Cummins Jack A, Gottlieb Daniel J, Sofer Tamar, Wallace Danielle A
Manchester Essex Regional High School, Manchester, MA, United States.
Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States.
J Med Internet Res. 2025 Jan 9;27:e58902. doi: 10.2196/58902.
People share health-related experiences and treatments, such as for insomnia, in digital communities. Natural language processing tools can be leveraged to understand the terms used in digital spaces to discuss insomnia and insomnia treatments.
The aim of this study is to summarize and chart trends of insomnia treatment terms on a digital insomnia message board.
We performed a natural language processing analysis of the r/insomnia subreddit. Using Pushshift, we obtained all r/insomnia subreddit comments from 2008 to 2022. A bag of words model was used to identify the top 1000 most frequently used terms, which were manually reduced to 35 terms related to treatment and medication use. Regular expression analysis was used to identify and count comments containing specific words, followed by sentiment analysis to estimate the tonality (positive or negative) of comments. Data from 2013 to 2022 were visually examined for trends.
There were 340,130 comments on r/insomnia from 2008, the beginning of the subreddit, to 2022. Of the 35 top treatment and medication terms that were identified, melatonin, cognitive behavioral therapy for insomnia (CBT-I), and Ambien were the most frequently used (n=15,005, n=13,461, and n=11,256 comments, respectively). When the frequency of individual terms was compared over time, terms related to CBT-I increased over time (doubling from approximately 2% in 2013-2014 to a peak of over 5% of comments in 2018); in contrast, terms related to nonprescription over-the-counter (OTC) sleep aids (such as Benadryl or melatonin) decreased over time. CBT-I-related terms also had the highest positive sentiment and showed a spike in frequency in 2017. Terms with the most positive sentiment included "hygiene" (median sentiment 0.47, IQR 0.31-0.88), "valerian" (median sentiment 0.47, IQR 0-0.85), and "CBT" (median sentiment 0.42, IQR 0.14-0.82).
The Reddit r/insomnia discussion board provides an alternative way to capture trends in both prescription and nonprescription sleep aids among people experiencing sleeplessness and using social media. This analysis suggests that language related to CBT-I (with a spike in 2017, perhaps following the 2016 recommendations by the American College of Physicians for CBT-I as a treatment for insomnia), benzodiazepines, trazodone, and antidepressant medication use has increased from 2013 to 2022. The findings also suggest that the use of OTC or other alternative therapies, such as melatonin and cannabis, among r/insomnia Reddit contributors is common and has also exhibited fluctuations over time. Future studies could consider incorporating alternative data sources in addition to prescription medication to track trends in prescription and nonprescription sleep aid use. Additionally, future prospective studies of insomnia should consider collecting data on the use of OTC or other alternative therapies, such as cannabis. More broadly, digital communities such as r/insomnia may be useful in understanding how social and societal factors influence sleep health.
人们在数字社区中分享与健康相关的经历和治疗方法，比如失眠方面的。可以利用自然语言处理工具来理解数字空间中用于讨论失眠及失眠治疗的术语。
本研究的目的是总结并绘制数字失眠留言板上失眠治疗术语的趋势。
我们对r/insomnia子版块进行了自然语言处理分析。利用Pushshift，我们获取了2008年至2022年r/insomnia子版块的所有评论。使用词袋模型来识别1000个最常用的术语，之后手动筛选出35个与治疗和药物使用相关的术语。使用正则表达式分析来识别并统计包含特定词汇的评论，随后进行情感分析以估计评论的语气（积极或消极）。对2013年至2022年的数据进行可视化趋势检查。
从2008年该子版块创建之初到2022年，r/insomnia上共有340,130条评论。在识别出的35个顶级治疗和药物术语中，褪黑素、失眠认知行为疗法（CBT-I）和安必恩是使用最频繁的（分别有15,005条、13,461条和11,256条评论）。当比较各个术语随时间的使用频率时，与CBT-I相关的术语随时间增加（从2013 - 2014年的约2%翻倍至2018年评论峰值超过5%）；相反，与非处方非处方药（OTC）助眠药（如苯海拉明或褪黑素）相关的术语随时间减少。与CBT-I相关的术语也具有最高的积极情感，并在2017年出现频率峰值。情感最积极的术语包括“卫生”（情感中位数0.47，四分位距0.31 - 0.88）、“缬草”（情感中位数0.47，四分位距0 - 0.85）和“CBT”（情感中位数0.42，四分位距0.14 - 0.82）。
Reddit的r/insomnia讨论板提供了一种替代方法，用于捕捉失眠人群在使用社交媒体时对处方药和非处方助眠药的使用趋势。该分析表明，与CBT-I（2017年出现峰值，可能是继美国医师学会2016年推荐CBT-I作为失眠治疗方法之后）、苯二氮䓬类药物、曲唑酮和抗抑郁药物使用相关的语言在2013年至2022年期间有所增加。研究结果还表明，r/insomnia Reddit参与者中使用非处方或其他替代疗法（如褪黑素和大麻）很常见，并且也随时间出现了波动。未来的研究除了考虑处方药外，还可以纳入其他替代数据源来跟踪处方药和非处方助眠药使用趋势。此外，未来关于失眠的前瞻性研究应考虑收集非处方或其他替代疗法（如大麻）使用的数据。更广泛地说，像r/insomnia这样的数字社区可能有助于理解社会和社会因素如何影响睡眠健康。
