Low rates of recognition of sleep disorders in primary care: comparison of a community-based versus clinical academic setting.

Objective: To determine the prevalence and recognition of sleep disorders in a community-based outpatient health setting compared to a university-based clinic in the same geographical location.Background: Sleep disorders are highly prevalent, affecting up to 70 million Americans to varying degrees. Despite increased risk for sleep disorders among minority or medically-indigent individuals, little attention has been paid to the sleep-related needs of these populations.
Methods: Two main data collection strategies were employed: (1) intensive database search for sleep-related diagnoses using ICD-9-CM diagnostic codes; (2) review of symptom checklists from patient charts. If database search revealed a positive sleep diagnosis, patient's chart was further queried for clinical assessment and outcome.
Results: The overall prevalence rate of sleep-related disorders in the community-based sample was 0.1%. According to chart review, younger patients and those of Hispanic origin were less likely to report sleep complaints or to have these diagnoses recorded by a physician. The overall prevalence rate of sleep diagnoses in the university-based sample was 3.1%. Age and gender were not significant predictors overall in this population, although sleep diagnoses varied significantly by gender.Conclusions: A low rate of recognition and diagnosis of sleep disorders was observed in both settings. Overall, these findings strongly emphasize the need for increased education and training in sleep disorders, particularly in community-based outpatient settings.