Prescription patterns of sedative hypnotic medications in the military health system

Rosenie Thelus Jean, Yingxin Hou, James Masterson, Adrian Kress, Vincent Mysliwiec

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Study Objectives: To evaluate prevalence of sedative hypnotic medications and their potential indication among active duty service members (ADSM) and non-ADSM receiving care in the Military Health System (MHS). Methods: Using a retrospective cohort study design, we extracted data on sedative hypnotic medications (benzodiazepine receptor agonists, benzodiazepines, sedating antidepressants, and melatonin receptor agonist) dispensed from January 2009 to December 2015. Prevalence was defined as ≥ 1 dispensing per patient per year whereas chronic episode was categorized as ≥ 90 days of continuous therapy. Chi square statistics, odds ratios, and 95% confidence intervals were calculated to assess meaningful differences between ADSM and non-ADSM. Results: Mean age at dispensing was 33.5 years in ADSM compared to 59.1 years in non-ADSM. Of all drugs dispensed, 79.2% (n = 2.4 million) were to male ADSM compared to 34.5% (11.5 million) to male non-ADSM. Zolpidem and trazodone were the two most frequently used medications, comprising more than 75% of all prescriptions. Age- and sex-adjusted prevalence peaked at 8.1% in 2013 for ADSM and at 4.9% in 2012 for non-ADSM and remained stable thereafter for both groups. Most episodes for ADSM (81.0%) and non-ADSM (65.0%) were acute or intermittent. ADSM were significantly more likely to have a sleep-related diagnosis associated with their episode than non-ADSM (odds ratio 2.35, 95% confidence interval 2.33–2.36), most frequently insomnia. Conclusions: ADSM had a 2% to 3% higher adjusted prevalence of sedative hypnotic medications than non-ADSM. The use of sedative hypnotics in the young ADSM population highlights the need for military-appropriate sleep practices and novel interventions to mitigate sleep disturbances and chronic sleep disorders in this population.

Original languageEnglish (US)
Pages (from-to)873-879
Number of pages7
JournalJournal of Clinical Sleep Medicine
Volume15
Issue number6
DOIs
StatePublished - 2019
Externally publishedYes

Keywords

  • Hypnotics
  • Insomnia
  • Military health population
  • Military personnel
  • Sedatives
  • Sleep disorders

ASJC Scopus subject areas

  • Medicine(all)

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