Prevalence of insomnia and its impact on daily function amongst Malaysian primary care patients

Asia Pacific Family Medicine

Cheong Lieng Teng¹  Danielle Mazza²  Abu-Hassan Zailinawati¹ 

[1]Department of Family Medicine, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, 70300, Malaysia

[2]Department of General Practice, Monash University, Melbourne, Australia

关键词: Malaysia;    Primary care;    Prevalence;    Psychological morbidity;    Insomnia;   

Others  :  790543
DOI  :  10.1186/1447-056X-11-9

 received in 2011-10-06, accepted in 2012-11-23,  发布年份 2012

【 摘 要 】

Background

Insomnia is a common public health problem and the prevalence and impact of insomnia in primary care attendees is not well documented in the Asian population.

Objectives

To determine the prevalence of self-reported insomnia symptoms amongst adult primary care attendees and the association with socio-demographic factors; to ascertain the impact of insomnia on daily functioning and to describe the psychological profile of patients with insomnia.

Methods

In this cross-sectional survey, 2049 adult patients (≥18 year old) attending seven primary care clinics in Peninsular Malaysia, completed the questionnaire asking about symptoms of insomnia (defined according to the International Classification of Sleep Disorders and DSM IV criteria) daytime impairment and psychological symptoms (assessed by Hospital Anxiety and Depression Scale).

Results

The response rate was 86.2%. A total of 60% reported insomnia symptoms, 38.9% had frequent insomnia symptoms (>3 times per week), 30.7% had chronic insomnia without daytime consequences and 28.6% had chronic insomnia with daytime dysfunction. Indian ethnicity (OR 1.79; 95%CI, 1.28-2.49), age ≥ 50 or older (OR 1.82; 95%CI, 1.10-3.01), anxiety symptoms (OR 1.65; 95%CI, 1.21-2.22) and depression symptoms (OR 1.65; 95%CI, 1.21-2.26) were risk factors for chronic insomnia with daytime dysfunction. Amongst those with chronic insomnia with daytime dysfunction, 47.8% had anxiety symptoms (OR, 2.01; 95%CI, 1.57-2.59) and 36.5% had depression symptoms (OR, 2.74; 95%CI, 2.04-3.68) based on HADs score. They also had tendency to doze off while driving and to be involved in road traffic accidents.

Conclusions

A third of primary care attendees have insomnia symptoms and chronic insomnia, associated with significant daytime dysfunction and psychological morbidity. By identifying those at risk of having chronic insomnia, appropriate interventions can be commenced.

