Impact of insomnia: Cultural and societal aspects from a European survey

This European study explored the cultural and societal aspects of chronic insomnia by means of a survey undertaken in France, Germany, Italy, Spain, and the United Kingdom. The primary objectives were to understand the impact of insomnia on the daily lives of patients, both personally and professionally, and to evaluate the patients' perceptions and coping strategies thus identifying cultural differences in the management of this disorder.

Based on online panels targeting insomnia sufferers, the survey included 755 patients aged 35 to 65 years with moderate to severe insomnia for at least three months, occurring at least three times per week (DSM-5 criteria for insomnia disorder, ISI score 15-28). Topics covered included the impact of insomnia on daily life, strategies for coping and managing insomnia, and patients' perceptions and views of insomnia.

A total of 755 patients completed the questionnaire. Most respondents were women (70%) and between 35 and 49 years of age (50%). About half of the patients (49%) had severe insomnia, with 49% experiencing it for over three years. Nearly 70% did not initially consider their insomnia serious, and 73% believed their condition would improve over time. Stress (39%), difficulty relaxing in the evening (37%), and a rapid flow of thoughts (37%) were identified as the main causes of insomnia. Insomnia was shown to significantly affect daily life, particularly work performance, relationships, and maintaining healthy habits. British patients were the most affected, with 85% reporting decreased work performance. In France, only 51% reported difficulties maintaining relationships. There were 77% of Britons who felt exposed to dangerous situations, such as drowsiness while driving (47%). Coping strategies varied by country but, overall, breathing exercises (43%), meditation (32%), and reducing caffeine intake (44%) were the most popular. Healthcare consultation approaches also varied. French patients consulted general practitioners (89%) but rarely specialists, while Germans consulted sleep specialists (20%) and psychiatrists (19%). Overall, 61% reported that doctors recommended lifestyle changes.

The survey highlights cultural differences in insomnia perception and management in Europe. Insomnia is often trivialized, thus delaying management. The results underline the need to raise awareness among patients and healthcare professionals of the importance of insomnia and its consequences on mental and physical health. Addressing chronic insomnia requires a multifaceted approach that includes cultural sensitivity, patient education, and proactive healthcare engagement. By understanding and integrating these elements, healthcare providers can better support patients to manage their condition, ultimately improving their quality of life.