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Prevalence and associations of multiple hypnotic prescriptions in a clinical sample

Bhanu Prakash Kolla1,2, Meghna P Mansukhani2, Subhajit Chakravorty3

  • 1Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|January 8, 2024
PubMed

Insights

Multiple hypnotic prescriptions are common, affecting 10% of patients. This practice is linked to increased rates of mood disorders, anxiety, chronic pain, and sleep issues, suggesting a need for personalized treatment approaches.

Area of Science:

  • Sleep Medicine
  • Clinical Pharmacology
  • Psychiatry

Background:

  • Multiple hypnotic prescriptions are frequently observed in clinical practice.
  • Understanding the characteristics and associations of multiple hypnotic prescriptions is crucial for patient care.

Purpose of the Study:

  • To investigate the prevalence of multiple hypnotic prescriptions.
  • To identify clinical and demographic factors associated with hypnotic use.
  • To explore the association between multiple hypnotic prescriptions and various diagnoses using a phenome-wide association study (PheWAS).

Main Methods:

  • Analysis of electronic health records (EHR) from 52,940 adult participants in the Mayo Clinic Biobank.
  • Comparison of demographic and clinical characteristics between participants with no, single, or multiple (≥ 2) hypnotic prescriptions.
  • Phenotype-based, phenome-wide association study (PheWAS) to identify diagnoses associated with multiple hypnotic prescriptions, adjusting for confounders.

Main Results:

  • 33% of participants received at least one hypnotic, and 10% received multiple hypnotics.
  • Hypnotic users were more likely to be older, female, White, with longer EHRs and more diagnoses.
  • Multiple hypnotic prescriptions were associated with younger age, female sex, longer EHRs, more diagnoses, and higher rates of mood disorders, anxiety disorders, suicidal ideation, restless legs syndrome, and chronic pain.

Conclusions:

  • Multiple hypnotic prescriptions are common and linked to a higher incidence of psychiatric, chronic pain, and sleep-related movement disorders.
  • These findings highlight the need for further research into potential genetic factors to enable personalized insomnia treatment strategies.
Abstract

Keywords:
hypnoticinsomniasleep aidsleep disturbancesleep medicationtreatment resistance

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