Sleep Aid Use Research Articles

300 The Use of Sleep Aids in Young Athletes and Non-Athletes: An Exploratory Study

Abstract Introduction Studies have shown that sleep in adolescents is characterized by sleep disturbances. Many teens resort to prescribed or nonprescribed medication to alleviate their sleep difficulties. Research suggests that sport and physical activity may be protective factors regarding sleep. The aims of the present study were to investigate the use of sleep aids among young athletes and non-athletes, and to identify possible factors associated with prescribed and nonprescribed sleep aids Methods 35 young athletes (14.6±0.7 years old; 54.3 % males) and 30 young non-athletes (15.1±0.7 years old; 16.7% males) completed questions on sleep aids, the Academic Motivation Scale, the anxiety and depression scales of the Beck Youth Inventory-II, and the Multidimensional Self-Esteem Questionnaire, at the beginning, middle, and end of the school year. Mean scores for the school year were computed for amotivation in school, intrinsic academic motivation of accomplishment, self-esteem, anxiety symptoms, and depressive symptoms. Teens were each categorized as user or non-user if they had or had not used sleep aids during the school year. First, comparison of sleep aids usage between groups were done using a Chi-square test. Then, both groups of athletes and non-athletes were combined. Amotivation, intrinsic motivation, self-esteem, and anxiety and depressive symptoms were compared between users and non-users using paired t-tests Results Results show that young non-athletes report using sleep aids more often than young athletes (X2(1,N=65)=5.205, p=.023). Indeed, 65.2% non-athletes compared to 34.8% athletes reported using sleep aids during school year. Users represent 35.4% of the total sample. T-tests showed that users have a significantly higher amotivation score (t(65)=-2.010, p=.049), more anxiety symptoms (t(65)=-2,480, p=.016), and more depressive symptoms (t(65)=-2,126, p=.037) than non-users. Conclusion These results show a high prevalence of prescribed and nonprescribed sleep aids usage in teens. Our results also suggest that sleep aids in young adolescents is associated with mental health problems and academic motivation issues. On the other hand, our results support that sport and physical activity may have a protective role regarding sleep. This highlights the importance to promote sport participation among adolescents. Support (if any) n/a

818 A Ghost from the Past: Unmasked Insomnia Affecting Hypoglossal Nerve Stimulation Therapy Adherence

Abstract Introduction Hypoglossal nerve stimulation (HNS) is an efficacious option for treating moderate to severe obstructive sleep apnea (OSA). However, there is sparse evidence regarding tolerance and adherence to HNS therapy in patients with a diagnosis of insomnia. Report of case(s) A 57-year-old man with well-controlled depression presented for evaluation for HNS therapy. He had been diagnosed with moderate OSA with an apnea-hypopnea index of 22/hour, intolerant of continuous positive airway pressure and mandibular advancement device. He underwent uvulopalatopharyngoplasty without significant improvement. At the time of initial evaluation, he denied history of insomnia and prior sleep aid use. He subsequently underwent successful HNS device implantation and activation. One week after HNS initiation, the patient reported new symptoms of significant difficulty with sleep onset and inability to fall back asleep, which was worse than his untreated OSA symptoms. Device interrogation did not reveal any hardware problems. Adjustments to start delay, pause time and device configuration with awake endoscopy did not improve tolerance. Subsequently, the patient disclosed a remote history of insomnia, which was treated with multiple hypnotics in addition to cognitive-behavioral therapy for insomnia (CBTi) and had resolved. He was diagnosed with recurrent chronic insomnia, for which eszopiclone was initiated without significant improvement. He eventually agreed to CBTi, with partial improvement in device tolerance and improvement in insomnia symptoms. Conclusion This case highlights that HNS therapy adherence can be affected by prior history of, or a current diagnosis of insomnia. Our patient had a predisposition for insomnia that was well controlled prior to HNS therapy initiation. The onset of recurrent insomnia with HNS activation suggests that HNS was a precipitating factor for his now chronic insomnia. Although there is insufficient evidence to suggest whether history of insomnia should affect the decision to initiate HNS therapy, this case illustrates the importance of screening for insomnia at pre-implant evaluation. Our center is now routinely screening for a history of insomnia to identify patients who may benefit from treatment prior to HNS implantation. Larger studies are needed to explore a possible relationship between insomnia and HNS adherence. Support (if any):

A Case-Control Study of Accidental Falls During Surgical Hospitalizations.

