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Impact of multimorbidity on the use of sleep medications among women: a population-based study in Southern Brazil

  • Psychiatrics • Original Article
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Abstract

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.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

M.T.A.O. received research productivity grants from the Brazilian Council for Scientific and Technological Development (CNPq) (process n. 307257/2013–4 and 307175/2017–0). J.S.D.C. received research productivity grants from CNPq (process nº 310595/2018–0). This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES), Finance Code 001: M.G.S; D.L.F, CAPES financial aid beneficiaries. The sponsors had no role in the design or conduct of this research.

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Authors and Affiliations

  1. Post-Graduate Programme in Collective Health, University of Vale Do Rio Dos Sinos, Unisinos, Av. Unisinos, 950, Cristo Rei, São Leopoldo, RS, CEP 93022-750, Brazil

    Michele Gabriela Schmidt, Débora Luiza Franken, Maria Teresa Anselmo Olinto, Juvenal Soares Dias da Costa & Vera Maria Vieira Paniz

  2. Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil

    Maria Teresa Anselmo Olinto

  3. Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil

    Juvenal Soares Dias da Costa

Authors
  1. Michele Gabriela Schmidt
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  2. Débora Luiza Franken
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  3. Maria Teresa Anselmo Olinto
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  4. Juvenal Soares Dias da Costa
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  5. Vera Maria Vieira Paniz
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Contributions

Michele Gabriela Schmidt: significant participation in the creation of the study, in the analysis/interpretation of data; involvement in the preparation and review of the manuscript; and approval of the final version of the manuscript for publication. Responsibility for the accuracy and investigation of all aspects of the research. Débora Luiza Franken: participation in the creation of the study, in data analysis; involvement in the elaboration of the manuscript; and approval of the final version of the manuscript for publication. Maria Teresa Anselmo Olinto: significant participation in the study design, data collection, and analysis/interpretation; involvement in reviewing the manuscript; and approval of the final version of the manuscript for publication. Juvenal Soares Dias da Costa: significant participation in the design of the study, in data collection, and approval of the final version of the manuscript for publication. Vera Maria Vieira Paniz: significant participation in the creation of the study, in the analysis/interpretation of data; involvement in the preparation and review of the manuscript; and approval of the final version of the manuscript for publication. Responsibility for the accuracy and investigation of all aspects of the research.

Corresponding authors

Correspondence to Michele Gabriela Schmidt or Vera Maria Vieira Paniz.

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Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethics Committee of the University of Vale do Rio dos Sinos under protocol number 650,443 and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Schmidt, M.G., Franken, D.L., Olinto, M.T.A. et al. Impact of multimorbidity on the use of sleep medications among women: a population-based study in Southern Brazil. Sleep Breath 27, 1135–1142 (2023). https://doi.org/10.1007/s11325-022-02672-5

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  • DOI: https://doi.org/10.1007/s11325-022-02672-5

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