A Descriptive Epidemiological Study of Pediatric Sleep Medications in Japan: A Health Insurance Claims-Based Analysis

Speaker(s)

Fujimoto K1, Tanaka S2, Mishima K3, Sakata Y1, Kubota N1, Koebisu M1, Fukasawa T4, Mizuno K4, Ishii M1, Moline M5, Kawakami K4
1Eisai Co., Ltd., Tokyo, Japan, 2Kobe Pharmaceutical University, Kobe, Japan, 3Akita University, Akita, Japan, 4Kyoto University, Kyoto, Japan, 5Eisai, Inc, Nutley, NJ, USA

Presentation Documents

OBJECTIVES: Insomnia in children can affect not only their physical and mental development but also their cognitive development, which can interfere with their school and social life. There are few reports on the actual treatment of pediatric insomnia in Japan. The aim of this study was to investigate the prescribing practices of sleep medications for patients under 18 years old.

METHODS: A large-scale nationwide claims database (from June 2021 to September 2022) provided by JMDC Inc. was used. Patients who could be followed for 180 days from the date of their first prescription of sleep medications were included in the analysis. The sleep medications were classified into five categories: melatonin receptor agonists (MRA), melatonin, dual orexin receptor antagonists (DORAs), Z-drugs and benzodiazepines (BZDs). The type and duration of sleep medication prescriptions, patient comorbidities, and concomitant psychotropic medications were analyzed.

RESULTS: The study included 10631 cases, with 977, 1899, 3401, and 4354 patients aged 0-6, 7-11, 12-14, and 15-17 years. The five sleep medication categories were as follows: MRA (32.3%), melatonin (29.9%), DORAs (18.4%), Z-drugs (11.0%), and BZDs (6.5%). The median duration (days) of use for the five categories was 47, 105, 30, 14, 14, respectively. The most common comorbidities within 180 days prior to initiation of sleep medications were insomnia (32.5%), autism spectrum disorder (14.6%), and depression (11.3%). Melatonin was more common in 0-11 years, MRA in 12-15 years, MRA and DORA in 16-18 years.

CONCLUSIONS: This study is the first to describe the use of sleep medications in pediatric patients in Japan. Our findings indicate that MRA and melatonin are most frequently used in children, followed by DORAs. Melatonin was used for the longest period among the categories. Approximately 90% of children prescribed sleep medications had neuropsychiatric comorbidities.

Code

EPH168

Topic

Epidemiology & Public Health

Topic Subcategory

Safety & Pharmacoepidemiology

Disease

Drugs, Mental Health (including addition), Pediatrics