Primary care is the frontline for help-seeking insomnia patients

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
• primary care
• help seek
• general practitioner
• health care
• nursing

Acknowledgement

We thank all general practitioners who facilitated our contact with the patients who participated in this study. We thank Leighton Jones for editing the revision.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

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).