Campbell Rebecca L, Bridges Ana J
Department of Psychology, University of Arizona, Tucson, AZ 85721, USA.
Department of Psychological Science, University of Arkansas, Fayetteville, AR 72701, USA.
J Clin Med. 2024 Sep 23;13(18):5629. doi: 10.3390/jcm13185629.
Insomnia is prevalent in primary care and associated with co-morbid physical and mental health conditions and poor health outcomes. While there are effective treatments for insomnia in specialty mental health care, many patients have difficulty accessing these interventions. To begin, patients do not always report their sleep challenges to physicians; meanwhile, primary care providers often do not screen for insomnia symptoms. Furthermore, patients may experience several barriers to accessing specialty care for insomnia treatment, such as a limited number of available providers, financial burden, lack of transportation, and low perceptions of treatment effectiveness. Primary care behavioral health (PCBH) is well-equipped to address the challenges of accessing evidence-based care for insomnia through (1) identifying sleep issues, (2) providing psychoeducation on the possible treatments for insomnia, (3) intervening with poor sleep habits and acute insomnia early to prevent chronic insomnia, and (4) delivering appropriate evidence-based interventions for chronic insomnia. Primary care clinics should leverage behavioral health providers to increase screening and embed interventions into routine care for the benefit of improved outcomes for patients with insomnia and other sleep challenges.
失眠在初级医疗保健中很普遍,且与共病的身心健康状况及不良健康结果相关。虽然在专科心理健康护理中有有效的失眠治疗方法,但许多患者难以获得这些干预措施。首先,患者并不总是向医生报告他们的睡眠问题;与此同时,初级医疗保健提供者通常不筛查失眠症状。此外,患者在获得失眠专科护理治疗时可能会遇到几个障碍,例如可用提供者数量有限、经济负担、缺乏交通工具以及对治疗效果的低认知度。初级医疗保健行为健康(PCBH)有能力通过以下方式应对获得基于证据的失眠护理的挑战:(1)识别睡眠问题;(2)提供关于失眠可能治疗方法的心理教育;(3)早期干预不良睡眠习惯和急性失眠以预防慢性失眠;(4)为慢性失眠提供适当的基于证据的干预措施。初级医疗保健诊所应利用行为健康提供者来增加筛查,并将干预措施纳入常规护理,以改善失眠患者和其他睡眠问题患者的治疗效果。