Sleep-medication for symptomatic insomnia in the general population of Japan

The commercial availability of psychotropic drugs has an important effect on the consumption of medications for the symptomatic treatment of insomnia. Traditional benzodiazepines have been the most frequently prescribed psychotropic medications for promoting sleep in clinical practice in Japan. In recent years, non-diazepine drugs, antidepressant selective serotonin-reuptake inhibitors and over-the-counter sleep aids have been introduced into the Japanese pharmaceutical market. This study aimed therefore to make a poplulation-based assessment of sleep-medication use using the baseline data of a nationally representative sample of 2800 Japanese adults collected in 1997 before such changes. The Pittsburgh Sleep Quality Index was used to measue the symptoms of insomnia and the use of sleep medicine. A total of 1871 subjects participated in our analyses. The overall age-adjusted prevalence of sleep-medication use was 7.4%: 1.3%, 2.0% and 4.1% for <1 time, 1-2 times, and 3+ times per week during the past month, 6.5% and 0.9% for medically prescribed medicine and self-medicated sleeping pills, respectively. Of those with frequent insomniac symptoms, 75% remaied untreated. However, 3% of the users suggests the possibiliy of hypnotic-dependency. Over one-half of the users had multiple illnesses and consulted two or more different medical specialists. Physicians accounted for a disproportionately high percentage of all prescriptions of sleep medicine. Neuropsychiatrists replaced physicians after sociodemographic adjustments. Diabetes mellitus, heart disease, hypertension, and gastroduodenal ulcer represented the most common medical illnesses relating to sleep medication. This study drives the need to further investigate how to manage and treat individuals with insomnia. © 2005 Japanese Society of Sleep Research.