Substance use for insomnia in Metropolitan Detroit

Abstract

Objective: People with insomnia are not typically treated medically for their insomnia. Studies have reported approximately 30% of insomniacs self-medicate with alcohol or over-the-counter (OTC) medications. This study was done to identify determinants and risks of different insomnia therapeutics. Methods: A random-digit-dial, computer-assisted survey of a representative sample of adults in Metropolitan Detroit, aged 18–65 years, is being conducted. A sample of all respondents over an 18-month period was collected ( n=1324) with a 68% response rate. Exclusive past-year use of alcohol for sleep was reported by 10% ( n=132), prescription medications by 8% ( n=108), and OTC medications by 10% ( n=135). Five percent used both alcohol and sleep medications. The three exclusive-use groups formed the comparison groups of the study. Results: The prescription drug group used medications for more consecutive nights and for more total nights than the alcohol and OTC users. Alcohol users were predominately male, while OTC and prescription drug users were predominately female. Alcohol users were more likely to be single than the others, and prescription drug users were older than the others. Prescription drug users had more severe insomnia and had greater disability, neuroticism, and daytime fatigue than the others. In contrast, the alcohol users had greater daytime sleepiness than the others. Conclusions: In Metropolitan Detroit, insomniacs receiving medical treatment have more severe insomnia and greater disability than those who self-treat. However, while the insomnia of those self-treating is less severe, it is still associated with some risks.