Insomnia disorder diagnosis and treatment patterns in primary care: A cross-sectional analysis of electronic medical records data

Background and purpose: About one in every three US adults is estimated to have insomnia disorder. Consequences of untreated insomnia disorder are debilitating and costly, and primary care providers (PCPs) are uniquely positioned to detect and treat insomnia, thus preventing its adverse outcomes. The goal of this study was to explore the utility of analyzing electronic medical record data to identify patterns in diagnosis and management of insomnia disorder by PCPs. Methods: This was a cross-sectional descriptive study. Numbers of medical records containing at least one insomnia disorder diagnosis code, one insomnia-related medication, or both were tabulated. Prevalence and odds ratios (ORs) were determined. Results: Insomnia disorder diagnoses were present in 9.4% of the records; 7.4% contained insomnia-related medication( s), and only 3.9% contained both. Diagnoses and medications were higher among women than men (ORs up to 2.87, depending on age range) and in general and increased with age. Conclusions: The prevalence of insomnia disorder diagnoses in primary care medical records falls below expectation for the population of interest, and less than half of patients with an insomnia disorder diagnosis are prescribed an insomnia-related medication. Electronic medical records provide an efficient window into insomnia disorder diagnosis and management patterns in the primary care setting. Implications for practice: Primary care providers may be missing opportunities to detect and treat insomnia disorder as a way of improving overall patient outcomes. Electronic medical record systems may require modification to facilitate more accurate data extraction.