Approach to the patient with a sleep complaint

Sleep complaints of varied types are extremely common in our society. Although one most commonly associates a sleep disturbance with a complaint of insomnia, excessive daytime sleepiness and abnormal events occurring during sleep at night are also frequent complaints. Approximately 10% of the population has a complaint of insomnia that occurs every night for 2 weeks or more,1 whereas up to 30% of people have some sleep disturbance a few nights every month. Up to 10% of the population has significant daytime tiredness and sleepiness and nearly everyone has had some type of abnormal intrusion into sleep such as nightmares, sleepwalking, or some other psychological or physiological intrusion into sleep. However, despite the prevalence in society of sleep disorders, the majority of patients do not present for treatment. About 28% have insomnia associated with a mental disorder.2 Yet, only 5-6% of people will seek a physician in order to address their sleep problem.3 Over 70% of those with insomnia have never discussed the sleep problem with a physician and the majority resort to over-the-counter medications or self-remedies in order to alleviate the sleep disturbance.