute of Medicine called for efforts to expand the awareness of sleep disorders among healthcare professionals through education and training.…”

Section: (Mis) Perceptions and Interactions Of Sleep Specialists And mentioning

confidence: 99%

“…9 Further, the healthcare system as a whole has not adapted to the care of sleep disorders patients and does not provide the resources or infrastructure needed to provide effective care across the continuum of the patient experience for sleep disorders. 9 In light of these and related data, the Institute of Medicine called for efforts to expand the awareness of sleep disorders among healthcare professionals through education and training. 1 However, barriers to primary providers' diagnosis and management of sleep disorders remain largely unknown.…”

Section: (Mis) Perceptions and Interactions Of Sleep Specialists And mentioning

confidence: 99%

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(Mis) Perceptions and Interactions of Sleep Specialists and Generalists: Obstacles to Referrals to Sleep Specialists and the Multidisciplinary Team Management of Sleep Disorders

Hayes

Murray

Castriotta

et al. 2012

Journal of Clinical Sleep Medicine

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Study Objectives: This study assessed generalists' perceptions and challenges in providing care to sleep disorders patients and the role of sleep specialists in improving gaps in care. Methods: A mixed-method approach included qualitative (semi-structured interviews, discussion groups) and quantitative (online surveys) data collection techniques regarding care of patients with obstructive sleep apnea (OSA) and shift work disorder (SWD). Results: Participants: OSA: generalists n = 165, specialists (internists, neurologists, psychiatrists, pulmonologists) n = 12; SWD: generalists n = 216, specialists n = 108. Generalists reported challenges in assessing sleep disorders and diagnosing patients with sleep complaints. Generalists lacked confi dence (selected ≤ 3 on a 5-pt Likert scale) in managing polypharmacy and drug interactions (OSA: 54.2%; SWD: 62.6%), addiction (OSA: 61.8%), and continuous positive airway pressure (OSA: 66.5%). Generalists in both studies reported defi cits in knowledge of monitoring sleep disorders (OSA: 57.7%; SWD:78.7%), rather relying on patients' subjective reports; 23% of SWD generalists did not identify SWD as a medical condition. Challenges to generalist-specialist collaboration were reported, with 66% of generalists and 68% of specialists in the SWD study reporting lack of coordination as a barrier. Generalists reported lack of consistency in sleep medicine and a perceived lack of value in consulting with sleep specialists. Conclusions S C I E N T I F I C I N V E S T I G A T I O N SI nadequate sleep is widespread in the United States, 1,2 affecting approximately 50-70 million Americans.1 Chronic lack of sleep and insomnia have important physiological and health effects as well as psychological, cognitive, safety, social, and economic implications.3 Obstructive sleep apnea (OSA) and shift work disorder (SWD) are two common sleep disorders with potentially serious social impact. OSA affects roughly 5% to 10% of the U.S. population or 18 million Americans, 4 including an estimated 11.6% of the shift work population.5 Shift work disorder, interruption of the normal sleep/wake cycle by the need to work shifts, or non-traditional daytime hours, and is referred to as circadian rhythm sleep disorder, shift work type, or shift work disorder (SWD).6 Approximately 20% of workers are estimated to work non-traditional schedules.7 Of these, 10% have been found to experience SWD. 8 In spite of their prevalence, substantial impact, and the availability of effective treatment strategies, sleep disorders are generally underdiagnosed and undertreated by healthcare providers.1,2 The annual Sleep in America survey 2 reported that 86% of respondents' generalists had never discussed sleep with them. Six of ten healthcare professionals reported not having enough time to discuss sleep problems during offi ce visits. Even when patients were asked about sleep issues, providers neither managed them directly nor referred patients to specialists. In another study, 90% of generalists rated their knowledge of sleep ...