Postoperative falls are preventable complications. The study aims were to describe the rate and circumstances surrounding postoperative falls and explore potential associations with patient and procedural characteristics with emphasis on the use of sedative medications. Medical records of hospitalized patients undergoing non-lower extremity surgery under general anesthesia from January 1, 2010, through April 30, 2018 were reviewed for falls within 72 postoperative hours. Perioperative use of sedatives, sleep aids, gabapentinoids, and opioids were abstracted. Each fall case was matched with two controls on age, sex, and procedure type. Descriptive statistics and multivariable analysis accounting for the matched design were performed. There were 343 falls among 200186 hospitalized surgical patients (incidence of 17.1 [95% CI: 15.4, 19.0] falls per 10000 procedures) with largest proportion of falls occurring on postoperative day 2 (n = 134, 39.1%). Most falls occurred in the general hospital wards (n = 304, 88.6%) and were unwitnessed (n = 186, 55.9%). The incidence of major injuries was 1.0 (95% CI: .1 - 3.6) per 100000 procedures. Home use of non-benzodiazepine hypnotics (odds ratio 2.68, 95% CI: 1.47, 4.88, P=.001) and blood transfusions were associated with increased fall risk. Hospital stay was longer in patients who fall (7 [4, 15] vs. 5 [3, 9] days, P < .001). The rate of postoperative falls in our institution was low and frequently unwitnessed. The use of non-benzodiazepine hypnotics is a modifiable risk factor associated with postoperative falls. Serious complications after falls were rare.

Correlates of COVID-19 pandemic-related increases in sleep aid and anti-anxiety medication use

ABSTRACT Objective The COVID-19 pandemic has created a stressful environment of fear, isolation, and economic instability. This study quantifies rates of self-reported increases in use of anxiety-related medications and sleep aids, and identifies demographic, health and psychosocial correlates during the initial stay-at-home period of the COVID-19 pandemic. Methods An online survey was administered to U.S. adults (n = 2,739), aged 18 and older, from April 14 to April 22, 2020 to assess self-reported change in anti-anxiety and sleep aid use during the stay-at-home protocols. Data were weighted to the US population for analysis. Results Weighted results indicate anti-anxiety and sleep aid medications increased for 35.7% and 41.2% of the population, respectively. Major depressive disorder (MDD), generalized anxiety disorder (GAD), and somatization disorder (SD) symptoms were associated with increased use of anti-anxiety medications. GAD and SD were associated with increased use of sleep aids. Perceived stress, quality of life, fatigue and concentration were associated with increased use of anti-anxiety medication and sleep aids. Conclusions These findings provide critical insights necessary in preparing for future outbreaks of similar magnitude. Developing policies to support economic and healthcare infrastructure is a necessary first step to ameliorating secondary health consequences from an infectious disease outbreak.

