Hyperarousal, as indicated by daytime alertness and anxiety, is a strong determinant of prescription sleep aid (PSA) use among people with insomnia, a recent study reported. Researchers analyzed longitudinal data from an urban, community-based cohort of 649 adults with Diagnostic and Statistical Manual of Mental Disorders (DSM-5)-based insomnia disorder. Participants completed standardized measures of sleep disturbance, daytime alertness, depression, and anxiety as a baseline with a follow-up 1 year later, reporting on the frequency of their PSA use at both time points. Researchers found:

• Approximately 19% of the sample used PSAs at baseline, the majority (69.4%) of whom continued use 1 year later.

• Anxiety and daytime alertness were the only independent predictors of both acute and chronic PSA use.

• Chronic PSA users did not report any significant improvements in sleep from baseline to follow-up relative to nonusers.

• Findings are consistent with emerging data showing that insomnia is not just a nocturnal sleep disorder but one characterized by 24-hour arousal.

Citation: Pillai V, Cheng P, Kalmbach DA, Roehrs T, Roth T, Drake, CL. Prevalence and predictors of prescription sleep aid use among individuals with DSM-5 insomnia: the role of hyperarousal. Sleep. 2016;39(4):825-832. doi:10.5665/sleep.5636.