【 授权许可】

   
2012 Zailinawati et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Ustun TB, Privett M, Lecrubier Y: Form, frequency and burden of sleep problem in general health care: a report from the WHO collaborative study on psychological problem in general health care. Eur Psychiatry 1996, 11(Supp 1):5S-10S.
• [2]Ohayon MM: Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev 2002, 6(2):97-111.
• [3]Groeger JA, Zijlstra FR, Dijk DJ: Sleep quantity, sleep difficulties and their perceived consequences in a representative sample of some 2000 British adults. J Sleep Res 2004, 13(4):359-371.
• [4]Kim K, Uchiyama M, Okawa M, Liu X, Ogihara R: An epidemiological study of insomnia among the Japanese general population. Sleep 2000, 23(1):41-47.
• [5]Yeo BK, Perera IS, Kok LP, Tsoi WF: Insomnia in the community. Singapore Med J 1996, 37:282-284.
• [6]Li RH, Wing YK, Ho SC, Fong S: Gender differences in insomnia: a study in the Hong Kong Chinese population. J Psychosom Res 2002, 53:601-609.
• [7]Ohayon MM, Hong SC: Prevalence of insomnia and associated factors in South Korea. J Psychosom Res 2002, 53:593-600.
• [8]Terzano MG, Parrino L, Cirignotta F, Ferini-Strambi L, Gigli G, Rudelli G: Studio Morfeo: insomnia in primary care, a survey conducted on the Italian population. Sleep Med 2004, 5:67-75.
• [9]Aikens JE, Rouse ME: Help-seeking for insomnia among adult patients in primary care. J Am Board Fam Pract 2005, 18(4):257-260.
• [10]Simon GE, VonKorff M: Prevalence, burden, and treatment of insomnia in primary care. Am J Psychiatry 1997, 154:1417-1423.
• [11]Leineweber C, Kecklund G, Janszky I, Akerstedt T, Orth-Gomer K: Poor sleep increases the prospective risk for recurrent events in middle-aged women with coronary disease. The stockholm female coronary risk study. J Psychosom Res 2003, 54(2):121-127.
• [12]Ford DE, Kamerow DB: Epidemiologic study of sleep disturbances and psychiatric disorders: an opportunity for prevention. JAMA 1989, 262:1479-1484.
• [13]Roth T: Comorbid insomnia: current directions and future challenges. Am J Manag Care 2009, 15(Suppl):S6-S13.
• [14]Léger D, Guilleminault C, Bader G, Lévy E, Paillard M: Medical and socio-professional impact of insomnia. Sleep 2002, 25(6):625-629.
• [15]Connor J, Norton R, Ameratunga S, Robinson R, Civil I, Dunn R: Driver sleepiness and risk of serious injury to car occupants: population based case control study. BMJ 2002, 324:1125-1129.
• [16]Ozminkowski RJ, Wang S, Walsh JK: The direct and indirect costs of untreated insomnia in adults in the United States. Sleep 2007, 30(3):263-273.
• [17]Sateia MJ, Doghramji K, Hauri PJ, Morin CM: Evaluation of chronic insomnia. An american academy of sleep medicine review. Sleep 2001, 23:243-308.
• [18]Zailinawati AH, Schattner P, Mazza D: Doing a pilot study: why is it essential? Mal Fam Physician 2006, 1(2&3):70-73.
• [19]John MA: A new method of measuring daytime sleepiness: the Epworth Sleepiness Scale. Sleep 1991, 14:54-55.
• [20]Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983, 67:361-370.
• [21]International Classification of Sleep Disorders, Revised: Diagnostic and Coding Manual. American Sleep Disorders Association; 2001.
• [22]Diagnostic and Statistical Manual of Mental Disorders. 4th edition. American Psychiatric Association; 1994.
• [23]Edinger JD, Bonnet MH, Bootzin RR, American Academy of Sleep Medicine Work Group: Derivation of research diagnostic criteria for insomnia: report of an American Academy of Sleep Medicine Work Group. Sleep 2004, 27(8):1567-1596.
• [24]Herrmann C: International experiences with the Hospital anxiety and depression scale- A review of validation data and clinical results. J Psychosom Res 1997, 42(1):17-41.
• [25]Lam CL, Pan PC, Chan AW: Can the hospital anxiety and depression (HAD) scale be used on Chinese elderly in general practice? Fam Pract 1995, 12:149-154.
• [26]Quek KF, Atiya AS, Heng NC, Beng CC: Validation of the hospital anxiety and depression scale and the psychological disorder among premature ejaculation subjects. Int J Impot Res 2007, 19:321-325.
• [27]Zailinawati AH, Ariff K, Nurjahan M, Teng CL: Epidemiology of insomnia in Malaysian adults: a community-based survey in 4 urban areas. Asia Pac J Public Health 2008, 20(3):224-233.
• [28]Kamil MA, Teng CL, Hassan SA: Snoring and breathing pauses during sleep in the Malaysian population. Respirology 2007, 12(3):375-380.
• [29]Nor’Aishah AB, Rampal KG: Study of fatigue amongst bus drivers. , National University of Malaysia: Masters Thesis in Public health (Occupational Health); 2004.
• [30]Malaysia; health situation and trend. 2010. [cited 2011 29th September]; Available from: http://www.wpro.who.int/countries/maa/2010/health_situation.htm webcite
• [31]Malaysian Institute of Road Safety Research (MIROS). 2010. [cited 2011 29th September]; Available from: http://www.miros.gov.my/web/guest/national webcite
• [32]Drowsy driving and automobile crashes. National Center on Sleep Disorders Research and National Highway Traffic Safety Administration; 1998.
• [33]Hohagen F, Rink K, Käppler C: Prevalence and treatment of insomnia in general practice: a longitudinal study. Eur Arch Psychiatry Clin Neurosci 1993, 242:329-336.
• [34]Fong SY, Wing YK: Longitudinal follow up of primary insomnia patients in a psychiatric clinic. Aust N Z J Psychiatry 2007, 41:611-617.
• [35]Vollrath M, Wicki W, Angst J, The Zurich study: VIII. Insomnia: association with depression, anxiety, somatic syndromes, and course of insomnia. Eur Arch Psychiatry Neurol Sci 1989, 239(2):113-124.
• [36]Zhang B, Wing YK: Sex differences in insomnia: a meta-analysis. Sleep 2006, 29:85-93.