Sleep Problems in Primary Care: A North Carolina Family Practice Research Network (NC-FP-RN) Study

Journal: Journal of American Board of Family Medicine. 2007 Jul-Aug;20(4):365-74.

Authors and affiliations: Alattar M, Harrington JJ, Mitchell CM, Sloane P. University of North Carolina, Chapel Hill, North Carolina, USA.

PMID: 17615417

Background: The prevalence and nature of sleep disorders in primary care has not been widely studied. As part of a survey conducted in 5 family practice offices in North Carolina, we screened adult patients for sleep syndromes and sought to ascertain which demographic status and health status were associated with these disorders.

Methods: We approached 2,963 consecutive adults who presented for office visits to the 5 study practices. The 4-page study questionnaire, which was available in English and Spanish, included items on insomnia, excessive daytime sleepiness, obstructive sleep apnea syndrome, and restless legs syndrome. Analyses evaluated the relationship between sleep syndromes and demographic factors, health status, and disability.

Results: We enrolled 1,935 patients (65.3% response rate).

n More than half reported excessive daytime sleepiness,

n One third had insomnia,

n More than 25% had symptoms of restless legs syndrome,

n And 13% to 33% reported obstructive sleep apnea syndrome symptoms.

n Participants who rated their health as poor reported significantly higher rates of all sleep disturbance items.

n Patients with hypertension, pain syndromes, and depression had a significantly increased risk for all sleep complaints.

n Patients who reported limited activity had a significant risk of restless legs syndrome.


n Sleep complaints are highly prevalent in primary care populations.

n Patients with the highest risk for sleep disturbance are those with pain, mental illness, limited activity, and overall "poor physical and mental health."

n Because sleep disorders are associated with a significant health impact, positive responses to questions regarding sleep symptoms should prompt further diagnostic inquiry.

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