J Med Assoc Thai 2009; 92 (2):273

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Sleep Problems in Out-Patient of Primary Care Unit
Tubtimtes S Mail, Sukying C , Prueksaritanond S

Objective: The prevalence and factors associated with sleep problems among out-patients of the Family
Medicine Department in Ramathibodi Hospital were evaluated and their management was assessed.

Material and Method: Descriptive study, out-patients in family medicine clinic (n = 512) were selected by
stratified random sampling. Sleep problems during the previous month were assessed by using questionnaires.
Excessive daytime sleepiness (EDS) was assessed by Epworth sleepiness scale. The medical records of 45
patients with habitual insomnia during the previous 6 months were retrieved to study its management. The
data were analyzed by Chi-square, Odds ratio, 95% Confident Interval and binary logistic regression.

Results: Half of the subjects (50.4%) had chronic diseases. Age range was 20-78 years old and 69.9% were
female. Insomnia distributed almost equally in all age groups. Approximately 57.9% and 19.5% of the subjects
reported insomnia and sleepiness. One fourth of the participants (24.7%) had snored and this was more often
in men than women (OR 1.7). Anxiety score, female, and perception of their illness and disease were strong
factors associated with insomnia. Most of them (71.1%) did not consult their doctors despite having habitual
insomnia. From medical records reviewed, only one fourth of them (28.9% and 26.7%) were recorded about
the insomnia and the prescriptions.

Conclusion:
More than half of the out-patients in primary care had sleep problems, especially insomnia, and
excessive daytime sleepiness, but few of them consulted their doctors. This problem should not be overlooked.
Psychological problems and anxiety with their illness were associated with insomnia. Therefore, exploring
and understanding their problems are important issues to manage and render advice for their quality sleep.

Keywords: Outpatients, Primary health care, Sleep initiation and maintenance disorders

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