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Trends in Sedative-Hypnotic Prescription Among Insomnia Patients: A Nationwide Cohort Study From 2010 to 2022 in
Jiyoon Shin1,2, So Yon Jun3, Donghyun Won3,4
1Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Background:
Global insomnia prevalence increased during the coronavirus disease 2019 (COVID-19) pandemic, driving higher demand for sedative-hypnotics. The objective of this study was to compare sedative-hypnotic prescription patterns in South Korea from 2010 to 2022 and assess the potential impact of the COVID-19 pandemic.
Methods:
This population-based cohort study from January 1, 2010, to December 31, 2022, used the Korean National Health Insurance's Health Insurance Sharing Service database of 8,136,437 (60.4% female) unique insomnia patients aged 18 and older. Prescriptions for sedative-hypnotic groups (benzodiazepines, non-benzodiazepines, antidepressants, and antipsychotics), number of patients prescribed sedative-hypnotics, and predicted and observed prescription rates by sex, age, and sedative-hypnotic group were analyzed.
Results:
The number of prescriptions per 1,000 population increased across all sedative-hypnotic groups before and during the pandemic. Women and the elderly had higher prescriptions for all sedative-hypnotic groups compared to men and other age groups. Antidepressant prescriptions saw the highest percentage increase (men 38.6%; women 37.1%) in 1st half of 2020 compared to 2019, followed by antipsychotics (men 28.9%; women 25.7%). Antidepressant prescriptions showed the largest increase relative to predicted levels across all age groups from 2020 to 2021, while non-benzodiazepines exhibited the smallest increase (men 5.6%; women 4.5%). In the 18-29 age group, prescriptions for all sedative-hypnotic groups exceeded predicted numbers in 2021.
Conclusion:
This study found that sedative-hypnotic prescriptions steadily increased from 2010 to 2022, with the trend becoming more pronounced during the COVID-19 pandemic, when prescription rates tended to exceed predicted levels in Korea. Monitoring the use of sedative-hypnotics for insomnia in women, the elderly, and young adults is essential for potential adverse effects and associated mental problems.
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