IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i16p8573-d614077.html
   My bibliography  Save this article

Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis

Author

Listed:
  • Adam D. Bramoweth

    (VISN 4 Mental Illness Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Research Office Building (151RU/MIRECC), University Drive, Pittsburgh, PA 15240, USA
    Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Research Office Building (151C), University Drive, Pittsburgh, PA 15240, USA
    Current Address: Research Office Building (151RU/MIRECC), University Drive C, Pittsburgh, PA 15240, USA.)

  • Caitlan A. Tighe

    (VISN 4 Mental Illness Research, Education and Clinical Center, VA Pittsburgh Healthcare System, Research Office Building (151RU/MIRECC), University Drive, Pittsburgh, PA 15240, USA)

  • Gregory S. Berlin

    (VA Connecticut Healthcare System, 950 Campbell Avenue (116B), West Haven, CT 06516, USA
    Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06511, USA)

Abstract

The objective was to examine insomnia and insomnia-related care within a regional network of Department of Veterans Affairs (VA) facilities since the VA roll-out of cognitive behavioral therapy for insomnia (CBT-I) in 2011. A retrospective analysis of VA electronic health records (EHR) data from 2011 to 2019 was conducted. The annual and overall prevalence of four insomnia indicators was measured: diagnoses, medications, consultations for assessment/treatment, and participation in CBT-I. Also examined were sociodemographic and clinical differences among veterans with and without an insomnia indicator, as well as differences among the four individual insomnia indicators. The sample included 439,887 veterans, with 17% identified by one of the four indicators; medications was most common (15%), followed by diagnoses (6%), consults (1.5%), and CBT-I (0.6%). Trends over time included increasing yearly rates for diagnoses, consults, and CBT-I, and decreasing rates for medications. Significant differences were identified between the sociodemographic and clinical variables across indicators. An evaluation of a large sample of veterans identified that prescription sleep medications remain the best way to identify veterans with insomnia. Furthermore, insomnia continues to be under-diagnosed, per VA EHR data, which may have implications for treatment consistent with clinical practice guidelines and may negatively impact veteran health.

Suggested Citation

  • Adam D. Bramoweth & Caitlan A. Tighe & Gregory S. Berlin, 2021. "Insomnia and Insomnia-Related Care in the Department of Veterans Affairs: An Electronic Health Record Analysis," IJERPH, MDPI, vol. 18(16), pages 1-11, August.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8573-:d:614077
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/16/8573/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/16/8573/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Adam D. Bramoweth & James Luther & Barbara H. Hanusa & Jon D. Walker & Charles W. Atwood & Anne Germain, 2018. "Clinical Characterization of Insomnia among Veterans with PTSD: Identifying Risk Factors for Diagnosis and Treatment with Sedative-Hypnotics," Defence and Peace Economics, Taylor & Francis Journals, vol. 29(1), pages 78-90, January.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.

      More about this item

      Keywords

      ;
      ;
      ;
      ;
      ;

      Statistics

      Access and download statistics

      Corrections

      All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:16:p:8573-:d:614077. See general information about how to correct material in RePEc.

      If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

      If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

      If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

      For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

      Please note that corrections may take a couple of weeks to filter through the various RePEc services.

      IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.