Sleep history is neglected diagnostic information
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Sleep problems are treatable causes of morbidity and mortality, but little is known about how often the history fundamental to diagnosis is obtained. We recorded the frequency of sleep histories during encounters with simulated patients by 20 experienced primary care practitioners, 23 uninstructed medical interns, and 22 interns who had previous instruction about sleep disorders. Sleep histories were uncommonly obtained by uninstructed physicians (0% of practitioners, 13% of interns), but trained interns more often (81.8%) asked about sleep. If sleep problems are to be prioritized, major changes in physician education and behaviors are essential. Focused instruction about sleep influences physician behavior.
- National Commission on Sleep Disorders Research: Wake Up America: A National Sleep Alert. January, 1993.
- Dement WC, Mitler MM. It’s time to wake up to the importance of sleep disorders. JAMA. 1993;269:1548–9. CrossRef
- Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA. 1989;262:1479–84. CrossRef
- Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5. CrossRef
- Hla KM, Young TB, Bidwell T, Palta M, Skatrud JB, Dempsey J. Sleep apnea and hypertension. A population-based study. Ann Intern Med. 1994;120:382–8.
- Phillipson EA. Sleep-apnea—a major public health problem. N Engl J Med. 1993;328:1271–3. CrossRef
- Orr WC, Stahl ML, Dement WC, Reddington D. Physician education in sleep disorders. J Med Educ. 1980;55:367–9.
- Medical School Curriculum Task Force, Association of Professional Sleep Societies. The Medical School Curriculum Consensus Workshop: consensus document. Sleep. 1988;11:566–70.
- Rosen RC, Rosekind M, Rolsevear C, Cole WE, Dement WC. Physician education in sleep and sleep disorders: a national survey of U.S. medical schools. Sleep. 1993;16:249–54.
- Coleman RM, Zarcone VP, Redington D, et al. Sleep-wake disorders in a family practice clinic. Sleep Res. 1980;9:192.
- Haponik EF. Sleep problems of elderly persons: clinicians’ perspectives. Sleep. 1992;15:168–72.
- Everitt DE, Avorn J, Baker MW. Clinical decision-making in the evaluation and treatment of insomnia. Am J Med. 1990;89:357–62. CrossRef
- Martin C, Zarcone V, LaBarber G, et al. Insomnia as presented to the private practice of a general physician. Sleep Res. 1979;8:201.
- Norman GR, Neufeld VR, Walsh A, Woodward CAM, McConvey GA. Measuring physicians’ performances by using simulated patients. J Med Educ. 1985;60:925–34.
- Stillman PL, Swanson DB, Smee S, et al. Assessing clinical skills of residents with standardized patients. Ann Intern Med. 1986;105:762–71.
- Stillman PL, Swanson DB. Ensuring the clinical competence of medical school graduates through standardized patients. Arch Intern Med. 1987;147:1049–52. CrossRef
- Strohl KP, Redline S. Recognition of obstructive sleep apnea. Am J Respir Crit Care Med. 1996;154:279–89.
- Crocker BD, Olson LG, Saunders NA, et al. Estimation of the probability of disturbed breathing during sleep before a sleep study. Am Rev Respir Dis. 1990;142:14–8.
- Hoffstein V, Szalai JP. Predictive value of clinical features in diagnosing obstructive sleep apnea. Sleep. 1993;16:118–22.
- Haponik EF, Camp G. I SNORED: a simple sleep history for clinicians. Am J Respir Crit Care Med. 1994;149:A53. Abstract.
- Sleep history is neglected diagnostic information
Journal of General Internal Medicine
Volume 11, Issue 12 , pp 759-761
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- sleep problems
- sleep histories
- physician education
- Industry Sectors
- Author Affiliations
- 1. Section on Pulmonary/Critical Care, Department of Medicine, Bowman Gray School of Medicine, Medical Center Blvd., 27157, Winston-Salem, NC
- 2. Office of Educational Research and Services, Bowman Gray School of Medicine, Winston-Salem, NC
- 3. the Department of Internal Medicine, Bowman Gray School of Medicine, Winston-Salem, NC
- 4. Department of Dermatology, Bowman Gray School of Medicine, Winston-Salem, NC
- 5. Department of Family and Community Medicine, Bowman Gray School of Medicine, Winston-Salem, NC
- 6. Department of Psychiatry, Bowman Gray School of Medicine, Winston-Salem, NC
- 7. Department of Family Medicine, Bowman Gray School of Medicine, Winston-Salem, NC
- 8. Carolinas Medical Center, 28232-2861, Charlotte, NC