0531 Efficacy of a Single 4 Hour CBT-I Workshop in a Community Sample with Self-Reported Insomnia Symptoms

Abstract Introduction Cognitive behavioral treatment for insomnia (CBT-I) is the first line of treatment for insomnia. However, experts have noted that the expanded use of CBT-I is limited by the small number of specialty-trained clinicians, as well as the duration and cost of individual treatment sessions (usually 6-8). One solution is a single-session educational group format delivered by a trained health educator rather than a licensed clinician. Our objective was to evaluate the efficacy of group CBT-I delivered by a Ph.D. level health educator to community dwelling individuals with self-reported insomnia symptoms. Methods Participants were referred from clinicians, our website, and social media postings. Participants completed the Insomnia Severity Index, provided information on type of sleep aid use and frequency, and the presence of co-morbid conditions prior to and 1-month post attendance of a single 4-hour CBT-I workshop. Results Participants (N = 31) were 58 ± 12 years of age (range 29 - 80); 11 Males, 20 Females; 90.6% white; 66% married; 71.8% at least a college graduate; and 34.3% had an average income of &amp;gt; $100K. Comorbidities included pulmonary disease (6%), GI disease (9.6%), endocrine disease (9.6%), and headaches (25.8%). Insomnia Severity Index scores significantly improved from baseline (19.6 ± 5.06) to 1-month (FU 13.7 ± 6.33) (t = 21.9, P &amp;lt; .001)). Similarly, frequency of sleep aid use significantly dropped (χ 2 = 105.7, p = .017). Subjective improvement in sleep was reported as the following: 12.5% much better, 56.3% better, 25% the same, and .03% worse. Conclusion These data indicate that a single 4-hour CBT-I workshop delivered by a health educator can significantly reduce insomnia symptoms, improve subjective sleep quality, and reduce sleep aid use among community dwelling adults with self-reported insomnia symptoms within 1-month. These data extend what has been shown primarily in older adults. That is, brief behavioral treatment for insomnia can be acceptable and efficacious to anyone reporting insomnia symptoms. Support The Insomnia Clinic

0931 Parenting Stress Can Be Predicted by Parent and Child Sleep, and Can Be Reduced by an Intervention Targeting Child Sleep in Vulnerable Families

Abstract Introduction Studies suggest that family intervention programs should consider different sources of parenting stress (PS). Knowing that child sleep has an impact on PS, this study aimed to examine if a child sleep intervention can affect PS in vulnerable families. Methods In a first study, parent and child sleep habits along with PS were assessed using Parenting Stress Index-Short Form, Pittsburgh Sleep Quality Index and homemade questions assessing child sleep. Measures were administered to 138 community mothers (children 3-79 months). Multiple linear regression analyses examined mothers and child sleep associations to PS, controlled by family income. Following results of this first study, 11 vulnerable mothers (children 39-68 months) participated in a child sleep intervention specifically developed for vulnerable families. Measures administered were the same as for study 1, but in this study, the Child Sleep Habits Questionnaire was used to assess the child sleep. Wilcoxon’s t-test compared pre and post-intervention measures. Results In the first study, sleep onset latency (SOL; β= -.25; p= .003), waketime (β= -.28; p= .003) and sleep aids (β= -.19; p= .048) explained 23.6% of PS variance. When child sleep variables were added to the model, only bedtime resistance was significant (β= -.23; p= .023) and increased the explained variance to 30.6%. Following the child sleep intervention, no significant changes in parent sleep were observed. However, results show improvement of child bedtime resistance (Mpre=10.73; Mpost=8.36; p= .027) and PS (Mpre=3.50; Mpost=3.82; p= .05). Conclusion Our results suggest that higher PS is explained by greater struggles in parents sleep (higher SOL, later waketime and higher use of sleep aids) as well as bedtime resistance behaviors in children. Furthermore, PS can be reduced by an intervention improving child bedtime resistance, even if parent sleep is not improved. Support

