Screening for sleep disorders and their medical and psychiatric comorbidities

Screening for sleep disorders and their medical and psychiatric comorbidities

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Background: Sleep disorders are common in medical out-patients.They are seldom addressed despite being known to worsen overall health of patients.Detailed evaluation to differentiate these into primary sleep disorders, psychiatric and medical co-morbidity or both can be done by a liaison Psychiatrist.Managing these is necessary for providing good quality recovery for the patient.Method: Cross-sectional survey of 148 randomly selected medical out-patients in a tertiary care hospital was carried out to assess various sleep disorders.

Pittsburgh sleep quality index was used for assessment.They were assessed by qualified psychiatrist to establish Psychiatric diagnosis by clinical #3.37 ESPRESSO interview as per ICD-10 classification.Co-occurrence of these with chronic medical problems as diagnosed by clinician was documented.Results: Sleep disorders were common in medical out-patients (48.64%).

Commonest among them was difficulty initiating sleep and reduced duration.A significant number screened to have sleep disorders, also had psychiatric co-morbidities (63.8%), Depressive disorders being the commonest (52.1%).Chronic medical illnesses were present in 50 (33.

8%) of the all patients assessed for having sleep disorders.Co-occurrence of medical and psychiatric co-morbidities was not statistically significant.Conclusion: Considering high prevalence, patients should be routinely assessed for various sleep Cushions problems by Physician and referred to Psychiatrist for management as many of them also have psychiatric co-morbidities.Physician and Psychiatrist liaison is important in managing complex medical and psychiatric co-morbidities associated with sleep disorders.