4.5 Article

Use of hypnotic drugs among children, adolescents, and young adults in Scandinavia

Journal

ACTA PSYCHIATRICA SCANDINAVICA
Volume 144, Issue 2, Pages 100-112

Publisher

WILEY
DOI: 10.1111/acps.13329

Keywords

melatonin; utilization; hypnotics; Scandinavia; insomnia; sleep disorders

Categories

Funding

  1. National Institutes of Health
  2. Alcon
  3. Almirall
  4. Astellas
  5. Astra-Zeneca
  6. Boehringer-Ingelheim
  7. LEO Pharma
  8. Novo Nordisk
  9. Servier

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The use of hypnotic drugs, especially melatonin and sedating antihistamines, increased among young Scandinavians from 2012 to 2018, with Sweden showing the largest increase compared to Norway and Denmark. The variation in hypnotic use between Scandinavian countries may be due to differences in sleep problems prevalence, healthcare access, or clinical practice.
Background Hypnotic use in children and adolescents is controversial. Objective To describe the use of hypnotic drugs (melatonin, z-drugs, and sedating antihistamines) among 5- to 24-year-old Scandinavians during 2012 to 2018. Methods Aggregate-level data were obtained from public data sources in Sweden, Norway, and Denmark. We calculated annual prevalence (users/1000 inhabitants) stratified by age group, sex, and country. Quantity of use (Defined Daily Dose (DDD)/user/day) was estimated for Norway and Denmark. Results Melatonin was the most commonly used hypnotic, and its use increased markedly from 2012 to 2018, particularly among females and 15- to 24-year-old individuals. Sweden had the highest increase in use (6.5 to 25/1000) compared with Norway (10-20/1000) and Denmark (5.7-12/1000). The annual prevalence of sedating antihistamine use was also highest in Sweden, reaching 13/1000 in 2018 in comparison to 7.5/1000 in Norway and 2.5/1000 in Denmark. Z-drug use decreased in all countries toward 2018, dropping to 3.5/1000 in Sweden, 4.4/1000 in Norway, and 1.7/1000 in Denmark. The quantity of hypnotic use in Norway and Denmark was 0.8-1.0 DDD/user/day for melatonin in 2018, as compared to 0.1-0.3 for z-drugs and antihistamines. Conclusion The use of melatonin and sedating antihistamines increased among young Scandinavians during 2012-2018, and the increase was twice as high in Sweden compared with Norway and Denmark. In addition, Sweden had the highest use of sedating antihistamines. The Scandinavian variation of hypnotic use could reflect differences in frequency of sleep problems between populations or variation of healthcare access or clinical practice between countries.

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