Primary Care Records and Population Prevalence of Chronic Insomnia: Do They Match?

Background/Objectives: Chronic insomnia is a widespread condition with significant health implications, yet it is often underdiagnosed in clinical practice. This study aims to evaluate how well the prevalence of chronic insomnia documented in primary care records aligns with estimates from population-based surveys, assessing the diagnostic reliability of healthcare services. Methods: We conducted a comparative analysis using two data sources: the EPINSOM cross-sectional survey, which applied ICSD-3 criteria to estimate insomnia prevalence in a representative Spanish adult population, and primary care electronic health records from the SIDIAP database, which includes anonymized records for approximately 80% of Catalonia’s population. Individuals with major psychiatric, neurological, or oncological comorbidities were excluded. Prevalence rates by age and sex were statistically compared using z-tests for independent samples. Results: In Catalonia, the survey estimated the prevalence of chronic insomnia disorder at 13.6%, while primary care records reported significantly lower rates (5.1%) among adults. Discrepancies were consistent across all age groups, except in those aged ≥55 years, where prevalence rates were more aligned (18.2% clinical vs. 18.2% survey). Women were more frequently diagnosed in both datasets. Survey-derived prevalence of insomnia symptoms reached 41.39%, highlighting substantial underrecognition in clinical practice.Conclusions: Primary care electronic records substantially underestimate insomnia prevalence compared with population-based estimates, suggesting underdiagnosis, especially among younger adults. Enhanced training in sleep disorders for primary care professionals and better integration of standardized diagnostic protocols may improve detection and treatment of this common condition.