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Insomnia Underdiagnosed And Undertreated Article

Insomnia Underdiagnosed And Undertreated

Washington -- March 22, 2005 -- An enormous gap exists between the prevalence of insomnia and the actual management of people with the condition, investigators said here at a workshop entitled, "Open Your Eyes to Sleep", sponsored by Sanofi-Synthelabo.

"While roughly 20 to 30 percent of adults worldwide suffer from insomnia, less than 50 percent of them will be diagnosed with the condition," said Dr. Goran Hajak, professor of psychiatry at the University of Regensburg in Regensburg, Germany.

A major reason for poor recognition of insomnia is that patients often do not speak to the doctor about their problem, he explained. In a recent German survey, only 46 percent of chronic insomniacs and 25 percent of occasional insomniacs reported that they had discussed their insomnia with a physician. Furthermore, only 5 percent of patients had sought help specifically for insomnia.
The survey also found that patients were hesitant to discuss insomnia with their physicians because they were afraid their problem would be seen as trivial, or conversely, they were afraid they would be told they had a serious illness.

"Based on the findings, we believe that doctors should encourage patients to describe their sleeping habits and inform them that effective treatments are available," he added.

Physicians also tend to trivialize insomnia, Professor Jorge Alberto Costa E Silva, Director of the International Center for Mental Health at New York University School of Medicine in New York, New York, added. In this case, the problem is that physicians are often unaware that the onset of insomnia may signal serious illnesses.
"Poor sleepers are more than twice as likely as good sleepers to have ischemic heart disease in the six years after first experiencing sleeping difficulties, and they are also about three times as likely as good sleepers to develop frequent headaches."

Professor Costa E Silva pointed out that physicians often ascribe insomnia to "the stress of modern life" and tend to be unaware that insomnia is an established risk factor for psychiatric illness. "The risk of depression is four times greater in insomniacs than in those not suffering from sleeping difficulties," he said. In addition, 25 to 40 percent of insomniacs have significant anxiety. The abuse of alcohol and other substances is more prevalent in insomniacs.

"It's not surprising that physicians tend to undermanage insomnia," he observed. "In their entire medical training, only 1.5 hours are devoted to the problem of insomnia."

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