Studio Morfeo 2: Survey on the management of insomnia by Italian general practitioners

Mario Giovanni Terzano, Fabio Cirignotta, Susanna Mondini, Luigi Ferini-Strambi, Liborio Parrino, behalf of the Progetto Morfeo Committee on behalf of the Progetto Morfeo Committee

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background and purpose: To carry out an observational epidemiological survey (Studio Morfeo 2) in order to define the management procedures of insomnia in a large Italian population presenting directly to the general practitioner (GP). Patients and methods: Each GP recruited five insomniac subjects in the course of 1 week or 5 consecutive office days over a period of 2 weeks. On each office day, a brief questionnaire (Q1) including five questions investigating insomnia symptoms and current use of treatment was administered to the first 10 patients who referred to the GP office for reasons associated with their own health. The first patient of each day classified as insomniac underwent a second investigation based on a more detailed questionnaire (Q2) including demographic variables, socio-economic status, general medical conditions, severity, duration and clinical features of insomnia, daytime dysfunction, sleep satisfaction and therapeutic management. Results: In a primary care setting, insomnia symptoms are often persistent ( > 1 year), recurrent ( > 1/week) and accompanied by daytime consequences. Two out of three patients with insomnia symptoms are dissatisfied with their sleep. In most cases, insomnia symptoms are underrated both by the patients, who cover the problem or reject treatment, and by the GP, who limits intervention on the sleep disorder (scarcely modifying ongoing therapy both in responders and in non-responders). In responders, treatment was confirmed in 91% of cases and discontinued in only 2%. When there was no improvement, or if insomnia symptoms became worse (non-responders), treatment was nevertheless continued in 74.5% of cases, either maintaining the same ineffective dose, increasing the dose, or adding another drug or a non-pharmacological procedure. Regardless of specific medication, the Italian GP privileges the pharmacological approach, which is fourfold more frequent than non-pharmacological therapy (78.6 versus 18.2%). Non-benzodiazepine hypnotic drugs are mostly prescribed when the GP decides to apply medication in previously untreated patients with insomnia symptoms. Self-administration is not unusual among the patients with insomnia symptoms and is more common among non-responders. Conclusions: Italian GPs tend to confirm the ongoing therapy and avoid re-evaluation of the treatment regimen. Limited use of non-pharmacological treatment in the Italian primary care setting is in line with this conservative approach of the GPs who tend to be problem-solvers rather than problem-seekers.

Original languageEnglish
Pages (from-to)599-606
Number of pages8
JournalSleep Medicine
Volume7
Issue number8
DOIs
Publication statusPublished - Dec 2006

Fingerprint

Sleep Initiation and Maintenance Disorders
General Practitioners
Therapeutics
Primary Health Care
Sleep
Surveys and Questionnaires
Self Administration
Hypnotics and Sedatives
Pharmaceutical Preparations
Economics
Demography
Pharmacology
Health

Keywords

  • Epidemiology
  • Healthcare
  • Hypnotic drugs
  • Insomnia
  • Primary care
  • Symptoms

ASJC Scopus subject areas

  • Dentistry(all)
  • Ophthalmology
  • Pulmonary and Respiratory Medicine
  • Neurology

Cite this

Terzano, M. G., Cirignotta, F., Mondini, S., Ferini-Strambi, L., Parrino, L., & on behalf of the Progetto Morfeo Committee, B. O. T. P. M. C. (2006). Studio Morfeo 2: Survey on the management of insomnia by Italian general practitioners. Sleep Medicine, 7(8), 599-606. https://doi.org/10.1016/j.sleep.2006.02.003

Studio Morfeo 2 : Survey on the management of insomnia by Italian general practitioners. / Terzano, Mario Giovanni; Cirignotta, Fabio; Mondini, Susanna; Ferini-Strambi, Luigi; Parrino, Liborio; on behalf of the Progetto Morfeo Committee, behalf of the Progetto Morfeo Committee.

In: Sleep Medicine, Vol. 7, No. 8, 12.2006, p. 599-606.

Research output: Contribution to journalArticle

Terzano, MG, Cirignotta, F, Mondini, S, Ferini-Strambi, L, Parrino, L & on behalf of the Progetto Morfeo Committee, BOTPMC 2006, 'Studio Morfeo 2: Survey on the management of insomnia by Italian general practitioners', Sleep Medicine, vol. 7, no. 8, pp. 599-606. https://doi.org/10.1016/j.sleep.2006.02.003
Terzano MG, Cirignotta F, Mondini S, Ferini-Strambi L, Parrino L, on behalf of the Progetto Morfeo Committee BOTPMC. Studio Morfeo 2: Survey on the management of insomnia by Italian general practitioners. Sleep Medicine. 2006 Dec;7(8):599-606. https://doi.org/10.1016/j.sleep.2006.02.003
Terzano, Mario Giovanni ; Cirignotta, Fabio ; Mondini, Susanna ; Ferini-Strambi, Luigi ; Parrino, Liborio ; on behalf of the Progetto Morfeo Committee, behalf of the Progetto Morfeo Committee. / Studio Morfeo 2 : Survey on the management of insomnia by Italian general practitioners. In: Sleep Medicine. 2006 ; Vol. 7, No. 8. pp. 599-606.
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