Trends in Sedative-Hypnotic Prescription Among Insomnia Patients: A Nationwide Cohort Study From 2010 to 2022 in Korea

Abstract

Background: Global insomnia prevalence increased during the coronavirus disease 2019 (COVID-19) pandemic, driving higher demand for sedative-hypnotics. The objective of this study was to compare sedative-hypnotic prescription patterns in South Korea from 2010 to 2022 and assess the potential impact of the COVID-19 pandemic. Methods: This population-based cohort study from January 1, 2010, to December 31, 2022, used the Korean National Health Insurance’s Health Insurance Sharing Service database of 8,136,437 (60.4% female) unique insomnia patients aged 18 and older. Prescriptions for sedative-hypnotic groups (benzodiazepines, non-benzodiazepines, antidepressants, and antipsychotics), number of patients prescribed sedative-hypnotics, and predicted and observed prescription rates by sex, age, and sedative-hypnotic group were analyzed. Results: The number of prescriptions per 1,000 population increased across all sedativehypnotic groups before and during the pandemic. Women and the elderly had higher prescriptions for all sedative-hypnotic groups compared to men and other age groups. Antidepressant prescriptions saw the highest percentage increase (men 38.6%; women 37.1%) in 1st half of 2020 compared to 2019, followed by antipsychotics (men 28.9%; women 25.7%). Antidepressant prescriptions showed the largest increase relative to predicted levels across all age groups from 2020 to 2021, while non-benzodiazepines exhibited the smallest increase (men 5.6%； women 4.5%). In the 18-29 age group, prescriptions for all sedativehypnotic groups exceeded predicted numbers in 2021. Conclusion: This study found that sedative-hypnotic prescriptions steadily increased from 2010 to 2022, with the trend becoming more pronounced during the COVID-19 pandemic, when prescription rates tended to exceed predicted levels in Korea. Monitoring the use of sedative-hypnotics for insomnia in women, the elderly, and young adults is essential for potential adverse effects and associated mental problems.