0511 Patterns of Concomitant Over-the-Counter, Natural Product and Prescription Sleep Aid Use: A Population-Based Study

Abstract Introduction Despite limited evidence, over-the-counter medications (OTC) and natural products (NP) are increasingly combined with prescribed medications (Rx) to manage insomnia symptoms. Self-medication patterns are expected to be heterogenous and may predispose individuals to inappropriate medication-taking behaviors, but little is known about the usage trajectories of sleep aids. This study investigates patterns of concomitant NP, OTC and Rx use in a Canadian population-based sample. Methods Data were derived from a longitudinal study on the natural history of insomnia. Participants were 3416 adults (62% female, Mage = 49.7, MInsomnia Severity Index= 8.4). Self-reported data for OTC, NP and Rx use in the last year (yes/no) was extracted at 0-, 6- and 12-month follow-up. A Latent Class Growth Curve Analysis was conducted to identify patterns of concomitant sleep aid use. Participants also completed a battery of clinical measures including the Ford Insomnia Response to Stress Test, Dysfunctional Beliefs and Attitudes about Sleep scale (16-item), Beck Depression Inventory, Insomnia Severity Index and the Pittsburgh Sleep Quality Index. Preliminary associations between class membership and baseline covariates were evaluated using the χ 2 test or a one-way ANOVA. Sampling weights were applied to all analyses, adjusting for partial non-response. Results Analyses revealed a 6-class solution; each class reflected a preferential agent(s) choice, which remained stable over 12-months: Minimal Use (74.5%), Rx-Dominant (11.3%), NP-Dominant (6.3%), OTC-Dominant (4.3%), Rx-NP-Dominant (2.4%), and Rx-OTC-Dominant (1.1%). Classes with prominent prescribed agent use were older [F(5, 207.6) =27.2, p&amp;lt;0.001], more likely to seek help [χ 2(5, n=2977) =653.1, p&amp;lt; 0.001] and consume alcohol [χ 2(5, n=2968) =49.2, p&amp;lt; 0.001]. Clinically, these individuals reported greater stress reactivity [F(5, 2966) =48.4, p&amp;lt; 0.001], depressive symptoms [F(5,197.4) =32.0, p&amp;lt;0.001], dysfunctional sleep beliefs [F(5, 2987) =54.3, p&amp;lt; 0.001], insomnia severity [F(5, 2983) =88.4, p&amp;lt; 0.001] and poorer sleep quality [F(5, 203.8) =124.2, p&amp;lt; 0.001]. Conclusion A majority of adults used agents minimally. Stability of medication-taking patterns suggests that individuals adopt less sporadic approaches when combining sleep aids than previously assumed. Clinical profiles and sleep aid choice could pre-empt vulnerabilities to inappropriate self-medication. Support Research supported by a grant from the Canadian Institutes of Health Research (MOP#115103)

A Systematic Review of Risk Factors for Sleep Disruption in Critically Ill Adults.

Numerous risk factors for sleep disruption in critically ill adults have been described. We performed a systematic review of all risk factors associated with sleep disruption in the ICU setting. PubMed, EMBASE, CINAHL, Web of Science, Cochrane Central Register for Controlled Trials, and Cochrane Database of Systematic Reviews. English-language studies of any design published between 1990 and April 2018 that evaluated sleep in greater than or equal to 10 critically ill adults (> 18 yr old) and investigated greater than or equal to 1 potential risk factor for sleep disruption during ICU stay. We assessed study quality using Newcastle-Ottawa Scale or Cochrane Risk of Bias tool. We abstracted all data independently and in duplicate. Potential ICU sleep disruption risk factors were categorized into three categories based on how data were reported: 1) patient-reported reasons for sleep disruption, 2) patient-reported ratings of potential factors affecting sleep quality, and 3) studies reporting a statistical or temporal association between potential risk factors and disrupted sleep. Of 5,148 citations, we included 62 studies. Pain, discomfort, anxiety/fear, noise, light, and ICU care-related activities are the most common and widely studied patient-reported factors causing sleep disruption. Patients rated noise and light as the most sleep-disruptive factors. Higher number of comorbidities, poor home sleep quality, home sleep aid use, and delirium were factors associated with sleep disruption identified in available studies. This systematic review summarizes all premorbid, illness-related, and ICU-related factors associated with sleep disruption in the ICU. These findings will inform sleep promotion efforts in the ICU and guide further research in this field.

The associations of self-stigma, social constraints, and sleep among Chinese American breast cancer survivors.

