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0511 Patterns of Concomitant Over-the-Counter, Natural Product and Prescription Sleep Aid Use: A Population-Based Study
Sleep ( IF 5.6 ) Pub Date :  , DOI: 10.1093/sleep/zsaa056.508
J M Cheung 1, 2, 3 , D C Jarrin 2 , S Beaulieu-Bonneau 2, 4 , H Ivers 2, 3 , G Morin 2 , C M Morin 2, 3
Affiliation  

Abstract
Introduction
Despite limited evidence, over-the-counter medications (OTC) and natural products (NP) are increasingly combined with prescribed medications (Rx) to manage insomnia symptoms. Self-medication patterns are expected to be heterogenous and may predispose individuals to inappropriate medication-taking behaviors, but little is known about the usage trajectories of sleep aids. This study investigates patterns of concomitant NP, OTC and Rx use in a Canadian population-based sample.
Methods
Data were derived from a longitudinal study on the natural history of insomnia. Participants were 3416 adults (62% female, Mage = 49.7, MInsomnia Severity Index= 8.4). Self-reported data for OTC, NP and Rx use in the last year (yes/no) was extracted at 0-, 6- and 12-month follow-up. A Latent Class Growth Curve Analysis was conducted to identify patterns of concomitant sleep aid use. Participants also completed a battery of clinical measures including the Ford Insomnia Response to Stress Test, Dysfunctional Beliefs and Attitudes about Sleep scale (16-item), Beck Depression Inventory, Insomnia Severity Index and the Pittsburgh Sleep Quality Index. Preliminary associations between class membership and baseline covariates were evaluated using the χ 2 test or a one-way ANOVA. Sampling weights were applied to all analyses, adjusting for partial non-response.
Results
Analyses revealed a 6-class solution; each class reflected a preferential agent(s) choice, which remained stable over 12-months: Minimal Use (74.5%), Rx-Dominant (11.3%), NP-Dominant (6.3%), OTC-Dominant (4.3%), Rx-NP-Dominant (2.4%), and Rx-OTC-Dominant (1.1%). Classes with prominent prescribed agent use were older [F(5, 207.6) =27.2, p<0.001], more likely to seek help [χ 2(5, n=2977) =653.1, p< 0.001] and consume alcohol [χ 2(5, n=2968) =49.2, p< 0.001]. Clinically, these individuals reported greater stress reactivity [F(5, 2966) =48.4, p< 0.001], depressive symptoms [F(5,197.4) =32.0, p<0.001], dysfunctional sleep beliefs [F(5, 2987) =54.3, p< 0.001], insomnia severity [F(5, 2983) =88.4, p< 0.001] and poorer sleep quality [F(5, 203.8) =124.2, p< 0.001].
Conclusion
A majority of adults used agents minimally. Stability of medication-taking patterns suggests that individuals adopt less sporadic approaches when combining sleep aids than previously assumed. Clinical profiles and sleep aid choice could pre-empt vulnerabilities to inappropriate self-medication.
Support
Research supported by a grant from the Canadian Institutes of Health Research (MOP#115103)


中文翻译:

0511伴随柜台销售,天然产品和处方睡眠辅助使用的模式:一项基于人群的研究

摘要
介绍
尽管证据有限,但非处方药(OTC)和天然产品(NP)越来越多地与处方药(Rx)结合使用,以治疗失眠症状。预期自我用药模式是异类的,并且可能使个人易于采取不适当的服药行为,但对睡眠辅助剂的使用轨迹知之甚少。这项研究调查了在加拿大人口样本中同时使用NP,OTC和Rx的模式。
方法
数据来自对失眠自然史的纵向研究。参与者为3416名成人(62%的女性,M年龄= 49.7,M失眠严重度指数= 8.4)。在0、6和12个月的随访中提取了去年自我报告的OTC,NP和Rx使用情况(是/否)。进行了潜伏类生长曲线分析,以确定同时使用助眠剂的模式。参与者还完成了一系列临床措施,包括福特对压力测试的失眠反应,功能失调的信念和对睡眠量表的态度(16个项目),贝克抑郁量表,失眠严重度指数和匹兹堡睡眠质量指数。使用χ类别成员和基线协变量之间的关联的初步评价 2测试或单向方差分析。将采样权重应用于所有分析,并调整部分无响应。
结果
分析揭示了6级解决方案。每个类别均反映了首选代理的选择,该选择在12个月内保持稳定:最少使用(74.5%),Rx占主导地位(11.3%),NP占主导地位(6.3%),OTC占主导地位(4.3%), Rx-NP占主导地位(2.4%)和Rx-OTC占主导地位(1.1%)。具突出规定剂使用的类是老年人[F(5,207.6)= 27.2,p <0.001],更可能寻求帮助[χ  2(5,N = 2977)= 653.1,p <0.001]和消耗酒精[χ  2(5,n = 2968)= 49.2,p<0.001]。临床上,这些人报告的应激反应性更高[F(5,2966 )= 48.4,p <0.001],抑郁症状[F(5,197.4)= 32.0,p <0.001],睡眠功能障碍[F(5,2987 )= 54.3 ,p <0.001],失眠严重度[F(5,2983)= 88.4,p <0.001]和较差的睡眠质量[F(5,203.8)= 124.2,p <0.001]。
结论
大多数成年人很少使用药剂。服用药物的模式的稳定性表明,在组合睡眠辅助工具时,个人采用的零散方法比以前设想的要少。临床资料和选择助眠药可以避免因不适当的自我药物治疗而引起的脆弱性。
支持
由加拿大卫生研究院(MOP#115103)资助的研究
更新日期:2020-05-27
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