The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Prevalence, burden, and treatment of insomnia in primary care
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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“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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“Other objectives were to: (1) assess the hypnotic efficacy of zolpidem 10 mg relative to placebo, (2) evaluate the safety of eszopiclone compared with placebo and zolpidem 10 mg, (3) assess the effect of treatment on the daytime symptoms of insomnia, and (4) make qualitative comparisons among the 5 drug conditions.”
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McCrae, C. S., Wilson, N. M., Lichstein, K. L., Durrence, H. H., Taylor, D. J., Bush, A. J., & Riedel, B. W. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00543-3 · Cited by 50
“Because insomnia is associated with significant healthcare costs and morbidity [8–12], it represents a major health threat for the elderly.”
BackgroundQuality Measures for the Care of Patients with Insomnia
Edinger, J. D., Buysse, D. J., Deriy, L. V., Germain, A., Lewin, D. S., Ong, J. C., & Morgenthaler, T. I. (2015) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.4552 · Cited by 51
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“Specifically, those with insomnia had significantly higher total health services costs than those without.(23)”
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Kosinski, M. R., Janagap, C. C., Gajria, K., & Schein, J. R. (2007) · Clinical Therapeutics · doi:10.1016/j.clinthera.2007.12.001 · Cited by 47
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MethodAnxiety sensitivity: predictor of sleep-related impairment and medication use in chronic insomnia
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“Individuals who complain of sleep disturbance are more likely to use the health care system.(8,9) Walsh and Engelhardt(10) estimate that the total direct US domestic cost of insomnia was US$13.”
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Rybarczyk, B. D., Lopez, M., Schelble, K., & Stepanski, E. J. (2005) · Behavioral Sleep Medicine · doi:10.1207/s15402010bsm0303_4 · Cited by 46
“This hypothesis was based on studies showing that insomniawasan independentpredictorofqualityof life in individualswithchronic illness (Katz & McHorney, 1998; Simon & VonKorff, 1997).”
MethodRational and targeted pharmacologic treatment of fibromyalgia
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“Pharmacologic agents include pure sedatives acting on benzodiazepine receptors, sedating antihistamines and sedating antidepressants [115].”
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Levenson, J. C., Troxel, W., Begley, A. E., Hall, M. H., Germain, A., Monk, T. H., & Buysse, D. J. (2013) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.2404 · Cited by 45
“11,12 Insomnia is accompanied by signifi cant individual and societal cost 13 and is associated with greater healthcare utilization, greater impairment, 10,14 and an increased risk of comorbid medical and psychiatric conditions.”
Comparison of Lorazepam and Zopiclone for Insomnia in Patients with Stroke and Brain Injury
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“Insomnia has also been associated with increased healthcare costs and social disability.(5) Hypnotics are often prescribed to improve restfulness so that patients may be more productive during the day.”
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“(5-15) While cross-sectional studies have demonstrated the association between sleep complaints and functional impairment (16-18), including disability (19), there are a paucity of studies which have examined whether sleep complaints predict the subsequent development of disability.”
BackgroundCost Effectiveness of Long-Term Treatment with Eszopiclone for Primary Insomnia in Adults
Botteman, M. F., Ozminkowski, R. J., Wang, S. S., Pashos, C. L., Schaefer, K., & Foley, D. J. (2007) · CNS Drugs · doi:10.2165/00023210-200721040-00005 · Cited by 43
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“Therefore, it is not surprising that sleep complaints are more common among patient populations than in the general population (Katz & McHorney, 1998; Simon & VonKorff, 1997; Terzanoa et al., 2004).”
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“In addition, sleep problems are a significant burden among patients in terms of functional impairment and reduced quality of life [4].”
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“21,22 Wiegand postulated that physicians favor antidepressants over FDA-approved benzodiazepines due to uninformed perceptions of the safety and nonaddictive advantages of antidepressants over benzodiazepine receptor agonists.”
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“Diagnostic rates of insomnia however—based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) —range between 5%-20% in the general adult population [4] and 20%-30% in primary care medical settings [5,6].”