The aim of the current study was to examine the incidence of poor sleep quality, medication use, and dysfunction and the association of self-stigma and perceived social constraints (i.e., ambivalence over emotional expression; AEE) on sleep among a sample of Chinese American breast cancer survivors. The data were based on self-report baseline data (n = 136) from an expressive writing intervention study for Chinese American breast cancer survivors (MTime since diagnosis = 27.17months; SD = 19.31). Participants completed self-report questionnaires related to psychological and physical health and health behaviors. Using linear regression and path modeling, our hypotheses were tested using models where (1) self-stigma predicted sleep characteristics (i.e., quality, medication use, and dysfunction) with (2) AEE mediating the relationship between self-stigma and sleep. Participants frequently reported poor sleep quality (44.9%), use of sleep aids (37.5%), and difficulty staying awake during the day (37.5%). Greater self-stigma was related to greater AEE (b = .48, SE = .09, p < .05), which was related to worse sleep quality (b = - .19, SE = .08, p < .05), greater use of sleep aids (b = .25, SE = .11, p < .05), and greater difficulty staying awake during the day (b = .30, SE = .09, p < .05). Further, the indirect effect of self-stigma on sleep quality (ab = - .09, 95% CI - .19, - .03), use of sleep aids (ab = .12, 95% CI .03, .25), and difficulty staying awake during the day (ab = .15, 95% CI .06, .18) through AEE was significant. The results of this study highlight significant sleep-related problems among Chinese American breast cancer survivors and the importance of considering cultural beliefs of cancer in counseling. Chinese American breast cancer survivors are at risk for sleep-related difficulties due, in part, to perceived self-stigma and emotional constraints. Greater education and community outreach to Chinese communities may help destigmatize breast cancer and encourage emotional expression around cancer-related topics.

Determinants of Sleep Medication Use among Participants in the National Alzheimer's Coordinating Center Uniform Data Set.

Sufficient sleep is critical for health in older adults, but prescription sleep aids are associated with numerous health risks (e.g., cognitive impairment and falls). We examine usage prevalence of two medication categories-sedative hypnotics (SH) and medications commonly used for insomnia (MCUFI)-among adults aged 45+ in the National Alzheimer's Coordinating Center data set. Analyzing the visits conducted between September 2005 and June 2018, we determine the factors associated with SH and MCUFI use, including sociodemographic, health, independence, and cognitive statuses. Usage rates were 9% for MCUFI (N = 3,279) and 4% for SH (N = 1,382). Multivariable logistic regression identified White race, higher education, younger age, depression, and sedative polypharmacy as factors associated with prescription sleep aid use. We conclude that sleep medication usage rates among older adults, higher likelihood of sedative medication polypharmacy, and higher likelihood of MCUFI use among adults with cognitive impairment are findings of concern and may warrant clinical intervention.

Cannabis and alcohol use for sleep aid: A daily diary investigation.

One in 5 college students use substances such as cannabis and/or alcohol to help sleep. Despite this high prevalence of sleep aid use, there remains a lack of research on the potential day-to-day sleep- and substance-related consequences. The current study examined associations of cannabis and alcohol sleep aid use with subsequent sleep and substance use consequences among college students. Of a baseline sample of 217 college students endorsing past-month cannabis and/or alcohol use (1% cannabis only, 42% alcohol only, 58% both), 83 students endorsing past-month cannabis and/or alcohol use for sleep aid (Mage = 19.33 [SD = 1.11], 30% male, 72% White) completed online questionnaires for 14 consecutive days to report daily sleep, substance use, and negative substance consequences. Multilevel models demonstrated that nights of cannabis sleep aid use predicted longer same-night sleep duration, shorter same-night wake time after sleep onset, and greater next-day daytime fatigue within person, after controlling for daily cannabis frequency. Alcohol sleep aid use was not associated with sleep-related outcomes or negative drinking consequences after controlling for daily alcohol quantity; these null results may be due to a low frequency of alcohol sleep aid use (1% of observations) over 14 days of assessment. Results highlight daytime fatigue as a potential adverse short-term outcome of cannabis sleep aid use, despite its proximal sleep-related benefits. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Insomnia, Short Sleep, And Snoring In Mid-To-Late Pregnancy: Disparities Related To Poverty, Race, And Obesity.

