Advertisement

Trends in prescriptions for sedative–hypnotics among Korean adults: a nationwide prescription database study for 2011–2015

  • Mi Hyun Lee
  • Jae-Won Choi
  • Joonki Lee
  • Aesun Shin
  • Seong Min Oh
  • Sun Jae JungEmail author
  • Yu Jin LeeEmail author
Original Paper

Abstract

Purpose

This study investigated prescriptions for sedative–hypnotics via data obtained from the Health Insurance Review and Assessment (HIRA) service.

Methods

Data on sedative–hypnotic prescriptions from the HIRA service of the Republic of Korea were analyzed from 2011 to 2015. We included prescriptions for subjects > 18 years of age from hospitals and community healthcare centers. In addition, subgroup analyses with a subsample restricted to prescriptions from patients with diagnostic codes F510 (nonorganic insomnia) or G470 (insomnia) were performed. After analyzing the number of prescriptions by individual pharmacy items, the prescription codes were grouped as: (1) benzodiazepines; (2) non-benzodiazepines, including zolpidem; (3) antidepressants; and (4) antipsychotics. We calculated the monthly percent change in the number of prescriptions by drug group using Joinpoint regression.

Results

Among the sedative–hypnotic groups, benzodiazepines were the most commonly prescribed drugs in Korea during the study period. As a single sedative–hypnotic item, zolpidem was the most frequently prescribed medication for patients with insomnia. Prescriptions for all groups of sedative–hypnotics increased significantly during the study period. When stratified by age group, antipsychotic prescriptions increased significantly by 0.19–0.21% per month among men and women aged 50–59 years and > 70 years. Prescriptions for antidepressants in 30–39-year-old men increased significantly by 0.20%.

Conclusions

Benzodiazepine prescriptions as well as those for antipsychotics and antidepressants to treat insomnia increased during 2011–2015 in Korea. Monitoring the use of sedative–hypnotics at the national level is necessary, especially in the elderly population.

Keywords

Sedatives Hypnotics Prescription Insomnia 

Notes

Acknowledgements

This study was supported by the research fund of the Mental Health Technology Development Project (Project No. HM15C1197).

Compliance with ethical standards

Conflict of interest

On behalf of all of the authors, the corresponding author states that there are no conflicts of interest.

Supplementary material

127_2018_1615_MOESM1_ESM.docx (15 kb)
Supplementary material 1 (DOCX 14 KB)

