Despite these steep economic, medical, and personal health burdens, sleep is rarely assessed in routine clinician-patient medical encounters. A recent survey of American primary care physicians found that 33% of PCPs never asked their patients about their sleep habits. It is a two-way problem, since over 55% of adults with sleep problems never report sleep issues to their physician .
One bottleneck in this stalemate is a lack of available knowledge, skills, and systems-related support for clinicians. This situation is compound by low rates of patient awareness of the causal health implications of poor sleep, and knowledge that there are effective treatments . Of relevance for disparities in medical care, Black, indigenous, and multiracial patients more frequently suffer from insufficient sleep duration compared with non-Hispanic White patients .
Rather than attempting to assess for the full panoply of sleep disorders, we suggest an alternate approach that involves the clinician asking their patient about their subjective degree of sleep health. In this context, the RU-SATED scale represents a short and simple starting point . Patients are instructed to rate their subjective sleep regularity, satisfaction with sleep, daytime alertness, ability to remain asleep during the night , sleep efficiency, and sleep duration.
Universal administration of the RU-SATED scale , the clinician can identify patients who may be at higher risk of having a sleep disorder. A “positive” score on the RU-SATED should prompt the clinician to ask the patient about the specific symptoms they are experiencing as they relate to sleep quantity and quality. Using this information, the patient can then be offered a more specific, validated sleep disorder scale or referral to a sleep specialist.