Abstract
Chinese herbal medicine (CHM) has been commonly used for treating insomnia in Asian countries for centuries. The aim of this study was to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequency and patterns of CHM use in treating insomnia. We obtained the traditional Chinese medicine (TCM) outpatient claims from the National Health Insurance in Taiwan for the year 2002. Patients with insomnia were identified from the diagnostic code of International Classification of Disease among claimed visiting files. Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM. Results showed that there were 16 134 subjects who visited TCM clinics for insomnia in Taiwan during 2002 and received a total of 29 801 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (25.3%). In addition, female subjects used CHMs for insomnia more frequently than male subjects (female : male = 1.94 : 1). There was an average of 4.8 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for insomnia. Shou-wu-teng (Polygonum multiflorum) was the most commonly prescribed single Chinese herb, while Suan-zao-ren-tang was the most commonly prescribed Chinese herbal formula. According to the association rule, the most commonly prescribed CHM drug combination was Suan-zao-ren-tang plus Long-dan-xie-gan-tang, while the most commonly prescribed triple drug combination was Suan-zao-ren-tang, Albizia julibrissin, and P. multiflorum. Nevertheless, further clinical trials are needed to evaluate the efficacy and safety of these CHMs for treating insomnia.
Highlights
IntroductionIndividuals with insomnia may suffer from the inability to fall asleep, remain asleep, or have non-restorative sleep, thereby influencing their daytime functioning [2]
Insomnia is a common health problem in the general population worldwide [1]
We obtained the traditional Chinese medicine (TCM) outpatient claims from the National Health Insurance in Taiwan for the year 2002
Summary
Individuals with insomnia may suffer from the inability to fall asleep, remain asleep, or have non-restorative sleep, thereby influencing their daytime functioning [2]. From an etiologic point of view, this sleep disorder can be characterized as primary insomnia, which does not result from physical or mental factors [3]. Secondary insomnia is caused by factors, such as psychological, psychosocial, or drug dependency [4]. Therapy for insomnia in Western medicine is mainly based on prescribed medications such as benzodiazepines, antidepressants, anticonvulsants, or over-the-counter antihistamines [5]. These medications are sometimes associated with adverse effects and are not suitable for longterm use [5]. In addition to the aforementioned medications, there are behavioral and cognitive therapies or alternative and complementary treatments utilized in Western countries, such as melatonin, l-tryptophan, herbal passionflower, valerian and St John’s wort [5, 6]
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