Minori Enomoto1, Shingo Kitamura2, Hisateru Tachimori3, Masahiro Takeshima4, Kazuo Mishima5. 1. Department of Medical Technology, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan; Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan. Electronic address: enomotomr@stf.teu.ac.jp. 2. Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan. Electronic address: s-kita@ncnp.go.jp. 3. Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan. Electronic address: tachi@ncnp.go.jp. 4. Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan. Electronic address: m.takeshima@med.akita-u.ac.jp. 5. Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; International Institute for Integrative Sleep Medicine, Tsukuba, Japan. Electronic address: mishima@med.akita-u.ac.jp.
Abstract
OBJECTIVE: Patients with chronic insomnia are prone to long-term use of hypnotics. Reported risk factors include aging, female sex, and comorbid psychiatric disorders. However, most previous studies have been cross-sectional cohort studies. METHOD: We conducted a retrospective cohort study using medical service payment data for 330,000 people to determine the duration of prescription of hypnotics and the risk factors for long-term use. We followed up 3981 patients (2382 M, 1599 F, age 40.3 ± 12.4 years) who were prescribed hypnotics for the first time between April 2005 and March 2008. RESULTS: Of these 3981 patients, 59.6% were prescribed hypnotics for only 1 month, 11.3% were prescribed hypnotics for 2 consecutive months, and 10.1% of patients continued receiving prescriptions for the entire 12-month observation period. In multiple logistic time-dependent Cox analyses, use of antidepressants, mean dose of hypnotics, and advanced age were significantly associated with long-term use of hypnotics (p < 0.01). In an analysis of the association between long-term use of hypnotics and prescribed dosage, high monthly dose, advanced age, and department of first visit were significantly associated with long-term use (p < 0.01). CONCLUSION: These clinical indicators may be effective for early identification of patients with insomnia who are at high risk of developing physical dependence on hypnotics.
OBJECTIVE:Patients with chronic insomnia are prone to long-term use of hypnotics. Reported risk factors include aging, female sex, and comorbid psychiatric disorders. However, most previous studies have been cross-sectional cohort studies. METHOD: We conducted a retrospective cohort study using medical service payment data for 330,000 people to determine the duration of prescription of hypnotics and the risk factors for long-term use. We followed up 3981 patients (2382 M, 1599 F, age 40.3 ± 12.4 years) who were prescribed hypnotics for the first time between April 2005 and March 2008. RESULTS: Of these 3981 patients, 59.6% were prescribed hypnotics for only 1 month, 11.3% were prescribed hypnotics for 2 consecutive months, and 10.1% of patients continued receiving prescriptions for the entire 12-month observation period. In multiple logistic time-dependent Cox analyses, use of antidepressants, mean dose of hypnotics, and advanced age were significantly associated with long-term use of hypnotics (p < 0.01). In an analysis of the association between long-term use of hypnotics and prescribed dosage, high monthly dose, advanced age, and department of first visit were significantly associated with long-term use (p < 0.01). CONCLUSION: These clinical indicators may be effective for early identification of patients with insomnia who are at high risk of developing physical dependence on hypnotics.
Authors: Maria Tanielian; Jumana Antoun; Munir Sidani; Ahmad Halabi; Malak Hoballah; Kegham Hawatian; Georges Assaf Journal: BMC Prim Care Date: 2022-05-02