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“In recent years, few studies have assessed the hypothesis that sleep disturbance is associated with more frequent utilization of health services in adult samples (Simon and VonKorff, 1997; Novak et al., 2004; Gilmer et al., 2005).”
BackgroundPsychosocial Correlates of Insomnia Severity in Primary Care
Bluestein, D. A., Rutledge, C., & Healey, A. C. (2010) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2010.02.090179 · Cited by 41
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“This procedure is consistent with earlier studies that considered the selection of the options “Always” or “Often” as an indication that the subject has the problem.(27,29,37,38)”
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Cognitive Behavioral Therapy for Insomnia in Older Adults
Bélanger, L., LeBlanc, M., & Morin, C. M. (2011) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2010.10.003 · Cited by 39
“Significant and chronic insomnia, on the other hand, produces negative consequences for the individual and is typically associated with increased daytime fatigue, mood disturbances, and cognitive problems that contribute to reduced quality of life (Simon & VonKorff, 1997).”
Blay, S. L., Andreoli, S. B., & Gastal, F. L. (2007) · Annals of Clinical Psychiatry · doi:10.1080/10401230701468099 · Cited by 39
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“Estimates of the prevalence of chronic insomnia vary depending on the criteria used and population studied but have been reported to be from 10% to as high as 40%(10-15).”
BackgroundSweetman, A., Lovato, N., Micic, G., Scott, H., Bickley, K., Haycock, J., Harris, J. K., Gradisar, M., & Lack, L. C. (2020) · Sleep Medicine · doi:10.1016/j.sleep.2020.08.023 · Cited by 40
The assessment and management of insomnia in primary care
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Co‐occurring depression and insomnia in Australian primary care: recent scientific evidence
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Sleep Locus of Control: Report on a New Scale
Vincent, N., Sande, G., Read, C. N., & Giannuzzi, T. (2004) · Behavioural Sleep Medicine · doi:10.1207/s15402010bsm0202_1 · Cited by 39
“…experience persistent sleep problems, leading to the development of fatigue, reduced concentration and memory, absenteeism, increased errors and accidents, and various other health care problems (Roth & Ancoli-Israel, 1999; Shochat, Umphress, Israel, & Ancoli-Israel, 1999; Simon & VonKorff, 1997).”
BackgroundConcordance of Sleep and Pain Outcomes of Diverse Interventions: An Umbrella Review
Doufas, A. G., Panagiotou, O. A., & Ioannidis, J. P. A. (2012) · PLoS ONE · doi:10.1371/journal.pone.0040891 · Cited by 37
“Approximately 10% of patients seen in primary care report major insomnia [7] and sleep disturbances exist in 50–89% [8–10] or more [11,12] patients with chronic pain.”
BackgroundVaag, J. R., Saksvik‐Lehouillier, I., Bjørngaard, J. H., & Bjerkeset, O. A. (2015) · Behavioral Sleep Medicine · doi:10.1080/15402002.2015.1007991 · Cited by 37
“…a link between insomnia and decreased concentration, difficulties performing duties, work-related accidents, decreased job performance, and work absenteeism (Kessler et al., 2012; Léger, Guilleminault, Bader, Lévy, & Paillard, 2002; Miriam Kuppermann & Mazonson, 1995; Simon & VonKorff, 1997).”
BackgroundPredicting Treatment Response in Older Adults with Insomnia
Gagné, A., & Morin, C. M. (2001) · Journal of Clinical Geropsychology · doi:10.1023/a:1009537722740 · Cited by 37
Insomnia and hypnotic use in Campo Grande general population, Brazil
Souza, J. C., Magna, L. A., & Reimão, R. (2002) · Arquivos de Neuro-Psiquiatria · doi:10.1590/s0004-282x2002000500003 · Cited by 37
Palesh, O. G., Mustian, K. M., Peppone, L. J., Janelsins, M. C., Sprod, L. K., Kesler, S. R., Innominato, P. F., Roth, T. G., Manber, R., Heckler, C. E., et al. (2012) · Sleep Medicine · doi:10.1016/j.sleep.2012.06.001 · Cited by 37
“In the general population, sleep problems are associated with significant impairments in quality of life [7], almost a two-fold increase in accidents [8], increased days spent in bed, and decreased activity [9].”
