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The Journal of the American Board of Family Practice 18:257-261 (2005)
© 2005 American Board of Family Practice

Help-Seeking for Insomnia among Adult Patients in Primary Care

James E. Aikens, PhD and Mary E. Rouse, PhD, MBChB, MRCGP

Department of Family Medicine (JEA), University of Michigan Medical School, Ann Arbor, MI
Department of Psychiatry (JEA), University of Michigan Medical School, Ann Arbor, MI
Glover Street Medical Centre (MER), Perth, UK

Correspondence: Corresponding author: Dr. J. E. Aikens, Department of Family Medicine, University of Michigan, 1018 Fuller Street (Box 0708), Ann Arbor, MI 48109 (e-mail: aikensj{at}umich.edu)

Objective: To clarify the patient characteristics associated with seeking medical help for insomnia.

Methods: A consecutive sample (n = 700) of adults attending a nonurgent primary care appointment was screened for sleep problems. A follow-up mailed survey then assessed insomnia symptoms, daytime impairment, beliefs about sleep, medication use, sleepiness and fatigue, and medical help-seeking.

Results: Fifty-two percent of patients with probable insomnia reported discussing this with a physician. Multivariate logistic regression analyses indicated that discussing one’s probable insomnia with a physician was independently associated with having a greater number of medical conditions (OR, 2.19 [95% CI, 1.13 to 4.22]), being more highly educated (1.67 [95% CI, 1.11 to 2.51]), sleeping less per night (OR, 0.71 [95% CI, 0.52 to 0.96]), and greater perceived daytime impairment due to insomnia (OR, 2.07 [95% CI, 1.06 to 4.03]).

Conclusions: Primary care patients often seek medical help when they experience insomnia. Clinical treatment ought to especially target poor sleepers presenting with significant insomnia-related impairment, medical morbidity, or both. Future research should further clarify the role of medical and psychiatric comorbidities and determine whether resolution of insomnia and its consequences improves the outcomes of common medical conditions.


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Copyright © 2005 by the American Board of Family Medicine.