Predictors of primary medical care consultation for sleep disorders

Bartlett, Delwyn J.; Marshall, Nathaniel S.; Williams, Anthony; Grunstein, Ron R.

doi:10.1016/j.sleep.2007.09.002

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Volume 9, Issue 8 , Pages 857-864, December 2008

Predictors of primary medical care consultation for sleep disorders

Delwyn J. Bartlett
- Sleep & Circadian Research Group, Woolcock Institute of Medical Research, University of Sydney, P.O. Box M77, Missenden Road, NSW 2050, Australia
- Department of Respiratory & Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia
- Corresponding author. Address: Sleep & Circadian Research Group, Woolcock Institute of Medical Research, University of Sydney, P.O. Box M77, Missenden Road, NSW 2050, Australia. Tel.: +61 2 9515 8530; fax: +61 2 9515 7070.
Nathaniel S. Marshall
- Sleep & Circadian Research Group, Woolcock Institute of Medical Research, University of Sydney, P.O. Box M77, Missenden Road, NSW 2050, Australia
Anthony Williams
- Sleep & Circadian Research Group, Woolcock Institute of Medical Research, University of Sydney, P.O. Box M77, Missenden Road, NSW 2050, Australia
Ron R. Grunstein
- Sleep & Circadian Research Group, Woolcock Institute of Medical Research, University of Sydney, P.O. Box M77, Missenden Road, NSW 2050, Australia
- Department of Respiratory & Sleep Medicine, Royal Prince Alfred Hospital, Sydney, Australia

Received 14 March 2007; received in revised form 31 August 2007; accepted 1 September 2007.

Abstract

Objectives

To describe the prevalence and risk factors for primary care consultations for insomnia and/or snoring/sleep apnea.

Methods

Retrospective cross-sectional, population-based postal survey of 10,000 people randomly selected from the New South Wales electoral roll; 3300 responded (35.6%). Direct contact with a random subset from the non-responders (n=100) was also undertaken with a response rate of 49%.

Results

The population weighted prevalence for having insomnia was 33.0%, with 11.1% visiting a doctor. The weighted prevalence for reporting a visit to the doctor for snoring/sleep apnea was 6.2%, while 2.9% reported having visited a doctor for both disorders. The percentages of males and females consulting their doctor for either sleep disorder were similar. Independent risk factors for insomnia visits were: being older, daytime sleepiness, short sleep durations, and reduced enthusiasm. Self-medication for insomnia symptoms was common. Independent risk factors for snoring/sleep apnea visits were: being older, daytime sleepiness, short sleep durations, and reduced enthusiasm.

Conclusions

The risk factors for seeking medical help for self-suspected insomnia or snoring/sleep apnea were similar. The reported excess proportion of men being diagnosed in sleep apnea clinics appears to be related to a differential referral by clinicians. We recommend that clinicians discuss both insomnia and snoring/sleep apnea because these disorders are commonly found in patients presented with either condition.

Keywords: Snoring, Sleep apnea, Insomnia, Primary care, Self-medication, Australia, Epidemiology