ArticleBMJ open2025
A modified Delphi consensus to reframe and prioritise the management of chronic insomnia in UK primary care.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
objectivesChronic insomnia is a prevalent but under-recognised sleep disorder in the UK, affecting 6.8%-14.9% of adults. It is associated with significant health and economic burdens, yet remains under-diagnosed and poorly managed in primary care. This study aimed to address key gaps in the understanding, diagnosis and management of chronic insomnia and to develop consensus-based recommendations to optimise care pathways across the National Health Service.
designA modified Delphi consensus study.
settingUK primary care, involving general practitioners, pharmacists and sleep specialists.
participantsA multidisciplinary steering group of seven UK healthcare professionals (HCPs) with expertise in chronic insomnia developed 39 statements. These were tested in a two-round Delphi survey distributed to a panel of 201 HCPs. Consensus was defined as ≥75% agreement on a 4-point Likert scale.
resultsConsensus was reached for 37 of the 39 statements. Key findings included the recognition of chronic insomnia as a distinct chronic condition, the recommendation to include routine sleep-related screening in primary care and the need for increased HCP training in cognitive behavioural therapy for insomnia and pharmacological treatment. Respondents highlighted the necessity for greater awareness and public engagement regarding insomnia and its treatment options. In spite of mitigating biases, responses may have been subject to acquiescence bias.
conclusionsThe study identifies systemic barriers to effective insomnia care and calls for chronic insomnia to be prioritised in UK primary care. The resulting consensus recommendations aim to reduce the burden of untreated insomnia, improve patient outcomes, enhance healthcare delivery and increase economic productivity.
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