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Cited by 695Sleep and related disordersObstructive Sleep Apnea ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Prevalence, burden, and treatment of insomnia in primary care

Gregory E. Simon, Michael VonKorff·1997·American Journal of Psychiatry
DOI 10.1176/ajp.154.10.1417
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Abstract

OBJECTIVE: The prevalence, burden, and management of insomnia among primary care patients were evaluated. METHOD: Consecutive patients aged 18 to 65 years in primary care clinics of a staff-model health maintenance organization (N = 1,962) were screened with the 12-item General Health Questionnaire. A stratified random sample (N = 373) completed face-to-face diagnostic assessments including the Composite International Diagnostic Interview, a brief self-rated disability questionnaire (Brief Disability Questionnaire), and the interviewer-rated Social Disability Schedule. A telephone follow-up survey was completed 3 months later. Use of psychotropic drugs, use of mental health services, and direct health care costs were assessed by using the health plan's automated data systems. RESULTS: Approximately 10% of the primary care patients reported major current insomnia (e.g., taking at least 2 hours to fall asleep nearly every night). Current insomnia was associated with significantly greater functional impairment (according to both Brief Disability Questionnaire and Social Disability Schedule), more days of disability due to health problems, and greater general medical service utilization. While insomnia was associated with depressive disorder and chronic medical illness, adjustment for these factors only partially accounted for the association of insomnia with disability and with health care utilization. Of the patients with current insomnia, 28% received any psychotropic drug; 14% received benzodiazepines and 19% received antidepressants. CONCLUSIONS: Insomnia among primary care patients is associated with greater functional impairment, lost productivity, and excess health care utilization.

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Crossref · 10.1176/ajp.154.10.1417

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  • There is a large need for psychological services for insomnia; about one third of adults report insomnia symptoms and about 10% meet diagnostic criteria for an insomnia disorder.

    “For example, there is a huge need for psychological services for the treatment of insomnia, a significant health problem with one third of the adult population reporting symptoms of insomnia and approximately 10% meeting diagnostic criteria for an insomnia disorder [53–56].”

    From A Behavior Change Model for Internet Interventions (2009) · cites this paper as [56]

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Authors
Simon, G. E., & VonKorff, M.
Affiliations
Group Health Cooperative (US)
ORCID
Gregory E. Simon
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
1997-10-01
Volume
154
Issue
10
Pages
1417-1423
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/ajp.154.10.1417
OpenAlex
W1273834102
Cited by
694
References
29
Citations by year
2026: 7 · 2025: 9 · 2024: 8 · 2023: 12 · 2022: 30 · 2021: 9 · 2020: 18 · 2019: 18 · 2018: 13 · 2017: 23 · 2016: 17 · 2015: 20 · 2014: 36 · 2013: 31 · 2012: 44
FWCI
13.33
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (1r03mh047765-01)
  • National Institute of Mental Health (MH-47765)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
insomnia, prevalence, functional disability, disability, health care utilization, psychotropic drug use, benzodiazepines, antidepressants, depressive disorders, chronic disease, productivity loss, primary care patients, health maintenance organizations
MeSH terms
Adult, Antidepressive Agents, Chronic Disease, Disability Evaluation, Female, Follow-Up Studies, Health Maintenance Organizations, Health Status, Humans, Sleep Initiation and Maintenance Disorders, Male, Primary Health Care, Psychiatric Status Rating Scales, Psychotropic Drugs, Severity of Illness Index, Telephone, Comorbidity, Prevalence

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