A study recently published in the Journal of the American Board of Family Medicine found that over one-third of adults who visit a primary care practice have sleep problems.
As summarized by the American College of Physicians:
34% woke up at least three times a night
14% had symptoms of sleep apnea
28% had symptoms of restless legs syndrome at least weekly
55% felt sleepy at least once a week during daily activities
37% dozed off at least once a week during daily activities
33% snored loudly at least once a week
Not all of the complaints could be attributed to specific sleep disorders such as obstructive sleep apnea or restless leg syndrome. Pain was a common cause of sleep disturbance. However, it is often difficult to tell if pain alone is causing the sleep disturbance:
Chronic back pain, arthritis, and joint pain and stiffness were associated with all of the sleep complaints studied. This finding is consistent with clinical research indicating the connection between pain and sleep disturbance21; however, in these analyses, it is impossible to determine which preceded or caused the other.22 Our analyses also identified increased risk of OSAS in patients with musculoskeletal pain. The cause of this relationship is unclear, but it can be postulated that disability and medications (especially opioids) may contribute to sleep apnea. RLS symptoms were also significant in patients with pain, a finding that mirrors others in the literature.23 Thus, a plan that addresses the sleep complaints as well as the pain can optimize the treatment of pain and improve quality of life.
Sleep disturbance is common in primary care patients. In many cases, the primary care physican can evaluate and treat the problem. In difficult cases, or when sleep apnea is suspected, referral to a sleep specialist is indicated.