Sleep a Neglected Pillar of Health, National Survey Shows

Physicians and patients agree on the importance of sleep for health, yet a few clinicians obtain a patient sleep history, and a few patients discuss their sleep problems with healthcare providers, a new national survey shows.

“Everybody thinks that sleep should be a pillar of health, but there is a big communication gap between patients and healthcare providers that may keep patients with insomnia from effective treatment,” Ruth Benca, MD, PhD, with Wake Forest University School of Medicine and Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, told Medscape Medical News.

As part of the Wake Up America survey, 1001 adults with a diagnosis of insomnia or self-reported sleep difficulties and 300 primary care physicians (PCPs) and 152 psychiatrists were asked about their views and attitudes on insomnia care.

The findings were presented at SLEEP 2022, the 36th annual meeting of the Associated Professional Sleep Societies.

Frustrated Patients

The majority of patients with sleep difficulties reported feeling frustrated (54%), irritated (52%), or stressed (51%) and/or reported that their mood is negatively affected (59%). Yet, 57% have not spoken to their doctor about it.

Virtually all PCPs (98%) and psychiatrists (97%) affirmed that sleep is critical to good health, yet only 12% of PCPs and 24% of psychiatrists routinely conduct a full sleep history.

Regarding treatment, 66% of patients with sleep difficulties do not think that current treatment options adequately improve their sleep. Yet, 50% of PCPs feel their patients are satisfied with their current treatment.

“There’s this perception among patients that they need some help with their sleep but there’s nothing out there, or maybe their doctors aren’t talking about it,” said Benca, co-chair of The Alliance for Sleep.

Another problem, said Benca, is that many patients feel there is a lot of “stigma” to take medications for insomnia, or even getting treatment for sleep; rather, they think they should be able to take care of the problem by themselves.

“While everybody is now starting to realize how important sleep is, in practice, we don’t yet treat sleep as something that is as important as things like diet and exercise and other health behaviors,” said Benca.

“Stating that sleep is important is not enough. We need to put our money where our mouth is — physicians need to address it and patients need to talk about it,” she added.

Patient-Physician Disconnect

Commenting on the study for Medscape Medical News, Shaheen E. Lakhan, MD, PhD, a neurologist and pain specialist in Boston, Massachusetts, said the vast majority of his patients have diagnosed sleep ailments.

The results of this survey, he said, “underscore the mismatch in satisfaction with current insomnia therapeutics between patients with insomnia and providers who treat insomnia.”

The survey also highlights the “deep stigma associated with taking sleep medications” like the controlled substances zolpidem (Ambien) and eszopiclone (Lunesta), Lakhan said.

“Last, while recognizing the importance of sleep to overall health, very few clinicians routinely take a full sleep history from their patients. Compounding minimal physician screening with patient stigma ultimately disempowers the patient and compromises equitable access to sleep treatments,” Lakhan said.

And although the study had an interesting design — a group of people with insomnia were compared with a group of physicians who treat insomnia — Lakhan said he’d like to see further survey studies that actually link patients’ perceptions with those of their actual treating physicians to determine the degree of mismatch across the board.

The Wake-Up America: The Night & Day Impact of Insomnia Survey was conducted online between September and October 2021 by The Harris Poll on behalf of Idorsia Pharmaceuticals.

Benca reports she is a consultant for Idorsia Pharmaceuticals. Lakhan reports no relevant disclosures.

SLEEP 2022: 36th Annual Meeting of the Associated Professional Sleep Societies. Abstract 0428. Presented June 6, 2022.

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