Women, older adults and people with lower incomes are more likely to use sleep medication, survey finds, despite potential health harms

Women, older adults and people with lower incomes are more likely to use sleep medication, survey finds, despite potential health harms


Millions of Americans say they regularly turn to drugs to fall asleep or stay asleep, a practice that experts say can be dangerous to their health. A new study found that about 8% of U.S. adults reported taking sleep medication every day or most days, with use more common among women, the elderly, or those with lower incomes. .

The data summary, released Wednesday by the US Centers for Disease Control and Prevention’s National Center for Health Statistics, analyzed sleep medication use data from more than 30,549 US adults that were collected by the National Health Interview Survey in 2020.

The researchers defined sleep medication use as taking any medication, either prescription or over-the-counter, to help you fall asleep or stay asleep on most days or every day in the past 30 days.

They found that women were more likely to take sleep medication than men across all age, race, ethnicity and income groups. Use of sleep medication was also highest among older adults, with 11.9% of those 65 and older saying they use a sleep aid every night or most nights.

Sleep medication use decreased as household income increased, from 10% among adults below the federal poverty level to 8.2% among those earning two or more times the federal poverty level.

“Previous research has found similar relationships,” said study co-author Lindsey Black, a researcher at the National Center for Health Statistics. “This report is useful in documenting the most recent prevalence estimates of adult sleep medication use and confirming that these differences still persist.”

Dr. Nishi Bhopal, a psychiatrist and sleep medicine physician, says these findings are concerning for a number of reasons.

“In women, sleep problems are often misdiagnosed. I see this in my clinical practice, where women can be diagnosed with insomnia when they actually have sleep apnea, because sleep apnea can manifest very differently in women than in men,” said Bhopal, who was not involved. in the new study. study.

Bhopal also found it alarming that the greatest use of sleeping pills was among older adults, for whom they are generally not recommended.

“Sleeping pills have many side effects, and older adults are more likely to experience the negative effects of these medications. These include things like confusion, risk of falls, broken bones, and even increased risk of cognitive problems like dementia. And so to see the higher rate of use in this population is worrisome.”

He added that “it is surprising, but not surprising” that the use of sleep medications increased with declining income. Other investigations has found that people with higher rates of financial stress and debt have more trouble sleeping and are more likely to be prescribed sleep medications.

Experts say that sleep medications can be useful tools when used for their intended purpose. They can be helpful for people experiencing acute stressors that make it difficult to sleep, such as divorce, job loss, or bereavement.

“It’s really important that we support patients the best way we can, because insomnia can lead to depression and anxiety,” Bhopal said. “So sleeping pills can be really helpful in that setting, but it’s not recommended to use them for more than two weeks.”

Using a sleep medication every day can lead to problems such as tolerance, where the body physically requires a higher dose of the drug to take effect, or dependency, where stopping the drug causes withdrawal symptoms such as seizures. People can also have rebound insomnia, which means they can’t sleep without the medicine.

Like lack of sleep itself, the constant use of sleep medications can have serious health consequences.

Research has found that older people who regularly take sedative-hypnotics have a five times higher risk of memory and concentration problems and a four times higher risk of daytime fatigue and sleepiness, which can lead to poor work performance or increased risk of car accidents.

Bhopal recommends using sleep medications “for the shortest possible time, in the minimum doses necessary. We will try to use them intermittently for support while we work on good behavior strategies and address the other issues that are contributing to their sleep problems,” he said.

Those behavioral strategies include maintaining a consistent sleep schedule, exercising regularly, managing stress during the day, and limiting caffeine and alcohol at night.

For those who continue to have difficulty sleeping, Bhopal says that cognitive behavioral therapy for insomnia can help.

“CBTI is the gold standard first-line treatment for chronic insomnia. It is much more than sleep hygiene. It actually addresses the issues that perpetuate insomnia and helps people reframe their thinking about sleep, and also gives them very practical tools to help restore their natural type of sleep-wake cycle.”

If you consistently have trouble sleeping, talk to your doctor to identify possible root causes.

“I think the main thing is not to be afraid to talk to your doctor about your sleep issues,” Bhopal said, “and ask about cognitive behavioral insomnia, ask about sleep apnea, ask about restless legs syndrome if you think has any of those conditions.”

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