Insomnia in primary care—a study from India

To study the prevalence and clinical correlates of insomnia among a sample of primary care attendees, in the state of Kerala, India. Cross-sectional survey. Primary care. 7017 adult patients [18–60 years] attending 71 primary health centers selected by cluster random sampling. Patients were assessed for insomnia using the Insomnia Severity Index. In addition to self-reported socio-demographic and chronic medical illness details, structured instruments were used to assess for mental disorders, disability and life satisfaction. Subclinical insomnia and clinical insomnia were reported by 17.7% and 4.7% subjects, respectively. Subjects with subclinical and clinical insomnia when compared to those without insomnia had higher odds of having older age, female gender, urban background, lower education, chronic medical and mental disorders, greater disability and poor life satisfaction. Subjects with clinical insomnia when compared to the subclinical group had higher odds of having older age, urban background, lower education, mental disorders and greater disability. Among mental disorders, depressive disorder was correlated with both clinical and subclinical insomnia. Clinical and subclinical insomnia is common among primary care attendees and both are associated with significant morbidity. This study highlights that it is a major public health concern, albeit neglected, which needs to be dealt as a priority.