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The Medicalization of Sleeplessness: A Public Health Concern
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Sleeplessness, a universal condition with diverse causes, may be increasingly diagnosed and treated (or medicalized) as insomnia. We examined the trend in sleeplessness complaints, diagnoses, and prescriptions of sedative hypnotics in physician office visits from 1993 to 2007. Consistent with the medicalization hypothesis, sleeplessness complaints and insomnia diagnoses increased over time and were far outpaced by prescriptions for sedative hypnotics. Insomnia may be a public health concern, but potential overtreatment with marginally effective, expensive medications with nontrivial side effects raises definite population health concerns.
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“Of note, the recommended first line treatment for insomnia is not pharmacotherapy, although pharmacotherapy remains the most widely-utilized approach(238).”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [238]
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Satria, R. D., Adikusuma, W., Sukorini, U., Avitasari, D. E., Harahap, I. S. K., Lesmana, M. H. S., Irham, L. M., Harahap, N. I. F., Rinastiti, P., Wardhana, D. A., et al. (2025) · Journal of Genetic Engineering and Biotechnology · doi:10.1016/j.jgeb.2025.100502 · Cited by 3
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Gabbay, F. H., Wynn, G. H., Georg, M. W., Gildea, S. M., Kennedy, C. J., King, A. J., Sampson, N. A., Ursano, R. J., Stein, M. B., Wagner, J. R., et al. (2023) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.10574 · Cited by 3
Metadata
- Authors
- Moloney, M. E., Konrad, T. R., & Zimmer, C. R.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2011-08
- Volume
- 101
- Issue
- 8
- Pages
- 1429-1433
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC3134490
- OpenAlex
- W1974600523
- Cited by
- 136
- References
- 37
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 4 · 2023: 3 · 2022: 8 · 2021: 5 · 2020: 9 · 2019: 14 · 2018: 14 · 2017: 19 · 2016: 20 · 2015: 7 · 2014: 10 · 2013: 5 · 2012: 6
- FWCI
- 9.07
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Agency for Healthcare Research and Quality (T32HS000032)
- National Institute on Aging (T32AG000272)
- National Center for Complementary and Alternative Medicine
- National Center for Complementary and Integrative Health (T32AT003378)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Keywords
- insomnia, medicalization, sedative-hypnotic drugs, prescribing trends, overtreatment, physician visits, public health problem, adverse drug reactions
- MeSH terms
- Adolescent, Adult, Aged, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Middle Aged, Drug Prescriptions, Young Adult
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