Assessment of Clinicians’ Knowledge and Attitudes Regarding Sleep Quality of Their Gastrointestinal Patients

Abstract

Introduction: Previous studies have shown that primary physicians understand the importance of sleep quality assessment, but few take a sleep history or provide sleep hygiene education to their patients. Given the high prevalence of sleep disturbances in patients with gastrointestinal (GI) disease, in particular patients with inflammatory bowel disease (IBD), we sought to evaluate clinician’s understanding of sleep disturbances in their GI patients. Methods: This is a prospective survey study administered to clinicians who care for GI patients at the university of Chicago and those attending a GI CME meeting in Chicago. The survey included demographic questions and questions about knowledge of sleep disturbances in GI diseases and the impact of patient related factors on sleep, including patients with IBD, evaluation of a sleep history, counseling about sleep hygiene and training received in sleep evaluation. Simple statistics were performed. Results: We received responses for 67 of 157 (43%) distributed surveys. The majority of respondents were <45 years old, 42% were female, and majority were attending physicians (64%) who practiced in a group outpatient private practice (36%) or academic setting (33%). Fifty-three percent of respondents saw more than 21 GI patients weekly. Fifty-seven percent believe that taking a sleep history is important and the majority (95%) stated they feel comfortable taking a sleep history, but only 36% take one on a regular basis. They felt that primary care physicians (79%) or gastroenterologists (60%) should perform a sleep history. Fifty-seven percent recognize the high prevalence of sleep disturbances in the general population, attributing the causes to obstructive sleep apnea, restless leg syndrome, or secondary insomnia. Clinicians believed that obesity had the greatest impact on sleep quality, followed by depression/anxiety, and stress. More importantly 92% felt that poor sleep quality had significant impact on patients’ quality of life. Of Clinicians, 51/67 (76%) care for IBD patients, and felt IBD patients’ sleep disruption was similar to the general population. Fifty-five percent said that taking sleep history was essential in the evaluation of IBD patients, but only 33% take a sleep history on regular basis. Majority thought that active disease played a large role in sleep quality in IBD patients. Few indicated that they have received any formal sleep training, and 79% would like to receive further sleep education. Fifty-five percent provided sleep hygiene education to their patients, 32% indicated they felt uncomfortable providing sleep education to patients. Conclusion: A large percentage of clinicians believe that taking a sleep history is important, but few ask about sleep quality on a regular basis. Given the high prevalence of sleep complaints in patients with GI illnesses, the recognition of sleep disruption and sleep hygiene education is essential in the comprehensive care of GI patients.