ObjectiveTo characterize sleep habits and parameters among women in mid-to-late pregnancy and to identify disparities associated with poverty, race, and obesity.DesignCross-sectional.SettingLarge multi-site health system in Metro Detroit.ParticipantsA total of 267 pregnant women (27.3% non-Hispanic black; gestational age: 27.99±1.20 weeks) completed online surveys on sleep quality, insomnia symptoms, sleep aid use, signs/symptoms of sleep-disordered breathing, and sociodemographics. Body mass index (BMI) and patient insurance were derived from medical records.ResultsAs high as 76.2% of the women reported global sleep disturbance, 30.6% endorsed snoring, 24.3% sleep <6 hrs/night, and over half screened positive for clinical insomnia. Yet, only 3.4% of the women reported an insomnia diagnosis and 3.0% reported a sleep apnea diagnosis. In unadjusted models, poverty, Medicaid coverage, self-identifying as black, and obesity before and during pregnancy (BMI ≥ 35) were associated with a wide range of sleep problems. However, adjusted models revealed specificity. Poverty was uniquely related to increased insomnia symptoms and trouble sleeping due to bad dreams. Obesity before pregnancy was related to poor sleep quality, snoring, sleep aids, and short sleep. Black women reported shorter sleep duration than white women but differed on no other sleep parameters.ConclusionClinical signs of insomnia and sleep-disordered breathing are common in mid-to-late pregnancy, but most cases go undetected. Problematic sleep disproportionately affects women in poverty, who self-identify as black, and who are obese before pregnancy. Poverty-related sleep issues are linked to insomnia, obesity-related disparities center on sleep-related breathing and medication use, and racial disparities relate to short sleep.

Internet-Based Cognitive Behavioral Therapy for Insomnia in Appalachian Women: A Pilot Study

ABSTRACT Objective/Background Appalachian women are disproportionately affected by insufficient sleep but live in a healthcare shortage area with prevalent prescription drug abuse. A self-administered, non-pharmacologic intervention such as Internet-based cognitive behavioral therapy for insomnia (CBT-I) may be ideal in this population, but psycho-social characteristics (e.g., high depression rates) and cultural norms (e.g., suspicion of technology) necessitate a pilot study. We evaluated the effectiveness of Sleep Healthy Using the Internet (SHUTi) on insomnia severity, sleep quality, perceived stress, depression symptoms, and sleep aid use in Appalachian women ages 45 +. Participants Forty-six women enrolled; 38 completed the six-week intervention in 2018 (mean age 55 years). Methods We employed a single group, pre/post-test, mixed-methods design. Participants completed an online survey and a qualitative interview pre- and post-intervention. Quantitative data were analyzed using one-way repeated measures ANOVA or generalized estimating equations. Interviews were qualitatively analyzed using a multi-stage coding process. Results Positive and statistically significant (p < .01) improvements were observed on mean scores for the Insomnia Severity Index (15.1 to 6.5), the Pittsburgh Sleep Quality Index (12.1 to 8.5), the Perceived Stress Scale (20 to 14.6), and the Center for Epidemiologic Studies Depression Scale Revised (9.8 to 5.2). The odds of reporting sleep medication use post-intervention were significantly lower than pre-intervention (OR 0.28 [95% CI 0.11–0.74]). Interviews highlighted most and least helpful intervention components and suggested that participants benefitted from SHUTi. Conclusions Internet-based CBT-I may be a useful, non-pharmacologic treatment that reduces insomnia severity, perceived stress, depression symptoms, and sleep aid use in middle-aged Appalachian women.

