Later sleep schedule and depressive symptoms are associated with usage of multiple kinds of hypnotics.
Usage of high doses of hypnotics possibly causes various adverse events. However, the risk factors of using multiple kinds of hypnotics have been inconclusive. To clarify this, we conducted a web-based cross-sectional questionnaire survey on the Japanese adult population.



A cross-sectional Internet-linked survey was conducted on 10,016 individuals and 1030 participants (10.3%) having subjective insomnia proceeded to subsequent analyses. The analyzed subjects were categorized into non-users of hypnotics (n = 833; 80.9%), users of a single kind of hypnotic (n = 96; 9.3%), and users of multiple kinds of hypnotics (n = 101; 9.8%). The descriptive variables including demographic data, scores of Center for Epidemiological Studies Depression Scale (CES-D), Short Form-8 Health-Related Quality of Life [QOL (SF-8)], Pittsburgh Sleep Quality Index (PSQI), and other parameters were compared among the groups.



The users of multiple kinds of hypnotics had the highest mean score of CES-D, the lowest mental component summary of QOL (SF-8), and the latest sleep schedule among the three groups (p < 0.001). Logistic regression analyses revealed that sex (female: OR = 2.38; p < 0.001) and age (≥43 years old: OR = 2.61; p < 0.001) were independently associated with use of a single kind of hypnotic, while later sleep schedule (midpoint of sleep ≥5:30 a.m.: OR = 2.26; p < 0.001) and higher CES-D score (≥16 points: OR = 2.41; p < 0.001) were independently associated with use of multiple kinds of hypnotics.



Characteristics of users of multiple kinds of hypnotics were different from those of users of a single kind of hypnotic.
Department of Psychiatry, Tokyo Medical University, Tokyo, Japan; Department of Somnology, Tokyo Medical University, Tokyo, Japan.
Akiyoshi
A
Shimura
Department of Psychiatry, Tokyo Medical University, Tokyo, Japan.
Yoshikazu
Y
Takaesu
Department of Somnology, Tokyo Medical University, Tokyo, Japan; Japan Society for the Promotion of Science, Tokyo, Japan.
Sayaka
S
Aritake
Department of Psychiatry, Tokyo Medical University, Tokyo, Japan; Department of Somnology, Tokyo Medical University, Tokyo, Japan.
Kunihiro
K
Futenma
Department of Somnology, Tokyo Medical University, Tokyo, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
Yoko
Y
Komada
Department of Psychiatry, Tokyo Medical University, Tokyo, Japan; Department of Somnology, Tokyo Medical University, Tokyo, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan. Electronic address: inoue@somnology.com.
Yuichi
Y
Inoue
D000328:Adult; D001569:Benzodiazepines / Q000009:adverse effects; D003430:Cross-Sectional Studies; D003863:Depression / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D012890:Sleep / Q000187:drug effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy
D006993:Hypnotics and Sedatives; D001569:Benzodiazepines
Benzodiazepine; Depression; Eveningness; Insomnia; Polypharmacy; Rhythm