Primary care provider evaluation and management of insomnia

Sun, Joy; McPhillips, Miranda; Chen, Ker Cheng; Zang, Yong; Li, Junxin; Oehlke, Jessica; Brewster, Glenna; Gooneratne, Nalaka S.

doi:10.5664/jcsm.9154

Cited by 16 publications

(18 citation statements)

References 50 publications

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“…However, we found that a relatively high proportion of HCP respondents in this survey stated that they refer their patients for CBT-I. This contrasts with other studies reporting that referrals for CBT-I or psychological treatment are uncommon (5–10%) [ 8 , 20 ], which is consistent with our finding that 8% of PWTS reported currently receiving CBT-I therapy. Given the known access challenges, our findings may represent overestimation by the HCPs in WUA, misperception of the definition of CBT-I (mistaking sleep hygiene for CBT-I), representativeness of our surveyed practitioners (may live in regions with better CBT-I access), and/or the fact that a very high rate of referrals may not have translated to real-world access for patients, unbeknownst to the referring HCPs.…”

Section: Discussionsupporting

confidence: 77%

“…In addition, the majority of PWTS, PCPs, and psychiatrists agreed with the characterization that sleep should be considered a key pillar of health. However, in practice, even while exercise, diet, and sleep have all been shown to be important for both physical and mental health [ 16 , 17 , 18 , 19 ], sleep has still not become a priority for most HCPs [ 8 , 11 , 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the impact of insomnia on everyday life, this condition is often inadequately addressed and frequently undertreated [ 8 , 9 ]. As many as 40–50% of patients surveyed reported significant sleep disturbances to their primary care physicians (PCPs) [ 4 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…As many as 40–50% of patients surveyed reported significant sleep disturbances to their primary care physicians (PCPs) [ 4 , 10 ]. However, PCPs, who provide the majority of sleep health care, may face constraints in managing insomnia given limited time, competing demands, and insufficient education on sleep disorders during their medical training [ 8 , 9 , 10 , 11 ]. As a result, persons with insomnia rarely receive interventions to address their symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, the limited number of sleep specialists makes it difficult for PCPs to refer to a specialist. As a result, people with trouble sleeping (PWTS) often cannot receive care from a sleep expert [ 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Wake Up America: National Survey of Patients’ and Physicians’ Views and Attitudes on Insomnia Care

Benca

Bertisch

Ahuja

et al. 2023

JCM

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While both patients and physicians consider sleep to be important, sleep health may not receive appropriate consideration during patient visits with health care professionals (HCPs). We completed the first large-scale survey of people with trouble sleeping (PWTS) and physicians who treat insomnia to understand their perspectives and potential discrepancies between them. The Harris Poll conducted online surveys of adult PWTS and HCPs (primary care physicians [PCPs] and psychiatrists) in the United States from September to October 2021. Respondents included 1001 PWTS, 300 PCPs, and 152 psychiatrists. Most HCPs agreed that sleep is critical to good health, yet very few reported routinely conducting full sleep histories on their patients. Approximately 30% of PWTS reported that their PCP never asks about sleep; zero HCPs in this survey reported “never” inquiring. Few HCPs reported being “very satisfied” with current treatment options; 50% of PCPs reported their patients being satisfied. Two-thirds of PWTS did not believe current treatment options adequately improved their sleep. This survey provides evidence that both PWTS and physicians agreed on the importance of sleep, but that treatment is often perceived as ineffective. This survey identifies a need for HCPs to address insomnia management and treatment gaps.

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Section: Discussionsupporting

confidence: 77%