Use of alcohol as a sleep aid, unhealthy drinking behaviors, and sleeping pill use among women veterans

ObjectivesSleep complaints, such as insomnia and sleep disturbances caused by posttraumatic stress disorder (PTSD), are more common among women veterans than nonveteran women. Alcohol use among some women may be partially motivated by the desire to improve sleep. This study evaluated rates of alcohol use as a sleep aid among women veterans and explored the relationship between alcohol use to aid sleep and drinking frequency and sleeping pill use. Design and settingNational cross-sectional population-based residential mail survey on sleep and other symptoms. ParticipantsRandom sample of women veteran VA users who completed a postal survey (N = 1533). InterventionsNone. MeasurementsThe survey included demographics, Insomnia Severity Index, Primary Care PTSD screen, and items on alcohol use frequency (days/week), use of prescription or over-the-counter sleep medications, and use of alcohol as a sleep aid (yes/no for each item) over the past month. ResultsA total of 14.3% of respondents endorsed using alcohol to aid sleep. Logistic regression models showed more severe insomnia (odds ratio [OR] = 1.03; 95% confidence interval [CI]: 1.01-1.06) and PTSD (OR = 2.11; 95% CI: 1.49-2.97) were associated with increased odds of using alcohol to aid sleep. Alcohol use to aid sleep was associated with increased odds of daily drinking (OR = 8.46; 95% CI: 4.00-17.87) and prescription (OR = 1.79; 95% CI: 1.34-2.38) and over-the-counter sleep aid use (OR = 1.54; 95% CI: 1.12-2.11). ConclusionsInsomnia and PTSD may increase risk for using alcohol as a sleep aid, which may increase risk for unhealthy drinking and for mixing alcohol with sleep medications. Findings highlight the need for alcohol use screening in the context of insomnia and for delivery of cognitive-behavioral therapy for insomnia to women veterans with insomnia.

Long-term sleep disturbance and prescription sleep aid use among cancer survivors in the United States.

Insomnia and related sleep disorders are common complaints among cancer patients, and use of prescription sleep aids can be high in the treatment setting. The prevalence of sleep disturbance and prescription sleep aid use in the community-dwelling cancer survivorship population, however, remains relatively unexplored. We aim to ascertain the extent to which a cancer diagnosis is associated with sleep disturbances and prescription sleep aid use as measured in several cross sections of individuals across multiple disease sites and time since cancer diagnosis. We used data from five cross-sectional cycles of the National Health and Nutrition Evaluation Survey (NHANES) from 2005 to 2014. We identified a total of 2371 individuals who reported a diagnosis of cancer (averaging 61years old) and 25,788 individuals who did not report a cancer diagnosis (averaging 45years old). We considered several patient-reported sleep-related outcomes. Multivariate regression analyses, as well as propensity score matching, were used to clarify the relationship between sleep disturbances, prescription sleep aid use, and cancer diagnosis, stratified by time since diagnosis and primary disease site. Reported sleep disturbance was common in cancer survivors, with approximately 34% of patients with a history of cancer reporting having ever been told they had trouble sleeping, compared to 23% of non-cancer patients in the general population with no history of cancer (p < 0.001). Propensity score matching supported a significantly higher rate of trouble sleeping among cancer survivors compared to matched controls. Compared to the general adult population without cancer, cancer survivors 11 or more years past diagnosis were more likely to report being diagnosed with trouble sleeping or a sleep disorder. Further, patients with gynecological cancers were more likely to report prescription sleep aid use, sleep disorders, and trouble sleeping compared to adults without a history of cancer. Sleeping problems are common in the cancer survivorship population, especially in patients with a long survivorship history and a history of gynecological cancers. Consideration of symptoms of insomnia and sleep disturbance may be helpful in the follow-up care of these patients.

