Insomnia and chronic diseases as a treatment challange in general practice

Abstract:

Insomnia is a common problem in elderly patients and patients with chronic diseases and represents a treatment challenge for general practitioners in their daily practice. Aim: The aim was to determine the most common chronic conditions in patients with insomnia treated in general practice. Material and methods: The study was carried out from January 1st, 2009 to January 1st, 2011, in two general practice offices, one located in an urban area in the city of Split (83 subjects) and the other in a rural area in the village of Muć (56 subjects). A total of 139 subjects suffering from insomnia and using zolpidem 5 mg and 10 mg were included in the study. The data on demographic parameters (age and gender) and comorbid conditions were collected from the patients’ medical records and analysed using descriptive statistical methods and χ² test. Results: There were more women (48, or 57%) than men treated for insomnia in the urban general practice office, whereas more men (45, or 80%) than women were treated for insomnia in the rural general practice office. There were significant differences between three age groups, i.e., those aged over 70, those aged between 50 and 70, and those younger than 50 years. Insomnia in the subjects from the city’s general practice office was significantly more often associated with hypertension and malignant diseases, whereas insomnia in the subjects from rural general practice was significantly more often associated with post-traumatic stress disorder. Conclusions: Treatment for insomnia was more often prescribed to women in the urban area and men in the rural area. Insomnia was more frequent in elderly people, patients with hypertension or malignant diseases and men suffering from post-traumatic stress disorder. 

Key words:
chronic disease; general practice; sleep initiation and maintenance disorders