National use of prescription medications for insomnia: NHANES 1999-2010.
OBJECTIVE
To determine current patterns and predictors of use of prescription medications commonly used for insomnia (MCUFI) in the U.S.


METHODS
Cross-sectional study.


METHODS
National Health and Nutrition Examination Survey, 1999-2010.


METHODS
32,328 noninstitutionalized community-dwelling U.S. adults.


METHODS
N/A.


RESULTS
WE DEFINED MCUFI USE AS USE OF ANY OF THE FOLLOWING MEDICATIONS IN THE PRECEDING MONTH: benzodiazepine receptor agonists (eszopiclone, zaleplon, zolpidem, estazolam, flurazepam, quazepam, temazepam, triazolam), barbiturates (amobarbital, amobarbitalsecobarbital, chloral hydrate), doxepin, quetiapine, ramelteon, and trazodone. We estimated prevalence of MCUFI use and concurrent use of another sedating medication. We determined predictors of MCUFI use using multivariate logistic regression. Overall, 3% percent of adults used a MCUFI within the preceding month. Zolpidem and trazodone were used most commonly. Overall MCUFI use increased between 1999-2000 and 2009-2010 (P value for trend < 0.001). Concurrent use of other sedating medications was high, with 55% of MCUFI users taking at least one other sedating medication and 10% taking ≥ 3 other sedating medications. Concurrent use of MCUFIs with opioids (24.6%) and non-MCUFI benzodiazepines (19.5%) were most common. After adjustment, adults seeing a mental health provider (aOR 4.68, 95% C.I. 3.79, 5.77), using other sedating medications (aOR 4.18, 95% C.I. 3.36, 5.19), and age ≥ 80 years (aOR 2.55, 95% C.I. 1.63, 4.01) had highest likelihood of MCUFI use.


CONCLUSIONS
In this nationally representative sample, reported use of prescription medications commonly used for insomnia (MCUFIs) within the preceding month was common, particularly among older adults and those seeing a mental health provider, with high use of sedative polypharmacy among MCUFI users.
Divisions of General Medicine and Primary Care ; Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA ; Harvard Medical School, Boston, MA.
Suzanne M
SM
Bertisch
Divisions of General Medicine and Primary Care ; Harvard Medical School, Boston, MA.
Shoshana J
SJ
Herzig
Department of Psychiatry, Sleep Disorders Clinical Research Program, Massachusetts General Hospital, Boston, MA ; Harvard Medical School, Boston, MA.
John W
JW
Winkelman
Divisions of General Medicine and Primary Care ; Harvard Medical School, Boston, MA.
Catherine
C
Buettner
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D055656:Prescriptions / Q000706:statistics & numerical data*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D014481:United States; D055815:Young Adult
D006993:Hypnotics and Sedatives
Insomnia; NHANES; benzodiazepines; hypnotics and sedatives; prescription medication use; sleep disorders