Correlates of benzodiazepine use in individuals with insomnia

Abstract

Background and purpose: Although benzodiazepines (BZDs) are commonly used in the treatment of insomnia, there is little information about psychological, health, and sociodemographic correlates associated with their use. Objective: This study examined correlates of benzodiazepine use for sleep in a clinical sample of patients seeking treatment for insomnia at a sleep disorders clinic. Patients and methods: The sample consisted of 97 individuals evaluated at a sleep disorders clinic for a presenting complaint of insomnia. Two groups were formed, including one with 61 patients who had been using BZDs for sleep for an average of 56.6 months (SD=68.0), and another with 36 patients who had insomnia but were not using BZDs or any other sleep aid. Logistic regressions, adjusting for an age difference between the user and non-user groups, were performed to examine variables associated with BZD use. Independent variables included demographic, medical, insomnia-related and psychological parameters and subjective sleep–wake characteristics. Unadjusted regression analyses were performed to identify factors associated with a pattern of long-term use (>12 months) within the user group. Results: Age was a significant predictor of BZD use (OR=1.84, P=0.0002). Significant age-adjusted predictors of BZD use included perceived insomnia severity (OR=1.17, P=0.038), depressive symptoms, (OR=1.108, P=0.009) and state and trait anxiety symptoms (OR=1.062, P=0.016; OR=1.084, P=0.005, respectively). Significant predictors of long-term use (>12 months) were age of insomnia onset (OR=0.951, P=0.0214), more frequent BZD use (OR=3.284, P=0.0221), and higher state-anxiety (OR=1.106, P=0.0471). Conclusions: Age, psychological variables and perceived sleep disturbances severity, are associated with BZD use in patients with insomnia.