JAMA & ARCHIVES
Arch Fam Med
SEARCH
GO TO ADVANCED SEARCH
HOME  PAST ISSUES  TOPIC COLLECTIONS  CME  PHYSICIAN JOBS  CONTACT US  HELP
Institution: STANFORD Univ Med Center  | My Account | E-mail Alerts | Access Rights | Sign In
  Vol. 2 No. 11, November 1993 TABLE OF CONTENTS
  Archives
  •  Online Features
  Original Contributions
 This Article
 •References
 •Full text PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Citation map
 •Citing articles on HighWire
 •Contact me when this article is cited
 Related Content
 •Similar articles in this journal

Management of Insomnia in Office-Based Practice

National Prevalence and Therapeutic Patterns

Stephen E. Radecki, PhD; Stephen A. Brunton, MD

Arch Fam Med. 1993;2(11):1129-1134.


Abstract

Objectives
To identify the characteristics of patients who present to office-based physicians with complaints of insomnia, the physicians' diagnoses related to these complaints, and the use of prescription sleep medications.

Methods
Based on 1989 and 1990 data from the National Ambulatory Medical Care Survey, with 3105 physicians participating (response rate, 74%). Participating physicians recorded data for a total of 81 853 patient visits. Patient characteristics, presenting complaint, diagnosis of condition, and pharmacologic therapy were included.

Results
Annually, there are 3.3 million visits to officebased physicians for complaints of insomnia, 65% of which are to primary care specialists. Rates of insomnia visits are somewhat higher for middle-aged (45 to 64 years of age) women, and data for female insomniacs suggest a trend toward diagnoses of depression compared with other (somatic) diagnoses for men. The prescribing of long-acting sleep medications does not differ significantly by physician specialty, but it declines with increasing patient age.

Conclusions
Physician visits for insomnia account for only a small proportion of office visits but offer the opportunity for identification of underlying illnesses and for the prevention of associated problems. While some differences in diagnosis are associated with patient characteristics (possibly reflecting a bias in the workup), sleep medications appear to be prescribed appropriately, with a declining rate in the prescribing of long-acting medications for older patients.



Author Affiliations

From the University of California Irvine/Long Beach Memorial Medical Center Family Practice Residency, Long Beach.



THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Treatment of Primary Insomnia
Ringdahl et al.
J Am Board Fam Med 2004;17:212-219.
ABSTRACT | FULL TEXT  

Increased Physician-Reported Sleep Apnea* : The National Ambulatory Medical Care Survey
Namen et al.
Chest 2002;121:1741-1747.
ABSTRACT | FULL TEXT  

Acute performance-impairing and subject-rated effects of triazolam and temazepam, alone and in combination with ethanol, in humans
Simpson and Rush
J Psychopharmacol 2002;16:23-34.
ABSTRACT  

The diagnosis and management of insomnia in clinical practice: a practical evidence-based approach
Holbrook et al.
CMAJ 2000;162:216-210.
ABSTRACT | FULL TEXT  

Meta-analysis of benzodiazepine use in the treatment of insomnia
Holbrook et al.
CMAJ 2000;162:225-233.
ABSTRACT | FULL TEXT  

INSOMNIA IN OFFICE PRACTICE
JWatch General 1993;1993:7-7.
FULL TEXT  




HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | PHYSICIAN JOBS | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 1993 American Medical Association. All Rights Reserved.