Survey finds most PCPs believe melatonin is a recommended insomnia treatment

Although melatonin is not recommended by the American Academy of Sleep Medicine as an insomnia treatment, about 70% of primary care physicians believe it is, a survey from The Alliance For Sleep found.

The second annual “Wake Up America” survey also reported that two-thirds of PCP and patient respondents felt that sleep hygiene alone is an insomnia treatment.

“Practicing good sleep hygiene is helpful for anyone trying to improve their sleep, but for someone experiencing insomnia, sleep hygiene habits on their own are not often sufficient,” Ruth Benca, MD, PhD, co-chair of The Alliance For Sleep, said in a press release. “Further, while melatonin may be helpful for treating circadian rhythm disorders, it is also not a solution for insomnia.”

Conducted from August through September, the Wake Up America survey was administered to 301 PCPs, 301 sleep specialists, 1,098 U.S. adults who have sleep insomnia or trouble sleeping but are not diagnosed with a sleep disorder and 1,005 U.S. adults with a sleep disorder diagnosis.

Survey responses revealed that 69% of PCPs, 67% of people with trouble sleeping and 70% of their partners believe melatonin is a treatment for insomnia. The results follow other reports demonstrating increasing trends in melatonin use over the past several years. A JAMA Open Network study found that the overall prevalence of melatonin use increased from 0.4% in 1999 to 2000 to 2.1% in 2017 to 2018.

The survey also revealed a disconnect between physicians and patients regarding conversations about sleep troubles. Although 61% of PCPs reported asking about sleep during routine visits, only 36% of people who struggle with sleep reported being asked.

Regarding specific questions on sleep, the one that patients said they were asked about the least was if they have anxiety that keeps them from sleeping (57%), a question that 97% of PCPs said they asked at least sometimes.

Stigma was shown to be a barrier for patients, with 39% believing that sleep insomnia is not considered to be a medical problem and 46% believing an individual should be able to improve sleep on their own. In turn, stigma then discouraged patients from:

• seeking treatment or medication (45%); and
• talking to a health care professional about trouble sleeping (30%).

“The stigma around treating insomnia and the perceived gap in dialogue between [people with trouble sleeping] and HCPs create additional barriers, making the journey for improved sleep even more difficult,” Patricia Torr, president and general manager of Idorsia Pharmaceuticals U.S., which sponsored the survey, said in the release.

The findings reinforce the need for more productive and educational dialogue between PCPs and patients, clearer information on sleep and insomnia and more resources for patients to address insomnia, according to The Alliance For Sleep.

References:

• Insomnia extends beyond the bedroom: Survey finds that trouble sleeping can lead to rocky relationships. https://www.prnewswire.com/news-releases/insomnia-extends-beyond-the-bedroom-survey-finds-that-trouble-sleeping-can-lead-to-rocky-relationships-301688279.html. Published Nov. 29, 2022. Accessed Nov. 29, 2022.
• Li J, et al. JAMA Open Netw. 2022;doi:10.1001/jama.2021.23652
• Wake up America. https://www.wakeupamericasurvey.com/. Accessed Nov. 29, 2022.