The relationship of primary health care use with persistence of insomnia: a prospective cohort study

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Hayward, Richard A ; Jordan, Kelvin P ; Croft, Peter (2012)
  • Publisher: Springer Nature
  • Journal: BMC Family Practice, volume 13, pages 8-8 (eissn: 1471-2296)
  • Related identifiers: doi: 10.1186/1471-2296-13-8, pmc: PMC3293729
  • Subject: Family Practice | Research Article | Cohort study | Primary health care | Persistence | Insomnia | RA | R1
    mesheuropmc: mental disorders

Abstract Background: Prevalence of insomnia symptoms in the general population is high. Insomnia is linked with high health care use and within primary care there are a number of treatment options available. The objective of this study was to determine the association of persistence and remission of insomnia with primary health care using a longitudinal study. Methods: A postal survey of registered adult (over 18 years) populations of five UK general practices, repeated after 1 year, linked to primary care records. Baseline survey responders were assessed for persistence of insomnia symptoms at 12 months. The association of primary care consultation or prescription for any mood disorder (defined as anxiety, depression, stress, neurosis, or insomnia) in the 12 months between baseline and follow-up surveys with persistence of insomnia was determined. Results: 474 participants reporting insomnia symptoms at baseline were followed up at 12 months. 131(28%) consulted for mood problem(s) or received a relevant prescription. Of these 100 (76%) still had insomnia symptoms at one year, compared with 227 (66%) of those with no contact with primary care for this condition (OR 1.37; 95% CI 0.83, 2.27). Prescription of hypnotics showed some evidence of association with persistence of insomnia at follow-up (OR 3.18; 95% CI 0.93, 10.92). Conclusion: Insomniacs continue to have problems regardless of whether or not they have consulted their primary care clinician or received a prescription for medication over the year. Hypnotics may be associated with persistence of insomnia. Further research is needed to determine more effective methods of identifying and managing insomnia in primary care. There may however be a group who have unmet need such as depression who would benefit from seeking primary health care. Keywords: Primary health care, Insomnia, Persistence, Cohort study
  • References (31)
    31 references, page 1 of 4

    1. Morphy H, Dunn KM, Lewis M, Boardman HF, Croft PR: Epidemiology of insomnia: a longitudinal study in a UK population. Sleep 2007, 30:274-280.

    2. Stewart R, Besset A, Bebbington P, Brugha T, Lindesay J, Jenkins R, Singleton N, Meltzer H: Insomnia comorbidity and impact and hypnotic use by age group in a national survey population age 16 to 74 years. Sleep 2006, 29:1391-1397.

    3. Phillips B, Mannino DM: Does insomnia kill? Sleep 2005, 28:965-970.

    4. Janson C, Lindberg E, Gislason T, Elmasry A, Boman GP: Insomnia in men-a 10-year prospective population based study. Sleep 2001, 24:425-430.

    5. Pellesen S, Nordhus , Nielsen H, Havik OE, Kvale G, Johnsen BH, Skjotskitt S: Prevalence of insomnia in the adult Norwegian population. Sleep 2001, 24:771-779.

    6. Ohayon MM: Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002, 6:97-111.

    7. Hamblin JE: Insomnia: an ignored health problem. Prim Care Clin Office Pract 2007, 34:659-674.

    8. Panossian LA, Avidan AY: Review of Sleep Disorders. Med Clin N Am 2009, 93:407-425.

    9. Hayward R, Jordan KP, Croft P: Health care use in persons with insomnia: a longitudinal study. Br J Gen Pract 2010, 60:334-340.

    10. Lustberg L, Reynolds CF: Depression and insomnia: questions of cause and effect:. Sleep Med Rev 2000, 4:253-262.

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