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. 2014 Aug 1;37(8):1283-93.
doi: 10.5665/sleep.3914.

Trends in outpatient visits for insomnia, sleep apnea, and prescriptions for sleep medications among US adults: findings from the National Ambulatory Medical Care survey 1999-2010

Earl S Ford  1 , Anne G Wheaton  1 , Timothy J Cunningham  1 , Wayne H Giles  1 , Daniel P Chapman  1 , Janet B Croft  1
Affiliations

Trends in outpatient visits for insomnia, sleep apnea, and prescriptions for sleep medications among US adults: findings from the National Ambulatory Medical Care survey 1999-2010

Earl S Ford et al. Sleep. .

Abstract

Study objective: To examine recent national trends in outpatient visits for sleep related difficulties in the United States and prescriptions for sleep medications.

Design: Trend analysis.

Setting: Data from the National Ambulatory Medical Care Survey from 1999 to 2010.

Participants: Patients age 20 y or older.

Measurements and results: The number of office visits with insomnia as the stated reason for visit increased from 4.9 million visits in 1999 to 5.5 million visits in 2010 (13% increase), whereas the number with any sleep disturbance ranged from 6,394,000 visits in 1999 to 8,237,000 visits in 2010 (29% increase). The number of office visits for which a diagnosis of sleep apnea was recorded increased from 1.1 million visits in 1999 to 5.8 million visits in 2010 (442% increase), whereas the number of office visits for which any sleep related diagnosis was recorded ranged from 3.3 million visits in 1999 to 12.1 million visits in 2010 (266% increase). The number of prescriptions for any sleep medication ranged from 5.3 in 1999 to 20.8 million in 2010 (293% increase). Strong increases in the percentage of office visits resulting in a prescription for nonbenzodiazepine sleep medications (∼350%), benzodiazepine receptor agonists (∼430%), and any sleep medication (∼200%) were noted.

Conclusions: Striking increases in the number and percentage of office visits for sleep related problems and in the number and percentage of office visits accompanied by a prescription for a sleep medication occurred from 1999-2010.

Citation: Ford ES, Wheaton AG, Cunningham TJ, Giles WH, Chapman DP, Croft JB. Trends in outpatient visits for insomnia, sleep apnea, and prescriptions for sleep medications among US adults: findings from the National Ambulatory Medical Care Survey 1999-2010.

Keywords: National Ambulatory Medical Care Survey; hypnotics; insomnia; outpatient care; trends.

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Figures

Figure 1
Figure 1
Numbers of office visits for insomnia or any sleep related reason for the visit among adults age 20 y or older, National Ambulatory Medical Care Survey 1999-2010.
Figure 2
Figure 2
Numbers of office visits with a diagnosis of sleep apnea or any sleep related diagnosis among adults age 20 y or older, National Ambulatory Medical Care Survey 1999-2010.
Figure 3
Figure 3
Average annual numbers of office visits that list polysomnography (ICD-9-CM 89.17) or multiple sleep latency testing (ICD-9-CM 89.18) among adults age 20 y or older, by 2-y intervals, National Ambulatory Medical Care Survey 1999-2010. The relative standard error for the period 2005-2006 was about 33% indicating that this estimate does not meet standards of reliability or precision.
Figure 4
Figure 4
Annual number of office visits accompanied by a prescription for sleep medications, National Ambulatory Medical Care Survey 1999-2010.
Figure 5
Figure 5
Percentage (95% confidence interval) of office visits by patients age 20 y or older with any sleep related reason for visit (A) or with any sleep-related diagnosis (B) who received a prescription for a hypnotic medication, by 4-y intervals, National Ambulatory Medical Care Survey 1999-2010. Benz, benzodiazepines; Nonbenz, nonbenzodiazepines; BRA, benzodiazepine receptor agonists; Any, any sleep medication.
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