After decades of steadily climbing, the use of medications to treat sleep disturbances has taken a dramatic tumble in the United States. In a new study published in the Journal of Clinical Sleep Medicine, researchers documented a 31 percent decline in the use of common sleep medications between 2013 and 2018. The team led by Dr. Christopher N Kaufmann, a University of Florida Health researcher, believes the decline is likely a result of increased awareness of the dangers posed by these medications.
This new study is quite an about-face to the market trends of previous decades that showed sleep medication use was on the rise. One study, in particular, showed that between 1993 and 2010, prescriptions for benzodiazepines (BZDs), a class of drugs commonly used to treat anxiety and insomnia that includes brand names like Valium and Xanax, and non-BZDs were on the rise.
Interestingly, the decline in the use of sleep medications was most notable among Americans over age 80. Specifically, the study showed a 86 percent decrease in the use of prescription sleep medications in this age group. And while the study found a decline in use among all drug classes, the sharpest drop was in FDA-approved sleep medications, which fell by 55 percent.
Study participants were asked to bring the drugs they had used in the previous month or provide the researchers with a pharmacy printout. For the purposes of the study, researchers focused only on medications used explicitly for insomnia and other transient sleep difficulties, categorizing them into two categories: FDA-approved sleep medications; and those used off-label for sleep disturbances. Researchers then examined the prevalence in use for sleep medications for the duration of the study.
Ultimately, researchers found that the use of prescription medications for sleep disturbance declined by 31 percent nationwide. As to what may have promoted the change, researchers point a finger at successful deprescribing and patient awareness initiatives.
Kaufman (the study’s lead researcher), told the UF Health newsroom that “ The gold standard is cognitive behavioral therapy for insomnia, a program involving multiple visits to a sleep specialist to change behaviors or poor habits that cause sleep loss.” He also acknowledged that while “behavioral treatments for insomnia are increasingly encouraged by physicians […] access to such care can be limited because of a dearth of providers.”
While the decline was mostly seen seen in older age groups, Kaufman told Sleepopolis that they didn’t find a difference in younger age groups.
“It should be noted, however, that among those ≤18 years, less than 1 percent reported using these medications, and so they simply are not using to the level that older age groups were,” Kaufman said. “The fact that use of medications for sleep disturbance declined in older age groups is encouraging especially due to concerns about the safety of these agents in this patient group.”
He also suggests that going digital may be the best way to bridge the gap. Telehealth and apps are becoming increasingly popular and for good reason. Users can access a form of CBT for their sleep disturbances that can be at least as effective or even more effective than sleep drugs.