Sleep Medication Use and Associated Factors Among Adults with Insomnia Symptoms: A Cross-Sectional Study in Brazil

Insomnia affects health, well-being, and productivity. Despite recommendations favoring Cognitive Behavioral Therapy for Insomnia (CBT-I) as first-line treatment, hypnotic medications remain widely used.

To examine the frequency and types of sleep medications used by individuals with insomnia symptoms seeking psychological treatment, as well as factors associated with hypnotic use.

The present cross-sectional study included 1,158 adults with insomnia symptoms recruited from a specialized service between 2021 and 2022. Participants completed online questionnaires assessing sociodemographic characteristics, medication use, and standardized measures of insomnia severity (Insomnia Severity Index), anxiety, and depression (Hospital Anxiety and Depression Scale). Descriptive analyses and multivariate logistic regression were performed.

From the total (n = 1,158), 60% of participants reported current use of sleep medication. The most frequently used classes were Z-drugs and benzodiazepines, followed by sedative antidepressants. Greater insomnia severity was the primary factor associated with hypnotic use (odds ratio = 1.14; p  < 0.001). White participants were also more likely to use hypnotics, regardless of insomnia severity.

Pharmacological treatment remains predominant among individuals with insomnia symptoms, despite recommendations for CBT-I as the first-line treatment. These findings highlight the importance of expanding access to behavioral interventions and promoting the rational use of sleep medications in Brazil.