BackgroundRole of Monitoring and Blunting Coping Styles in Primary Insomnia
Voss, U., Kolling, T., & Heidenreich, T. (2006) · Psychosomatic Medicine · doi:10.1097/01.psy.0000195881.01317.d9 · Cited by 36
“Focusing on these two coping modes, exclusively, Miller (8) developed a trait-state model of coping, proposing that (1) the beneficial effect of monitoring and blunting strategies on stress reduction depend on the control contingencies of a specific situation and (2) many individuals rigidly resort to either monitorin…”
BackgroundMethodEpidemiology of Insomnia: from Adolescence to Old Age
Johnson, E. O. (2006) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2006.06.006 · Cited by 36
Börsbo, B., Liedberg, G., & Björk, M. (2015) · Journal of Pain Research · doi:10.2147/jpr.s86611 · Cited by 35
“42 Thus, not all people experiencing poor sleep try to solve their problem by using hypnotic drugs or are not offered medication by their physician.”
Days-Out-of-Role Associated With Insomnia and Comorbid Conditions in the America Insomnia Survey
Hajak, G., Petukhova, M. V., Lakoma, M. D., Coulouvrat, C., Roth, T. G., Sampson, N. A., Shahly, V., Shillington, A. C., Stephenson, J. J., Walsh, J. K., et al. (2011) · Biological Psychiatry · doi:10.1016/j.biopsych.2011.08.010 · Cited by 35
“Although a few tudies have established associations of insomnia with impairents that persisted after adjusting for comorbidity (18,20,24), these results are limited by suboptimal assessments of insomnia and comorbid conditions.”
Can Sleep Be Bad For You? Can Insomnia Be Good?
Buysse, D. J., & Ganguli, M. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.2.137 · Cited by 33
Pharmacologic treatment of fibromyalgia
Baker, K., & Barkhuizen, A. (2005) · Current Pain and Headache Reports · doi:10.1007/s11916-005-0003-x · Cited by 35
Jansson‐Fröjmark, M., Lundqvist, D., Lundqvist, N., & Linton, S. J. (2007) · International Journal of Behavioral Medicine · doi:10.1007/bf03002996 · Cited by 34
Gellis, L. A., Gehrman, P., Mavandadi, S., & Oslin, D. W. (2010) · Military Medicine · doi:10.7205/milmed-d-09-00123 · Cited by 35
Chronic Insomnia and Health Care Utilization in Young Adults
Bramoweth, A. D., & Taylor, D. J. (2012) · Behavioral Sleep Medicine · doi:10.1080/15402002.2011.587067 · Cited by 34
“Simon and VonKorff (1997) noted that, ―Attempts to disentangle these relationships encounter difficulty at both the measurement or”
BackgroundAdverse effects of temazepam in older adults with chronic insomnia
Morin, C. M., Bastien, C., Brink, D., & Brown, T. R. (2003) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.454 · Cited by 33
“…increases with aging and older adults complain primarily of frequent or prolonged nocturnal awakenings, early morning awakenings with an inability to return to sleep, or a combination of these difficulties (Bliwise, 1993; Ford and Kamerow, 1989; Mellinger et al., 1985; Simon and VonKorff, 1997).”
BackgroundKrieger, T., Urech, A., Duss, S. B., Blättler, L. T., Schmitt, W. J., Gast, H., Bassetti, C. L., & Berger, T. (2019) · Sleep Medicine · doi:10.1016/j.sleep.2019.01.045 · Cited by 36
Pollack, M. F., Seal, B. S., Joish, V. N., & Cziraky, M. J. (2009) · Current Medical Research and Opinion · doi:10.1185/03007990903035505 · Cited by 33
“The data files used for this study were derived from two Medstat MarketScan research databases: (1) the Commercial Claims and Encounters Database (CCED), and (2) the Health and Productivity Management (HPM) Subset Database from 2000 to 2004.”
