Epidemiology of alcohol and medication as aids to sleep in early adulthood

Study objectives: In a representative sample of adults 18-45 years of age, this study addressed three questions about the use of sleep aids in the general population: (1) what are the past-year prevalences of the use of alcohol, over-the-counter medication and prescription medication to facilitate sleep? (2) among those who use these substances for sleep problems, what are the patterns of use? and (3) are there social factors, independent of sleep characteristics, that increase the likelihood of alcohol and medication use to aid sleep? Design: The 1996 Detroit Area Survey was a random-digit-dial, computer-assisted survey of a representative sample of 2,181 adults ages 18-45 in the Detroit primary metropolitan statistical area. Eligible household response rate was 86.8%. Results: In the general population, use of alcohol and medication as sleep aids in the past year was found to be fairly common: 13% used alcohol, 18% used medications and 5% used both. The prevalence of any substance use to aid sleep was 26%. The duration of use was short for the majority of users, less than 1 week. However, duration of use was greater for the majority of those using prescription sleep aids. A substantial minority of users report regular use lasting longer than 1 month: 15%, 9%, and 36% for alcohol, OTC medications, and prescription medications, respectively. Both sociodemographic and sleep characteristics were associated with alcohol and medication use to aid sleep. Difficulty falling asleep was the factor most strongly associated with use of substances to improve sleep. Sex, race/ethnicity, work shift, marital status and education were also significantly associated with one or more types of sleep aid use adjusting for difficulty falling asleep.