References

  1. 1.
    Thorpy MJ (2012) Classification of sleep disorders. Neurotherapeutics 9:687–701.  https://doi.org/10.1007/s13311-012-0145-6 CrossRefGoogle Scholar
  2. 2.
    Walsh JK, Coulouvrat C, Hajak G et al (2011) Nighttime insomnia symptoms and perceived health in the America Insomnia Survey (AIS). Sleep 34:997–1011.  https://doi.org/10.5665/SLEEP.1150 CrossRefGoogle Scholar
  3. 3.
    Morphy H, Dunn KM, Lewis M, Boardman HF, Croft PR (2007) Epidemiology of insomnia: a longitudinal study in a UK population. Sleep 30:274–280Google Scholar
  4. 4.
    Cho YW, Shin WC, Yun CH, Hong SB, Kim J, Earley CJ (2009) Epidemiology of insomnia in Korean adults: prevalence and associated factors. J Clin Neurol 5:20–23.  https://doi.org/10.3988/jcn.2009.5.1.20 CrossRefGoogle Scholar
  5. 5.
    McCall WV1, Reboussin BA, Cohen W (2000) Subjective measurement of insomnia and quality of life in depressed inpatients. J Sleep Res 9:43–48CrossRefGoogle Scholar
  6. 6.
    Daley M, Morin CM, LeBlanc M et al (2009) Insomnia and its relationship to healthcare utilization, work absenteeism, productivity, and accidents. Sleep Med 10:427–438.  https://doi.org/10.1016/j.sleep.2008.04.005 CrossRefGoogle Scholar
  7. 7.
    Sivertsen B, Øverland S, Pallesen S et al (2009) Insomnia and long sleep duration are risk factors for later work disability. The Hordaland Health Study. J Sleep Res 18:122–128.  https://doi.org/10.1111/j.1365-2869.2008.00697.x CrossRefGoogle Scholar
  8. 8.
    Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M (2008) Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med 4:487–504Google Scholar
  9. 9.
    Kripke DF, Langer RD, Kline LE (2012) Hypnotics’ association with mortality or cancer: a matched cohort study. BMJ Open 2:e000850.  https://doi.org/10.1136/bmjopen-2012-000850 CrossRefGoogle Scholar
  10. 10.
    de Gage SB, Moride Y, Ducruet T et al (2014) Benzodiazepine use and risk of Alzheimer’s disease: case–control study. BMJ 349:g5205.  https://doi.org/10.1136/bmj.g5205 CrossRefGoogle Scholar
  11. 11.
    Chen PL, Lee WJ, Sun WZ, Oyang YJ, Fuh JL (2012) Risk of dementia in patients with insomnia and long-term use of hypnotics: a population-based retrospective cohort study. PLoS One 7:e49113.  https://doi.org/10.1371/journal.pone.0049113 CrossRefGoogle Scholar
  12. 12.
    Chung KH, Li CY, Kuo SY, Sithole T, Liu WW, Chung MH (2015) Risk of psychiatric disorders in patients with chronic insomnia and sedative–hypnotic prescription: a nationwide population-based follow-up study. J Clin Sleep Med 11:543–551.  https://doi.org/10.5664/jcsm.4700 Google Scholar
  13. 13.
    Kim B, Ahn JH, Cha B et al (2015) Characteristics of methods of suicide attempts in Korea: Korea National Suicide Survey (KNSS). J Affect Disord 188:218–225.  https://doi.org/10.1016/j.jad.2015.08.050 CrossRefGoogle Scholar
  14. 14.
    OECD Health Statistics (2015)  https://doi.org/10.1787/health-data-en. Accessed 10 Dec 17
  15. 15.
    Sung-Hee OH et al (2014) In-depth investigation for prescribing trends of benzodiazepines in South Korea. Int J Clin Pharmacol Ther 52:460–470.  https://doi.org/10.5414/CP202008 CrossRefGoogle Scholar
  16. 16.
    Kronholm E, Markkula J, Virta LJ (2012) What is behind the seeming cessation of the increase in sleep medicine consumption in Finland during the last years. J Public Health Res 1:149–154.  https://doi.org/10.4081/jphr.2012.e23 CrossRefGoogle Scholar
  17. 17.
    Ford ES, Wheaton AG, Cunningham TJ, Giles WH, Chapman DP, Croft JB (2014) Trends in outpatient visits for insomnia, sleep apnea, and prescriptions for sleep medications among US adults: findings from the National Ambulatory Medical Care Survey 1999–2010. Sleep 37:1283–1293.  https://doi.org/10.5665/sleep.3914 CrossRefGoogle Scholar
  18. 18.
    Mong JA, Baker FC, Mahoney MM et al (2011) Sleep, rhythms, and the endocrine brain: influence of sex and gonadal hormones. J Neurosci 31:16107–16116.  https://doi.org/10.1523/JNEUROSCI.4175-11.2011 CrossRefGoogle Scholar
  19. 19.
    Glass J, Lanctôt KL, Herrmann N, Sproule BA, Busto UE (2005) Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits. Br Med J 331(7526):1169.  https://doi.org/10.1136/bmj.38623.768588.47 CrossRefGoogle Scholar
  20. 20.
    Kim L, Kim JA, Kim S (2014) A guide for the utilization of health insurance review and assessment service national patient samples. Epidemiol Health 30:36:e2014008.  https://doi.org/10.4178/epih/e2014008 CrossRefGoogle Scholar
  21. 21.
    Korea Statistics Office (2017) http://kostat.go.kr. Accessed 10 Dec 17
  22. 22.
    Bertisch SM, Herzig SJ, Winkelman JW, Buettner C (2014) National use of prescription medications for insomnia: NHANES 1999–2010. Sleep 37:343–349.  https://doi.org/10.5665/sleep.3410 CrossRefGoogle Scholar
  23. 23.
    Pillai V, Cheng P, Kalmbach DA, Roehrs T, Roth T, Drake CL (2016) Prevalence and predictors of prescription sleep aid use among individuals with DSM-5 insomnia: the role of hyperarousal. Sleep 39:825–832.  https://doi.org/10.5665/sleep.5636 CrossRefGoogle Scholar
  24. 24.
    Hermes EDA, Sernyak M, Rosenheck R (2013) Use of second-generation antipsychotic agents for sleep and sedation: a provider survey. Sleep 36:597–600.  https://doi.org/10.5665/sleep.2554 CrossRefGoogle Scholar
  25. 25.
    Kamphuis J, Taxis K, Schuiling-Veninga CC, Bruggeman R, Lancel M (2015) Off-label prescriptions of low-dose quetiapine and mirtazapine for insomnia in The Netherlands. J Clin Psychopharmacol 35:468–470.  https://doi.org/10.1097/JCP.0000000000000338 Google Scholar
  26. 26.
    Finnish Medical Society Duodecim and the Finnish Sleep Research Society working group (2008) Treatment of insomnia, current care guidelines. Duodecim 124:1782–1794Google Scholar
  27. 27.
    Ji KH, Kang MR (2017) Trends of public interest in sleep disorders: looking by internet searching volume. Sleep Med Res 8:62–67.  https://doi.org/10.17241/smr.2017.00101 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychiatrySeoul National University HospitalSeoulRepublic of Korea
  2. 2.Department of Psychiatry, Center for Sleep and ChronobiologySeoul National University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Preventive MedicineSeoul National University College of MedicineSeoulRepublic of Korea
  4. 4.Department of Preventive MedicineYonsei University College of MedicineSeoulRepublic of Korea

Personalised recommendations