Sleep Screening in Adults, Ages Eighteen to Sixty-Five, in Primary Care Settings

Background: Insomnia contributes to the deterioration of health, diminishes the quality of life, and increases the risk of injury. Despite being a common sleep disorder among adults, it is not frequently recognized due to the lack of sleep screening consensus. Purpose: The aim of this project was to implement an evidence-based assessment tool, the Insomnia Severity Index (ISI), at a primary care providers’ office to standardize sleep screenings. Methods: The quality improvement project was guided by Lewin’s Theory of Change. This screening project provided a background, purpose, and utilization of the ISI screening tool to a medical team consisting of one physician, two nurse practitioners, three nurses, and three medical assistants. The ISI screening tool was then implemented on patients, ages 18 to 65, in October 2021, during their annual physical exams. Results: A substantial increase was found in the number of patients who were screened for insomnia when compared with the data from prior years; In 2021, 36/96 (37.50%) patients were screened for insomnia and 3/36 (8.33%) of the screenings were invalidated due to patients not answering ≥2 more questions of the ISI screening tool. A total of 33/96 (34.37%) of the adult visits were included in this project. Whilen 2020, 10/65 (15.38%), and in 2019, 7/81 (8.64%). Conversely, there was a decrease in the number of patients who, although scoring 15 or above on the ISI (positive diagnosis of insomnia), received medical treatment; in 2021, 2/33 (6.01%), in 2020, 6/65 (9.23%), and in 2019, 7/81 (8.64%). Conclusions: Comparing 2021, 36/96 (37.50%), and 2019, 7/81 (8.64%), there was an increased rate of 333.9% of sleep screening rates and in 2020, 10/65 (15.38%), there was an increased rate of 143.82% of sleep screening rates; suggesting sleep screenings can be implemented in primary care settings for the treatment of insomnia. Keywords: insomnia, sleep disorder, sleep disturbance, sleep assessment, sleep screening, and insomnia diagnosis