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“…Ayrıca Amerika'da pediatristler ve aile hekimlerine yapılan uyku ve uyku bozuklukları ile ilgili bir anket sonucunda hekimlerin bu konuda yetersiz olduğu ve uyku konusunda yeterli eğitim almaları gerektiği vurgulanmaktadır (11,12). Bu veriler ışığında ülkemizde ve dünyada çocukla ilgilenen hekimlerin uyku konusunda yeterli olmadığı ve daha fazla eğitime ihtiyaç olduğu söylenebilir (13).…”

Section: Bulgularunclassified

Çocuk Sağlığı ile İlgilenen Hekimlerin Uyku Konusundaki Farkındalıkları

Gündüz¹,

Uşak²

2016

jtsm

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Objective: Sleep is crucial for development and growth of children. Sleep deprivation or deficiency leads to mortality and morbidity of the children, and influences the life quality of children and their family. Sleep disorders are easily diagnosed by pediatric health care providers, sleep problems may go unrecognized, and treatment and consultations may be insufficient. In the present study we aimed to demonstrate the awareness of pediatric health care providers in regards of child sleep issue. Materials and Methods: A questionnaire was filled out by pediatricians and family physicians attending to the Symposium of Social Pediatrics. Results: Of the participating 150 physician, 67.3% were pediatrician and 32.7% were family physician. Most of physicians were practicing in training and research hospitals or university hospitals. Of the physicians 65.3% had one or more children and three out of four (76.5%) had their offspring suffering from sleep problems. Most of physicians (87.3%) spent less than 15 minutes for a patient. It is found out physicians argued sleep issue with a minority of patients. Of the physicians only 12.8% indicated having sufficient education on sleep, 29.3% having sufficient knowledge and experience in sleep issue. More than half of the physicians were consulted by a patient suffering from sleep problems and the most consulted departments were child psychiatrist and/or the psychologists. Physicians having offspring suffering from sleep problems were more frequently informed parents in regards of sleep issue and made the patients consult to other departments. Conclusion: Children's sleep is often an overlooked issue in our country and pediatric health care providers are insufficient about this issue. Keywords: Children, sleep problems, sleep disorders, pediatricians, family physicians, awareness Amaç: Uyku, çocukların sağlıklı büyüme ve gelişmeleri için çok önemlidir. Bozulmuş veya yetersiz uyku çocukta morbidite ve mortaliteye yol açmakta, çocuğun ve ailesinin hayat kalitesini olumsuz etkilemektedir. Uyku bozuklukları çocuklarla ilgilenen hekimler tarafından daha kolay tanınmakla birlikte uyku problemlerinin tanısı atlanmakta, göz ardı edilmekte ve uygun bölümlere konsültasyonlar ve tedaviler yetersiz kalmaktadır. Bu çalışma ile ülkemizdeki çocuk sağlığı ile ilgilenen hekimlerin çocuklarda uyku konusundaki farkındalıklarını göstermek istedik. Gereç ve Yöntem: Bu çalışmada Sosyal Pediatri Sempozyumu'na katılan aile hekimleri ve pediatristlere bir anket doldurtuldu. Bulgular: Çalışmaya katılan 150 hekimin %67,3'ü çocuk hekimi iken; %32,7'si aile hekimi idi. Hekimlerin büyük çoğunluğu eğitim ve araştırma hastanesi veya üniversite hastanesinde çalışmakta idi. Hekimlerin %65,3'ünün çocuğu olduğu ve bunların dörtte üçünün (%76,5) çocuğunda uyku sorunu yaşadığı belirtilmiştir. Hekimlerin büyük bir çoğunluğu (%87,3) her bir hastasına 15 dakikadan az vakit ayırmakta idi. Hekimlerin uyku konusunu hastaların çok az bir kısmıyla konuştuğu görülmektedir. Hekimlerin sadece %12,8'i uyku konusunda yeterli e...

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Knowledge and Attitudes of Primary Care Physicians Toward Sleep and Sleep Disorders

Abstract: The majority of PCPs rated their own knowledge of sleep disorders as fair or poor. Knowledge testing and attitude assessment lend credence to these perceptions.

Cited by 77 publications

References 15 publications

Risk of Sleep Apnea in Hospitalized Older Patients

Risk of Sleep Apnea in Hospitalized Older Patients

(Mis) Perceptions and Interactions of Sleep Specialists and Generalists: Obstacles to Referrals to Sleep Specialists and the Multidisciplinary Team Management of Sleep Disorders

Çocuk Sağlığı ile İlgilenen Hekimlerin Uyku Konusundaki Farkındalıkları

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