0371 EFFECT OF SLEEP AID ON SLEEP: COMPARISON OF SLEEP TIME PARAMETERS USING POLYSOMNOGRAPHY AND DRUG INFORMATION DATABASE

Abstract

Introduction: Many different sleep aids are used to manage insomnia symptoms. Nevertheless, there is paucity of literature comparing this wide range of sleep aids comprehensively by measuring the effect of sleep aids using the gold standard, polysomnography (PSG). We conducted a study showing the effect of each sleep aid category on the sleep time parameters using PSG database. Methods: Twelve months of diagnostic polysomnographic data and drug information from the University Sleep Disorders Center database totaling 847 subjects of 18 years of age or older were collected and analyzed. The sleep aids were categorized into: benzodiazeping (BDZ) receptor agonists (Z-drugs), BDZs, melatonin agonists (MTN), antihistamines (AH), sedating tricyclic antidepressants (TCA), 5HT2A antagonists (5HTA: trazodone, mirtazapine, quetiapine). We examined the PSG time parameters of total sleep time (TST), sleep efficiency (SE), sleep latency (SL), and wake after sleep onset (WASO) based on the sleep aid category including sleep aid non-users. Results: Out of 847 subjects, 607 were sleep aid non-users and 240 were sleep aid users. Sleep aid non-users showed TST 333 min, SE 77.5%, SL 24.3 min, WASO 72.3 min. When adjusted for age, sex, body-mass index and apnea-hypopnea index, sleep aid users showed significantly better sleep parameters in SE (79.8 %; p < 0.05) and WASO (64.2 min; p < 0.05). Further analysis based on sleep aid categories showed the following: TST was significantly increased in MTN (413 min; p < 0.001) and BDZ (357 min; p < 0.05); SE was significantly increased in 5HTA (81.4 %; p < 0.05) and elevated in MTN (84.8%; p = NS); WASO was significantly lower in 5HTA (57.5 min; p < 0.05). AHs showed worse parameters than sleep aid non-users across all four sleep time (TST 298 min, SE 72.4%, SL 32.6 min, WASO 83.8 min). Conclusion: All sleep aids except antihistamine can benefit sleep quantity in patients with insomnia. The best categories are melatonin and 5-HT2A antagonists such as trazodone. On the other hand, antihistamines may worsen sleep. Melatonin receptor and 5-HT2A receptor might be more effective target of interest in future insomnia research.