Opinion
Video
Barriers to Addressing Sleep Health in Clinical Practice
Author(s):
In an upcoming Cure Connections program entitled “Barriers to Addressing Sleep Health in Clinical Practice” Dr Paul Doghramji will talk to a patient with insomnia and discuss challenges patients and physicians face when talking about sleep issues and in adequately treating insomnia.
Summary
Dr Doghramji introduces an upcoming Cure Connections program on “Barriers to Addressing Sleep Health in Clinical Practice.”
The discussion begins with the prevalence of insomnia in primary care. Dr Doghramji highlights that up to 50% of patients in primary care may have insomnia, but a significant number of them do not bring it up with their clinicians. Only around 5% of patients actively seek help for sleep issues. The conversation explores why patients might avoid discussing sleep problems, including potential self-resolution beliefs or concerns about prescription medications.
Dr Doghramji emphasizes that clinicians, including MDs (Medical Doctors), DOs (Doctor of Osteopathic Medicine), PAs (Physician Assistants), and NPs (Nurse Practitioners), often overlook asking about insomnia, contributing to a barrier in its recognition. The lack of understanding among clinicians about insomnia's importance in overall health compounds this issue. Barriers also include clinicians' uncertainty about how to address insomnia and a reluctance to prescribe medications due to concerns about side effects, addiction, and rebound insomnia.
The discussion further touches on the reluctance of clinicians to refer patients to sleep centers, with a common perception that these centers primarily focus on sleep apnea rather than insomnia.
The third part of the discussion explores available treatments and unmet needs in managing insomnia. Dr Doghramji mentions that traditional medications like benzodiazepines and selective benzodiazepine receptor agonists have fallen out of favor due to issues like tolerance, rebound, and addiction. Trazodone, an antidepressant without FDA indication for insomnia, has become a commonly prescribed option despite limited evidence of its efficacy.
Dr Doghramji concludes by introducing dual orexin receptor antagonists as promising medications for insomnia, offering potential benefits to patients struggling with sleep issues.
Video synopsis is AI-generated and reviewed by Neurology Live® editorial staff.
