Prevalence and management of chronic insomnia in Swiss primary care: Cross‐sectional data from the “Sentinella” practice‐based research network

We investigated the prevalence and treatment of patients with chronic insomnia presenting to Swiss primary care physicians (PCPs) part of “Sentinella”, a nationwide practice‐based research network. Each PCP consecutively asked 40 patients if they had sleep complaints, documented frequency, duration, comorbidities, and reported ongoing treatment. We analysed data of 63% (83/132) of the PCPs invited. The PCPs asked 76% (2,432/3,216) of included patients about their sleep (51% female); 31% (761/2,432) of these had had insomnia symptoms; 36% (875/2,432) had current insomnia symptoms; 11% (269/2,432) met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) criteria for chronic insomnia (61% female). In all, 75% (201/269) of patients with chronic insomnia had comorbidities, with 49% (99/201) reporting depression. Chronic insomnia was treated in 78% (209/269); 70% (188/268) took medication, 38% (102/268) benzodiazepines or benzodiazepine receptor agonists, 32% (86/268) took antidepressants. Only 1% (three of 268) had been treated with cognitive behavioural therapy for insomnia (CBT‐I). A third of patients presenting for a non‐urgent visit in Swiss primary care reported insomnia symptoms and 11% met the DSM‐5 criteria for chronic insomnia. Hypnotics were the most common treatment, but almost no patients received first‐line CBT‐I. Reducing the burden of insomnia depends on disseminating knowledge about and access to CBT‐I, and encouraging PCPs to discuss it with and offer it as a first‐line treatment to patients with chronic insomnia.