Regular hypnotic drug treatment in a sample of 32,679 Swedes: associations with somatic and mental health, inpatient psychiatric diagnoses and suicide, derived with automated record-linkage.

Abstract

We studied Swedish survey responders who reported regular treatment with hypnotic drugs, to find associations to perceived health problems, inpatient psychiatric diagnoses, and subsequent suicide. Among 32,679 sampled Swedes, 26,952 (83%) participated, 500 of which (2%) reported regular hypnotic drug treatment. The rate of treatment was higher in women, and increased by age in both sexes. The major findings were high odds of concurrent psychoactive drug treatments, nervous symptoms and insomnia, as well as high rates of circulatory and musculoskeletal conditions in both sexes, with indicators of disability and sleep-disturbing symptoms. During a 15-year period, 35% of the men and 21% of the women who reported regular hypnotic drug treatment had also been admitted to inpatient psychiatric care. Substance abuse was diagnosed in 20% of the men and 4.3% of the women reporting hypnotic drug treatment. In multiple logistic regression models, the highest odds for regular hypnotic drug treatment were incurred by recent/current insomnia, nervous symptoms, and other psychoactive drug treatment. We conclude that therapy was principally given according to some current peer guidelines. Yet, further research is needed into the risk/benefit ratio of sustained hypnotic drug therapy in patients with qualifying somatic and psychiatric disorders to obtain a more uniformly based consensus.

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

“…Among the users of sleep‐medication, individuals were more likely to take sleeping pills, with increasing the symptoms of insomnia. These results are consistent with previously reported findings in terms of the associations of sleep‐medication use with age and sex, 10–12,34–38 and insomniac symptoms 10,11,34,36–38 …”

Hypnotic Medications and Suicide: Risk, Mechanisms, Mitigation, and the FDA

“…The first of these studies examined 26,952 adult Swedes between 1975 and 1981, 500 of whom (2%) were frequent hypnotic users (345 women, and 155 men), and tracked suicides until 1985 in the national Cause of Death Registry. (19) Subsequent suicides were found in 1.1% of hypnotic-treated women versus 0.1% of the women not taking hypnotics (OR=2.6, p<0.05). No men died by suicide.…”

Sleep complaints predict coronary artery disease mortality in males: a 12‐year follow‐up study of a middle‐aged Swedish population

“…Both the first and second Cancer Prevention Study (CPS I and II) have reported associations between early death and sleeping pill utilization [7, 30]. It has also been demonstrated that regular users of hypnotics often have disabling psychiatric and somatic conditions [48, 49], and are frequently treated with other psychoactive drugs [48, 50]. In one survey more than one‐third of female hypnotic users were receiving health care not for sleep problems but for depression, anxiety and other reasons [51].…”

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