title: Insomnia treatment experience and preferences among veterans affairs primary care patients.
abstract: Insomnia is common, but undertreated, among primary care patients. Within the Veterans Health Administration (VA), increasing attention has been given to the treatment of insomnia within primary care settings, but little research has examined Veterans' treatment preferences. We examined preferences for sleep treatment among VA primary care patients. Participants (N = 126: 98% male, 89% white; M age = 60 years) completed a brief survey. On the basis of Insomnia Severity Index scores, 22% reported subthreshold and 13% moderate insomnia. Fifty percent reported having issues with sleep (falling asleep, staying asleep, or sleeping too much) in the past 12 months; among these, only 44% reported any discussion of medication (34%) or other strategies (32%) to improve sleep with medical providers. The most preferred treatment approach was to work it out on one's own, followed by consulting the primary care provider (PCP). The most preferred modality was a one-on-one meeting with the PCP, followed by a one-on-one meeting with the behavioral health provider. In conclusion, VA primary care patients preferred handling sleep problems on their own, but if seeking help, they preferred working with PCPs over behavioral health providers. The majority of Veterans preferred individual treatment and strategies other than medication.
authors.affiliation: Center for Integrated Healthcare (116C), Syracuse VA Medical Center, 800 Irving Avenue, Syracuse, NY 13210.
authors.forename: Robyn L
authors.initials: RL
authors.lastname: Shepardson
authors.affiliation: Center for Integrated Healthcare (116C), Syracuse VA Medical Center, 800 Irving Avenue, Syracuse, NY 13210.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Funderburk
authors.affiliation: Center for Integrated Healthcare (116C), Syracuse VA Medical Center, 800 Irving Avenue, Syracuse, NY 13210.
authors.forename: Wilfred R
authors.initials: WR
authors.lastname: Pigeon
authors.affiliation: Center for Integrated Healthcare (116C), Syracuse VA Medical Center, 800 Irving Avenue, Syracuse, NY 13210.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Maisto
mesh_terms: D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D057240:Patient Preference; D010817:Physician-Patient Relations; D058007:Physicians, Primary Care; D011320:Primary Health Care; D012648:Self Care; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000145:classification / Q000188:drug therapy / Q000628:therapy*; D014481:United States; D014728:Veterans