The Nationwide Insomnia Screening and Awareness Study (NISAS) 2000

Aim: To estimate the point prevalence of insomnia and other sleep disorders in primary care, by severity and impairments and doctor's recognition rates. Methods: Nationwide sample of 539 primary care settings along with their characterization. Standardized assessment of all attenders and the doctors (N = 19155 patients) on the NISAS target day using a sleep questionnaire (PSQI) and additional questions to cover psychosocial and additional clinical variables were conducted including a CGI-rating. Results: 1. Despite of only moderate self-rated competence with regard to recognition, diagnosis and treatment doctors in the prestudy indicated to primarily treat patients themselves, despite of substantial burden and time investment. 2. The patient sample could be regarded as typical. 3. Sleep complaints were found to be overall the 3rd most frequent reason. Almost every second patient on the assessment day indicated to suffer from sleep complaints. 26.5% fulfilled study criteria (DSM-IV) for insomnia (prevalence 16-19 years old: 17.5%, 80+ years old: 31.9%). Other sleep disorders were frequently comorbid with insomnia. 4. Doctors themselves using the CGI rated 46.4% of all primary care patients as having a sleep disorder, 85.6% of which were rated as chronic. Primary core doctors prevalence rate for insomnia was 25.9%. Only 54.3% of all patients were correctly diagnosed as insomnia by the doctor. Discussion: NISAS provides for the first time nationally representative estimates of sleep complaints and disorders according to severity, correlates and recognition in primary core. The high prevalence and the associated burden for primary care is highlighted along with the high degree of chronicity and partly marked deficits in recognition and diagnosis.