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PCPs should screen more for sleep problems

There is potentially a high, unmet need for screening and treatment for sleep problems in ethnically diverse urban primary care settings, according to data published in the Journal of Primary Care and Community Health.

“In the United States, 50 to 70 million adults have a sleep disorder,” Elizabeth K. Song, PhD, of the Albert Einstein College of Medicine, Bronx, New York, and colleagues wrote. “… Primary care providers can play a critical role in identifying and reducing disordered sleep. However, primary care settings typically do not routinely screen for sleep disorders, which may contribute to underidentification.”

To study the detection of sleep disorders in an ethnically diverse, urban primary care setting, the researchers surveyed 95 patients recruited from waiting rooms at two primary care clinics affiliated with a major metropolitan hospital in the Bronx in July and August 2015.

The surveys questioned whether patients had ever sought help for sleep problems, and asked them to self-report comorbidities and sleep behavior. The survey also included an insomnia severity index and the Berlin Questionnaire on sleep apnea. PCPs were given the screening results, and provided feedback on their potential clinical use.

According to the researchers, 31.6% screened positive for insomnia, while 42.1% were determined to be at high risk for sleep apnea. Only 32.6% of participants reported sleeping the recommended nightly 7 to 9 hours. The presence of chronic pain (P = .03) was associated with clinically significant insomnia. Obesity was associated with fewer hours of sleep per night (P = .03), and risk for sleep apnea (OR = 3.11; 95% CI, 1.28-7.5). In addition, 40% reported they were interested in receiving help for sleep issues during primary care visits, and 74.4% of PCPs found the screening at least “somewhat useful.”

“This pilot observational study suggests insomnia and sleep apnea may represent an unmet need among urban, predominantly black and Hispanic primary care patients,” Seng and colleagues wrote. “Only one-third of participants reported sleeping the recommended 7 to 9 hours each night.” – by Jason Laday

Disclosure: Seng reports research support from the National Institute of Health and the International Headache Academy. She also reports being a consultant for, or receiving honoraria or travel funding from, the American Academy of Neurology, the American Psychological Association Commission on Accreditation and GlaxoSmithKline. The remaining researchers report no relevant financial disclosures.