Long-term follow-up of patients with insomnia

It has been suggested that patients with insomnia who are lost to follow-up continue to experience symptoms. From winter 2006 to spring 2007, we contacted consecutive patients initially seen at a multidisciplinary sleep medicine clinic 3 to 5 years earlier and asked them about continuing symptoms. Among the 58 patients who agreed to participate, 43 (74%) reported that they still experienced difficulty initiating and/or maintaining sleep. Thirty-one of those patients had continued to receive treatment, 11 from a sleep medicine specialist and the remainder from other physicians. The majority listed zolpidem or eszopiclone as their primary medication, and many took multiple medications, including over-the-counter drugs and alternative medications. Most patients with insomnia were unaware of cognitive-behavioral therapy. These findings emphasize the need for primary care physicians to monitor symptoms of insomnia and to remain vigilant about potential treatment complications.