Unfortunately, this news makes a lot of sense to me: Sleep problems are extremely common, yet they go dramatically under-reported by patients and under-diagnosed by physicians. In addition, people with sleep problems are significantly more likely to require health-care treatment, including hospitalization, according to findings from an analysis of sleep data from the National Health and Nutrition Examination Survey (NHANES), a national survey that is conducted annually and covers a range of health and nutrition topics. The data used in this recent analysis represents the first time the survey has included questions specifically addressing sleep. The results shed important light on just how common problems with sleep are—and just how many are going undiagnosed and untreated.
Slightly more than 2,000 men and women participated in the sleep portion of the survey. The respondents had an average age of 46, and they all rated their own health as either “excellent,” “good,” or “very good.” Among this group, nearly everyone—99 percent—reported at least one sleep complaint. And many people reported multiple difficulties: the average number of sleep complaints per respondent was 4.2. The survey analysis also revealed:
- 54% don’t feel they are getting enough sleep
- 45% said they snore
- 45% suffer from excessive daytime sleepiness
- 37% have trouble falling asleep
- 12% experience some form of gasping or apnea while sleeping
Here’s where the numbers get even more troubling. Of those 99% who struggle with a sleep problem, only 24% told their doctors about their difficulty with sleep. This leads directly to the next problem revealed by this recent analysis: sleep problems are dramatically under-diagnosed. Researchers found that:
- 1% of respondents had been diagnosed with insomnia, yet 37% had possible insomnia
- 4.6% had received a sleep apnea diagnosis, but 33% had possible sleep apnea
We know that living with a sleep disorder can have serious consequences for your health. So it’s not surprising that the survey analysis also found people with sleep problems were significantly more likely to require a health-care visit of some type than those who slept without difficulty. Among those with sleep problems:
- 85% made some type of health-care visit in the past year, compared to 59% of those without sleep complaints
- 16% were hospitalized in the past year, compared to 8% of problem-free sleepers
- 20% required at least one mental-health visit, compared to 5% of those without sleep problems
- 14% missed at least 6 or more days of work, compared to 7% of those who slept without difficulty
- Those who slept fewer than 5 hours or more than 9 hours had the highest rates of reliance on health care.
- People with sleep problems were more likely to suffer from an array of chronic diseases, including cancer, cardiovascular problems, depression and diabetes.
These numbers are pretty staggering. For health-care professionals, the message is clear: make sleep a priority! Assessing sleep habits—and looking for possible problems with sleep—should be as essential to a patient’s exam as measuring blood pressure. I know there are many health-care providers who already give sleep issues the attention they deserve. With so many sleep disorders going undiagnosed, however, it’s clear that sleep is often getting left off the examination table.
The responsibility belongs not just to health care professionals. Your health—and your sleep—is in your hands. Here are some steps you can take to make sure your sleep is getting the attention it deserves:
Don’t ignore the snore. The first step in protecting and improving the quality of your sleep is to be attentive to your symptoms. Snoring, daytime tiredness, fatigue, irritability, lack of focus: these are all signs of sleep deficiencies that are often brushed aside.
Talk to your doctor. This one is a no-brainer. If you’ve noticed any signs or symptoms of disordered sleep, take your concerns to your physician. We all must be our own first advocate for our health: if you feel your sleep concerns are not being taken seriously, be persistent and, if necessary, seek out a health-care provider who will.
Commit to a sleep routine. Sleep is a critical factor in your mental and physical health, along with diet and exercise. Creating a sleep schedule that you can stick to, and that allows you to sleep 6-8 hours per night,
Kids count, too. Sleep problems are not exclusive to adults. Sleep difficulties can start even in very young children—and so can the consequences to their health. Helping your children develop strong sleep habits will help protect their health now and over the long term.
Doctors and patients: let’s get the sleep conversation started.
Michael J. Breus, PhD
The Sleep Doctor™
Everything you do, you do better with a good night’s sleep™