More Americans having difficulty with sleep

The following statistic should alarm you: there has been a 266% increase in office visits for sleep-related problems over a 10 year period.

This startling statistic comes from data collected from the National Ambulatory Medical Care Survey from 1999-2010.

It’s time for primary-care providers to learn more about sleep medicine because your practice will be confronted with more and more patients presenting with sleep ailments.

The number of office visits for insomnia has risen 13% among patients aged 20 years or older. The amount of patients seeks help for sleep apnea rose 442%. There was also an increase in the number of sleep medications written by 293%, which means 20.8 million prescriptions have been written for sleep medication.

My immediate thoughts are:

• Have we not effectively treated sleep problems in the past?
• Are patients becoming more aware of how important sleep is to health and demanding better care?
• Are we over-treating sleep problems?

I think the answer is somewhere in between.

Male patients were more likely to seek help for sleep disturbance over all, compared with female patients; whereas women were more likely to see a provider for insomnia. Patients aged 40 to 64 years old made up the greatest total number of visits.

The number of visits for patients diagnosed with sleep apnea rose from 1.1 million in 1999 to 8.4 million in 2009. During the same time period, the number of prescriptions for a hypnotic medication also increased significantly.

The increased prevalence of diabetes, obesity, and chronic diseases associated with an aging population may have contributed to the rise of diagnosed sleep-related illnesses, noted the researchers.

Another factor that may have contributed to the growth of sleep disorders could be the increased public awareness of sleep conditions. Between celebrity doctors Dr. Oz and increased marketing efforts for sleep-aid medications, the public is more conscious of sleep-related illnesses. Next time you’re in the grocery store, pick up a magazine; it’s a good bet that one of them has an article about sleep.

The investigators noted that providers are more aware than ever of how sleep affects health and may be identifying sleep disorders more frequently than in the past, adding another factor to consider in explaining the increase in sleep-related conditions.

The estimation of the number of sleep medication prescriptions is lower than what was found in other studies. For example, the IMS Institute for Healthcare Informatics estimated there were 66 million hypnotic and sedative medications filled in 2010. This study focused on 10 medications indicated for insomnia and it did not include other sedating medications that providers might use for insomnia, which could account for the difference.

Whatever the reason, we have to learn more about sleep or be willing to send patients for consultations with sleep professionals. There is a need for more study and understanding of sleep disorders in the primary-care setting.

Sharon M. O’Brien, MPAS, PA-C, is a practicing clinician with an interest in helping patients understand the importance of sleep hygiene and the impact of sleep on health.