Authors (Year) | Country (town and community) | Study population | Measures | Main findings | TDF Domain(s) |
---|---|---|---|---|---|
Kushida et al. (2000) [18] | United States (Idaho, rural cohort) | Primary care patients seen at the clinic over a 1 year period (1997–1998) n = 1249, all 18+. (participation rate 60.1% 1254/2087) | Questionnaires (focused on sleep disordered symptoms for insomnia, RLS, OSA), ESS, SF-36 – daytime functioning (face-to-face or mail-out/ Interviews | 32.3% had insomnia (29.7% of men and 34.5% of women). | Knowledge, Skills |
14.1% experienced insomnia on a nightly basis. | |||||
State that patients have limited access to sleep specialists and a lack of training for physicians | |||||
Aikens & Rouse (2005) [36] | United States (Urban population) | N = 700 consecutive attendees at primary care, screened for insomnia. 326 mailed a follow-up survey to which n = 180 responded | Questionnaires assessing insomnia, sleep quality, and daytime consequences of sleepiness and fatigue (ISI, PSQI, ESS, DBAS, MFIS) | Of the 180 responders, 72% had probable insomnia. Those who had discussed it with their physician (52% of those with probable insomnia) reported poorer overall health Those who were more educated, had >co-morbid symptoms, lower TST or > daytime dysfunction more likely to discuss | Knowledge, Behavioural regulation, Beliefs about consequences. |
Morin et al. (2006) [4] | Canada, Quebec Province. | 2001 French speaking adults aged 18+. Mean age 44.7 | Telephone survey with insomnia defined as per the DSM-IV and the ICD-10 | 29.9% reported insomnia symptoms. | Behavioural regulation, Beliefs about consequences. |
13% had consulted a healthcare professional about their insomnia. | |||||
15% had used a herbal product, 11% a prescribed sleep medication, 3.84% an OTC drug and 4.1% alcohol to manage insomnia. | |||||
Daytime fatigue, psychological distress and physical discomfort were symptoms prompting individuals to seek treatment. | |||||
Bartlett et al. (2008) [6] | Australia, New South Wales, (mixed urban-rural) | Postal survey of 10,000 people randomly selected from the electoral roll (5000 aged 18–24 and 5000 aged 25–64). 3300 responded. Direct contact with a random subset of non-responders (n = 100) was undertaken (response rate of 49%) by telephone. | Postal survey and direct contact. Survey included AIS and ESS. | Population weighted prevalence of insomnia = 33% and in 74.7% of these the complaint has been present for > 12 months. | Behavioural regulation, Beliefs about consequences. |
Population weighted prevalence of a visit to a doctor for insomnia = 11.1% | |||||
Risk factors for insomnia were: older age, daytime sleepiness, short sleep duration (< 6.5 h), reduced enthusiasm. | |||||
Self-medication for insomnia was common but often satisfaction with treatment was poor. For prescription drugs 39% of users were satisfied compared with 16% for OTC drugs and 25% for herbal products. | |||||
Bailes et al. (2009) [27] | Canada (Montreal, city cohort) | N = 191 older patients (aged 50+) in primary care. n = 138 from 2 hospital-based sleep clinics (new referrals aged 18+). | Sleep Symptom Checklist- 21 items (insomnia, sleep disorders, daytime symptoms and psychological distress) they had discussed with their physician in the past year. | Primary care patients often have sleep symptoms they do not discuss, or discuss non-specifically. | Knowledge |
Subsequent PSG with primary care participants | |||||
Those referred to the sleep clinic were more likely to have discussed sleep problems (also younger and more males) | |||||
Those who completed PSG more likely to report sleep symptoms compared with those who completed questionnaire only. | |||||
Dyas et al. (2010) [9] | UK (Lincolnshire, rural cohort | Patients (who had sought help for insomnia in the previous 6 months) | Focus groups/ semi-structured interviews separate for patients (n = 30, 11 M, 19 F, aged 25–70) | Patients felt a need to convince professionals of their health problems. | Beliefs about capabilities, Environmental Context and Resources |
Patients often suffered for long periods before seeking help, and had tried self-help methods | |||||
Patients recognised sleep problems were linked to detrimental outcomes. | |||||
Clinicians noted multiple causes of sleep problems | |||||
Clinicians often focused on underlying causes rather than addressing treatment or consequences of non-treatment. | |||||
Omvik et al. (2010) [46] | Norway | Epidemiological postal survey (n = 5000). Mean age 48.1. | Sleep medication prevalence and reasons for use questions | Prevalence of sleep medication use: Lifetime = 18.8%, Current = 7.9% and Chronic = 4.2%. | Social influences |
Bergen Insomnia Scale, Global Sleep Assessment Questionnaire, Structured Clinical Interview for DSM., WHOqoL, SDS | Sleep medication use associated with low SES, older age, female gender, frequent sleep and/or mood disturbance. | ||||
 | Among those who had ever used a sleep medication, 80.3% would prefer a non-drug treatment. | ||||
Senthilvel et al. (2011) [19] | United States (Cleveland Ohio, urban population) | New adult patients aged 18–65 (n = 101) 52% female, mean age = 38 years | CSHQ, Berlin, ESS, STOP, review of GP records of the consultation | 30% of cases = possible insomnia, but limited screening and sleep history obtained during the consult | Environmental Context and resources |
Bjorvatn et al. (2017) [15] | Norway | Patients visiting their GP (n = 1346), 35.9% Male | BIS, Self-reported sleep problems (1-item), insomnia (DSM-IV criteria), hypnotic use | BIS insomnia rate = 53.6%, sleep problems (single item) = 55.8%. | Knowledge, Skills |
Hypnotics used by 16.2% (daily use was 5.5%). |