Background: Insomnia is a rising global health concern, affecting 16.2% of adults and contributing to significant physical, psychological, and social consequences. As the first point of contact, primary care plays a crucial role in early detection and intervention. In Malaysia, data on insomnia in primary care are limited and outdated, despite evolving diagnostic criteria and recognition of its burden. This study aims to determine the prevalence and associated factors of insomnia to inform targeted prevention and management strategies.
Methods: A cross-sectional study was conducted at a university-based primary care clinic in Kuala Lumpur between December 2024 and March 2025. A total of 453 adult patients were recruited via systematic random sampling. Data collected included sociodemographic variables; depression and anxiety assessed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7); financial distress measured using the Financial Well-Being Scale (FWS); and insomnia severity using the Insomnia Severity Index (ISI). Multivariable logistic regression was performed to identify factors associated with clinical insomnia.
Results: The median age of participants was 55 years, with the majority being female (60.3%). Insomnia symptoms were present in 38.8% of participants, with 13.2% having clinical insomnia and 25.6% subthreshold insomnia. Multivariable analysis showed that clinical insomnia was significantly associated with younger age (18–34 years) [adjusted odds ratio (aOR) =3.91; 95% confidence interval (CI): 1.25–12.19; P=0.02], non-Malay ethnicity (aOR =2.52; 95% CI: 1.30–4.89; P=0.006), financial distress (aOR =3.08; 95% CI: 1.15–8.34; P=0.03), and the presence of depression or anxiety (aOR =6.25; 95% CI: 3.06–12.73; P<0.001).
Conclusions: Insomnia is highly prevalent in primary care and is associated with younger age, non-Malay ethnicity, and financial and psychological distress. These findings provide updated prevalence estimates and highlight the need for greater recognition and awareness of insomnia in primary care settings to support early detection and more effective management.
