title: Characteristics of insomnia in a primary care setting: EQUINOX survey of 5293 insomniacs from 10 countries.
abstract: OBJECTIVE
  To describe the characteristics of insomnia in primary care physicians' (PCPs') practices in 10 countries and to understand how the difficulty of maintaining sleep (DMS) was or was not associated with other insomnia symptoms such as difficulty initiating sleep (DIS), early morning awakenings (EMA) or nonrestorative sleep (NRS) in PCPs patients with insomnia.
  
  
  METHODS
  International, noninterventional, cross-sectional, observational survey conducted in a primary care setting in subjects complaining of sleep disturbances in 10 countries. A questionnaire based on DSM-IV and ICSD criteria was administered.
  
  
  RESULTS
  Thirteen thousand one hundred twenty-four subjects were enrolled by 647 physicians; 5293 of them (32.6%) had insomnia and were surveyed. The population was predominantly female (63.9%) with a mean age of 47.8±15.3 years; 39.9% of these patients have already been treated for sleep difficulties. Combination of all types of insomnia symptoms (DIS+DMS+EMA+NRS) was the most frequently reported combination (38.6% of the subjects), while the percentage of subjects presenting with only one type of insomnia symptom (DIS, DMS, EMA or NRS) was very low: 3%, 1.8%, 0.9% and 1.4% respectively. DMS was on average the most commonly reported insomnia symptom (80.2%). Multiple logistic regression showed that DMS, EMA and NRS symptoms were significantly linked with each other and also to other insomnia criteria (sleep satisfaction, sleep quality, sleep duration, number of hours of sleep, frequency of insomnia symptoms, wake up rested / unrested and non restorative sleep).
  
  
  CONCLUSIONS
  Patients visiting PCPs with insomnia are likely to present with severe and poly-symptomatic insomnia.
authors.affiliation: Université Paris Descartes, APHP, Centre du Sommeil et de la Vigilance, Hôtel Dieu de Paris, 75004 Paris, France. damien.leger@htd.aphp.fr
authors.forename: Damien
authors.initials: D
authors.lastname: Léger
authors.forename: Markku
authors.initials: M
authors.lastname: Partinen
authors.forename: Max
authors.initials: M
authors.lastname: Hirshkowitz
authors.forename: Sudhansu
authors.initials: S
authors.lastname: Chokroverty
authors.forename: Jan
authors.initials: J
authors.lastname: Hedner
mesh_terms: D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D014943:Global Health; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*