Road traffic noise and markers of adiposity in the Danish Nurse Cohort: A cross-sectional study

BackgroundStudies have suggested that traffic noise is associated with markers of obesity. We investigated the association of exposure to road traffic noise with body mass index (BMI) and waist circumference in the Danish Nurse Cohort. MethodsWe used data on 15,501 female nurses (aged >44 years) from the nationwide Danish Nurse Cohort who, in 1999, reported information on self-measured height, weight, and waist circumference, together with information on socioeconomic status, lifestyle, work and health. Road traffic noise at the most exposed façade of the residence was estimated using Nord2000 as the annual mean of a weighted 24-h average (Lden). We used multiple linear regression models to examine associations of road traffic noise levels in 1999 (1-year mean) with BMI and waist circumference, adjusting for potential confounders, and evaluated effect modification by degree of urbanization, air pollution levels, night shift work, job strain, sedative use, sleep aid use, and family history of obesity. ResultsWe did not observe associations between road traffic noise (per 10 dB increase in the 1-year mean Lden) and BMI (kg/m2) (β: 0.00; 95% confidence interval (CI): −0.07, 0.07) or waist circumference (cm) (β: −0.09; 95% CI: −0.31, 0.31) in the fully adjusted model. We found significant effect modification of job strain and degree of urbanization on the associations between Lden and both BMI and waist circumference. Job strained nurses were associated with a 0.41 BMI-point increase, (95% CI: 0.06, 0.76) and a 1.00 cm increase in waist circumference (95% CI: 0.00, 2.00). Nurses living in urban areas had a statistically significant positive association of Lden with BMI (β: 0.26; 95% CI: 0.11, 0.42), whilst no association was found for nurses living in suburban and rural areas. ConclusionOur results suggest that road traffic noise exposure in nurses with particular susceptibilities, such as those with job strain, or living in urban areas, may lead to increased BMI, a marker of adiposity.

Sleep aid use in elderly common, with OTC drugs most widely used

Sleep aid use in elderly common, with OTC drugs most widely used

Long-Term Trends in Sleep Disturbance and Prescription Sleep Aid Use among Cancer Survivors in the United States

Long-Term Trends in Sleep Disturbance and Prescription Sleep Aid Use among Cancer Survivors in the United States

Usage transitions between natural products, over‐the‐counter, and prescription sleep aid use: A longitudinal cross‐lagged analysis

Usage transitions between natural products, over‐the‐counter, and prescription sleep aid use: A longitudinal cross‐lagged analysis

Prescription and Nonprescription Sleep Product Use Among Older Adults in the United States

Older adults commonly use products that may be used to promote sleep, such as benzodiazepines and over-the-counter medications, but the current extent of use of both prescription and nonprescription products specifically for sleep in the United States is unknown. Respondents in this cross-sectional, nationally representative survey (the National Poll on Healthy Aging) of community-dwelling older adults aged 65-80 (n = 1,065) reported difficulty initiating sleep or early awakening ("sleep symptoms") and use of prescription medication or nonprescription aids to promote sleep ("sleep product"), including prescription sleep medication, over-the-counter (OTC) sleep aids, prescription pain medication, and herbal/natural sleep aids. Logistic regression was used to determine the association of respondent sociodemographic and clinical characteristics with the use of sleep products. Sleep symptoms were endorsed by 67.7% of respondents (95% confidence interval [CI] 64.7%-70.7%). Use of a sleep product was reported by 35.4% (95% CI 32.4%-38.6%), with 21.9% (95% CI 19.4%-24.7%) using OTC sleep aids, 12.5% using herbal/natural aids (95% CI 10.6%-14.8%), 8.3% using prescription sleep medication (95% CI 6.7%-10.3%), and 5.0% using prescription pain medication (95% CI 3.8%-6.7%). Self-reported fair/poor mental health (relative to excellent/very good) was associated with increased odds of sleep product use (adjusted odds ratio 2.28, 95% CI 1.10-4.72, p = 0.03). More than a third of older adults use medications or aids to help with sleep-most commonly OTC aids. Clinicians should routinely ask older patients about sleep-related difficulties and the use of nonprescription sleep aids.