Objective

To investigate the association between multimorbidity and sleep medication use in women.

Methods

A population-based cross-sectional study was conducted on women (20–69 years) in Southern Brazil. Sleep medications were identified using the Therapeutic and Chemical Anatomical Classification. Multimorbidity was operationalized according to two cutoff points: diagnosis of either two or more or three or more chronic conditions and presence or absence of obesity. Explanatory variables included sociodemographic, behavioral, and health factors including obesity and common mental disorders (CMD) (assessed using the Self-Reporting Questionnaire 20 for CMD). Crude and adjusted prevalence ratios (PR) and 95% confidence intervals (95%CIs) were estimated with Poisson regression with robust variance using various adjustment models.

Results

In a sample of 1128 women, the prevalence of sleep medications was 14.3% (95%CI 12.2–16.3). After adjustments, the association between multimorbidity and sleep medication use yielded the following PR: multimorbidity ≥ 2:1.78 (95%CI, 1.23–2.56) and multimorbidity ≥ 3:1.90 (95%CI, 1.36–2.68). When obesity was included in the model, the effect was in the same direction but smaller, indicating that the presence of multimorbidity had an independent effect on the use of sleep medications, even after adjusting for CMD.

Conclusion

The presence of multimorbidity increased the probability of using sleep medications by approximately 80%, regardless of the observed cutoff point, inclusion of obesity in multimorbidity, and adjustment for CMD. Specific aspects of some chronic conditions may interfere with sleep quality, predisposing women to begin use of these medications at early ages and, consequently, to continue their use throughout later life.

中文翻译：

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多种疾病对女性睡眠药物使用的影响：一项在巴西南部进行的基于人群的研究

客观的

调查女性合并症与安眠药使用之间的关联。

方法

对巴西南部的女性（20-69 岁）进行了一项基于人群的横断面研究。使用治疗和化学解剖学分类确定睡眠药物。多重发病率根据两个截止点进行操作：诊断两种或多种或三种或多种慢性病以及是否存在肥胖症。解释变量包括社会人口学、行为和健康因素，包括肥胖和常见精神障碍 (CMD)（使用针对 CMD 的自我报告问卷 20 进行评估）。粗略和调整后的患病率 (PR) 和 95% 置信区间 (95%CI) 使用各种调整模型通过具有稳健方差的泊松回归进行估计。

结果

在 1128 名女性样本中，睡眠药物的流行率为 14.3% (95%CI 12.2–16.3)。调整后，合并症与睡眠药物使用之间的关联产生了以下 PR：合并症 ≥ 2:1.78 (95%CI, 1.23–2.56) 和合并症 ≥ 3:1.90 (95%CI, 1.36–2.68)。当模型中包含肥胖时，影响方向相同但较小，表明合并症的存在对睡眠药物的使用具有独立影响，即使在针对 CMD 进行调整后也是如此。

结论

无论观察到的截止点、是否将肥胖纳入多重病症以及针对 CMD 进行调整，多重病症的存在使使用安眠药的可能性增加了约 80%。一些慢性病的特定方面可能会影响睡眠质量，使女性容易在早年开始使用这些药物，并因此在以后的生活中继续使用这些药物。