Module 3: Assessment

Lesson 3

Learning outcome

Describe the epidemiology, comprehensive assessment, safety considerations and goals of care that need to be addressed in prescribing therapy for insomnia.

Assessment of insomnia, a condition which affects a relatively large number of adults, is discussed in relation to CDS therapy.  Safety considerations are identified related to prescribing CDS therapy for insomnia as well as the goals of care for this condition.

Epidemiology of insomnia

Prevalence varies by the definition of insomnia. In the USA, estimates of the prevalence of symptoms is 33%–50% of the adult population, symptoms with distress or impairment occur in 10%–15% of adults, and specific insomnia disorders occur in 5%–10% of adults (Schutte-Rodin et al., 2008).

Risk factors include increasing age, being female, comorbidity (medical, psychiatric, sleep, substance use), shift work, unemployment, and lower socioeconomic status.

The prevalence increases to 50%–75% of individuals with psychiatric and chronic pain disorders (Schutte-Rodin et al., 2008).

The relationship is bidirectional for psychiatric disorders and insomnia.