Artikel
Real-world data on persons self-reporting an insomnia diagnosis by a physician in Germany: Results of a pre-planned subgroup analysis of the EU National Health and Wellness Survey (NHWS)
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Veröffentlicht: | 30. September 2022 |
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Background and status of (inter)national research: People suffering from insomnia disorder have an increased risk of mental disorders, metabolic disorders, immuno and inflammatory system dysfunctioning and neurodegeneration. Absenteeism rates in Germany are approx. 3 times higher compared to persons without insomnia disorder. Therefore, the appropriate diagnosis and therapy of insomnia disorder is an essential medical and societal need.
Research question and objective: The objective of this pre-planned subgroup analysis of persons from Germany participating in a European survey was to assess real-world reports on insomnia diagnosis and medication treatment in Germany, using self-reported data.
Method or hypothesis: Data derived from the German participants of the 2020 EU (N=10,034) National Health and Wellness Survey (NHWS), which is a patient-reported survey administered yearly to a demographically representative sample of adults (with respect to age, sex, and region), were used. Information obtained from respondents who self-reported a diagnosis of insomnia confirmed by a physician (and no other sleep difficulties) and being on treatment with prescribed medicines for their insomnia (diagnosed & treated, DT; N=138), as well as diagnosed respondents that are not treated with prescribed medicines (diagnosed & untreated, DUt; N=394) were collected. Severity of insomnia was measured by Insomnia Severity Index (ISI).
Results: Insomnia was no/subthreshold, moderate or severe in 45%, 36% and 19% of DT, and 50%, 39% and 11% of DUt respondents, respectively. 35% of DT respondents reported to be treated with benzodiazepines or Z-drugs, and 65% with off-label medications. No information regarding cognitive behavioral therapy had been collected. DT had experienced mean±SD (median; 25th/75th percentile) 237±139 (290; 110/360) days of insomnia in the previous 12 months, while DUt had a mean of 200±137 (180; 63/360) days. The time since diagnosis of insomnia by a physician, as per mean±SD (median; 25th/75th percentile) was 8.1±7.7 (5.5; 2.0/11.0) years in DT, and 8.4±10.2 (5.0; 2.0/10.0) years in DUt. As for the DUt cohort, 72% had never taken a prescribed medicine for their insomnia, and 16% reported that the doctor ever recommended a prescription medicine for treatment of their insomnia.
Discussion: The proportion of respondents who had moderate to severe insomnia was comparable with 54% in DT, and 50% in DUt. Amongst persons diagnosed with insomnia there seems to be a substantial proportion that is not treated with prescribed medicines. The reasons for respondents being treated off-label or not being treated with medication cannot be identified based on the available data, which are self-reported.
Practical implications: The disease duration as well as the time since diagnosis reported is very long and is comparable in both groups (DT and DUt).
Appeal for practice (science and/or care) in one sentence: As the burden of insomnia to persons affected is substantial, the data indicate a high unmet medical need in Germany.
Funding: Sonstige Förderung; Idorsia Ltd., Allschwil, Schweiz