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

Abstract

The commercial availability of psychotropic drugs has an important effect on the consumption of medications for the symptomatic treatment of insomnia. Traditional benzodiazepines have been the most frequently prescribed psychotropic medications for promoting sleep in clinical practice in Japan. In recent years, non-diazepine drugs, antidepressant selective serotonin-reuptake inhibitors and over-the-counter sleep aids have been introduced into the Japanese pharmaceutical market. This study aimed therefore to make a poplulation-based assessment of sleep-medication use using the baseline data of a nationally representative sample of 2800 Japanese adults collected in 1997 before such changes. The Pittsburgh Sleep Quality Index was used to measue the symptoms of insomnia and the use of sleep medicine. A total of 1871 subjects participated in our analyses. The overall age-adjusted prevalence of sleep-medication use was 7.4% : 1.3%, 2.0% and 4.1% for <1 time, 1-2 times, and 3+ times per week during the past month, 6.5% and 0.9% for medically prescribed medicine and self-medicated sleeping pills, respectively. Of those with frequent insomniac symptoms, 75% remaied untreated. However, 3% of the users suggests the possibiliy of hypnoticdependency. Over one-half of the users had multiple illnesses and consulted two or more different medical specialists. Physicians accounted for a disproportionately high percentage of all prescriptions of sleep medicine. Neuropsychiatrists replaced physicians after sociodemographic adjustments. Diabetes mellitus, heart disease, hypertension, and gastroduodenal ulcer represented the most common medical illnesses relating to sleep medication. This study drives the need to further investigate how to manage and treat individuals with insomnia.

Sleep Disturbance and Its Association with Gastrointestinal Symptoms/Diseases and Psychological Comorbidity

“…This was similar to that reported in the US population [21] but was higher than that in Japanese population, which was approximately 17.3-22.3% [22]. The differences in prevalence reported in the various studies may be attributable to varying diagnostic questionnaires of SD.…”

Characteristics of Sleep Disturbances in Patients with Gastroesophageal Reflux Disease

“…The total scores are categorized into four degrees of severity: no clinically significant insomnia (0-7), mild insomnia (8)(9)(10)(11)(12)(13)(14), moderate insomnia (15)(16)(17)(18)(19)(20)(21) and severe insomnia (22)(23)(24)(25)(26)(27)(28).…”

“…In 2008, the National Sleep Foundation's Sleep in America Poll demonstrated that approximately half of all participants reported non-refreshing sleep a few nights per week or more, with 42% reporting frequently waking at night and 26% reporting difficulty in falling asleep (13). Nationwide epidemiological studies in Japan have shown that the prevalence of sleep disturbances is approximately 17.3-22.3% for men and 20.5-21.5% for women (14)(15)(16)(17). In addition, a nested case cohort study conducted in the UK indicated that there is a clear association between sleep disturbances and smoking, excessive alcohol consumption, psychiatric disorders (stress and depression), cardiovascular diseases (heart failure and coronary heart disease) and gastrointestinal diseases, including GERD and irritable bowel syndrome (18).…”

Effects of a Bovine Alpha S1-Casein Tryptic Hydrolysate (CTH) on Sleep Disorder in Japanese General Population

“…In the 1990s a newer class of medications, known as "non-benzodiazepine, benzodiazepine receptor agonists" were introduced for the treatment of insomnia [38,39]. Although highly effective in promoting sleep and seeming to have better safety profiles, these drugs are however associated with residual side-effects.…”