Department of Psychiatry, University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI; Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI.
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI.
Am J Geriatr Psychiatry. 2019 Jan;27(1):32-41. doi: 10.1016/j.jagp.2018.09.004. Epub 2018 Sep 14.
Older adults commonly use products that may be used to promote sleep, such as benzodiazepines and over-the-counter medications, but the current extent of use of both prescription and nonprescription products specifically for sleep in the United States is unknown.
Respondents in this cross-sectional, nationally representative survey (the National Poll on Healthy Aging) of community-dwelling older adults aged 65-80 (n = 1,065) reported difficulty initiating sleep or early awakening ("sleep symptoms") and use of prescription medication or nonprescription aids to promote sleep ("sleep product"), including prescription sleep medication, over-the-counter (OTC) sleep aids, prescription pain medication, and herbal/natural sleep aids. Logistic regression was used to determine the association of respondent sociodemographic and clinical characteristics with the use of sleep products.
Sleep symptoms were endorsed by 67.7% of respondents (95% confidence interval [CI] 64.7%-70.7%). Use of a sleep product was reported by 35.4% (95% CI 32.4%-38.6%), with 21.9% (95% CI 19.4%-24.7%) using OTC sleep aids, 12.5% using herbal/natural aids (95% CI 10.6%-14.8%), 8.3% using prescription sleep medication (95% CI 6.7%-10.3%), and 5.0% using prescription pain medication (95% CI 3.8%-6.7%). Self-reported fair/poor mental health (relative to excellent/very good) was associated with increased odds of sleep product use (adjusted odds ratio 2.28, 95% CI 1.10-4.72, p = 0.03).
More than a third of older adults use medications or aids to help with sleep-most commonly OTC aids. Clinicians should routinely ask older patients about sleep-related difficulties and the use of nonprescription sleep aids.
老年人通常会使用一些可能有助于睡眠的产品，如苯二氮䓬类药物和非处方药物，但目前在美国，人们使用处方和非处方助眠产品的情况尚不清楚。
本横断面、全国代表性调查（全国老年人健康调查）对 65-80 岁的社区居住老年人（n=1065）进行了调查，这些老年人报告了入睡困难或早醒（“睡眠症状”）以及使用处方药物或非处方助眠产品（“睡眠产品”）的情况，包括处方睡眠药物、非处方（OTC）助眠药物、处方止痛药和草药/天然助眠产品。使用逻辑回归来确定受访者社会人口统计学和临床特征与使用睡眠产品之间的关联。
67.7%的受访者（95%置信区间[CI] 64.7%-70.7%）有睡眠症状。报告使用睡眠产品的比例为 35.4%（95% CI 32.4%-38.6%），其中 21.9%（95% CI 19.4%-24.7%）使用 OTC 助眠药物，12.5%（95% CI 10.6%-14.8%）使用草药/天然助眠产品，8.3%（95% CI 6.7%-10.3%）使用处方睡眠药物，5.0%（95% CI 3.8%-6.7%）使用处方止痛药。与自评良好/非常好相比，自评一般/较差的心理健康状况与使用睡眠产品的几率增加相关（调整后的优势比 2.28，95% CI 1.10-4.72，p=0.03）。
超过三分之一的老年人使用药物或助眠产品-最常用的是非处方助眠产品。临床医生应定期询问老年患者睡眠相关问题和非处方助眠产品的使用情况。