MethodInsomnia - treatment pathways, costs and quality of life
Scott, G., Scott, H. M., O’Keeffe, K., & Gander, P. H. (2011) · Cost Effectiveness and Resource Allocation · doi:10.1186/1478-7547-9-10 · Cited by 33
“The differences in direct health costs between these two groups ranged from 5% to 200% (mean 57%, median 24%) [14-20].”
BackgroundTratamento não farmacológico para a insônia crônica
Passos, G. S., Tufik, S., Santana, M. G. D., Poyares, D., & Mello, M. T. D. (2007) · Revista Brasileira de Psiquiatria · doi:10.1590/s1516-44462006005000045 · Cited by 32
Factors Associated with Poor Sleep Quality in Primary Care
Kang, J.-M., Lee, J. A., Jang, J.-W., Kim, Y. S., & Sunwoo, S. (2013) · Korean Journal of Family Medicine · doi:10.4082/kjfm.2013.34.2.107 · Cited by 32
GABA A Receptors Are Well Preserved in the Hippocampus of Aged Mice
Palpagama, T. H., Sagniez, M., Kim, S., Waldvogel, H. J., Faull, R. L. M., & Kwakowsky, A. (2019) · eNeuro · doi:10.1523/eneuro.0496-18.2019 · Cited by 35
“Benzodiazepines are commonly used as therapeutic agents for the treatment of anxiety (Vajda and Burrows, 1983), depression (Johnson, 1985), and insomnia (Simon and VonKorff, 1997).”
BackgroundEffect of Valerian Extract Preparation (BIM) on the Sleep-Wake Cycle in Rats
Tokunaga, S., Takeda, Y., Niimoto, T., Nishida, N., Kubo, T., Ohno, T., Matsuura, Y., Kawahara, Y., Shinomiya, K., & Kamei, C. (2007) · Biological and Pharmaceutical Bulletin · doi:10.1248/bpb.30.363 · Cited by 32
Withdrawal Reactions after Stopping Hypnotics in Patients with Insomnia
LADER, M. H. (1998) · CNS Drugs · doi:10.2165/00023210-199810060-00004 · Cited by 32
Chiu, H., Xiang, Y., Dai, J., Chan, S., Leung, T., Yu, X., Hou, Z.-J., Ungvari, G., & Caine, E. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.03.050 · Cited by 37
“It is an important public health challenge due to its association with poorer overall health, impaired quality of life, and greater use of general medical services (Simon and VonKorff, 1997).”
BackgroundHarper, D. G., Plante, D. T., Jensen, J. E., Ravichandran, C. T., Buxton, O. M., Benson, K. L., O'Connor, S. P., Renshaw, P. F., & Winkelman, J. W. (2013) · SLEEP · doi:10.5665/sleep.2530 · Cited by 31
Prevalence of insomnia and its impact on daily function amongst Malaysian primary care patients
Hassan, Z. A., Mazza, D., & Teng, C. L. (2012) · Asia Pacific Family Medicine · doi:10.1186/1447-056x-11-9 · Cited by 31
“Studies conducted in Western settings have reported that primary care populations have a higher prevalence of insomnia (64-69%) than the general population [8-10].”
BackgroundInfluentialFunctional and Economic Impact of Sleep Loss and Sleep-Related Disorders
Colten, H. R., & Altevogt, B. M. (2006) · Cited by 31
Clinical Pharmacology of Sleep
Pandi-Perumal, S. R., & Monti, J. M. (2006) · Birkhäuser Basel eBooks · doi:10.1007/3-7643-7440-3 · Cited by 31
Metadata
- Authors
- Simon, G. E., & VonKorff, M.
- Affiliations
- Group Health Cooperative (US)
- ORCID
- Gregory E. Simon
- Venue
- American Journal of Psychiatry
- Published
- 1997-10-01
- Volume
- 154
- Issue
- 10
- Pages
- 1417-1423
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- 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 (medical) › 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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