Table 1 Research-based studies of self-care for adults for sleep disturbances, 2006–2016
Country | Sleep Assessment Tool/s | Condition/profile focus | Popular self-care products and practices | Method | Sample/predictors of use | Themes | |
|---|---|---|---|---|---|---|---|
Allen et al. 2008 | USA | Medical Outcomes Study (MOS) sleep questionnaire | Osteoarthritis, insomnia symptoms, insufficient sleep | Over-the counter (OTC)) medications (12% people with osteoarthritis and sleep disorders) Herbal medications (1% people with osteoarthritis and sleep disorders) | Cross-sectional, self-administered questionnaire survey | 1910 Being female white American versus female African American | 1 |
Andrews et al. 2013 | USA | PSQI, Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) and Sleep Heart Health Study (SHHS) Sleep Habits Questionnaire, ESS | Heart failure and Insomnia | St John’s wort (9% people with insomnia and stable heart failure), vitamins/mineral supplements (73% with insomnia and stable heart failure) OTCs (100% with insomnia and stable heart failure) | Two focus group sessions and questionnaires | 11 | 1, 2, 3, 4 |
Bin et al. 2012 | Australia | The Assessment of Quality of Life (AQOL) instrument, cross-validated against commonly used indicators of insomnia | Insomnia | Herbs, vitamins and minerals (20% adults with insomnia vs. 10% without insomnia). No concurrent use stats | Nationally representative cross-sectional national survey using computer-aided personal interviews | 8841 | 1, |
Braley et al. 2015 | USA | ISI, ESS, STOP-BANG questionnaire (for sleep apnea), ISI, RLS diagnostic criteria | Insomnia/OSA/RLS | OTCs. OTC hypnotic use frequency NOT associated with insomnia or sleep apnea. People with RLS versus those without had a higher prevalence of diphenhydramine-containing products (40% versus 18%, chi-squared P = 0.0002). | Medical records and self-administered questionnaires | 190 | 1 |
Cheung et al. 2014 | Australia | Clinician Diagnosis and ISI. | Insomnia | Valerian and supplements | Self-administered questionnaire and individual in-depth, semi-structured interviews | 26 | 2,3,4 |
Daley et al. 2009 | Canada | PSQI, ISI, algorithm based on APA Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and World Health Organization (WHO) ICD-10 classification of mental and behavioral disorder: diagnostic criteria for research | Insomnia and insomnia symptoms | OTC medications (76% adults with insomnia vs. 62% good sleepers) OTC medications for insomnia (10% adults with insomnia syndrome, 5% insomnia symptoms and 1% of good sleepers). | Self-administered questionnaires and government health-care databases | 953 | 1 |
Henry et al. 2013 | USA | Physician confirmed diagnosis | Insomnia | OTC medications or dietary supplements (46% adults with insomnia) Diet or exercise (25% adults with insomnia) Yoga (13% adults with insomnia) Self-hypnosis (13% adults with insomnia) Relaxation (13% adults with insomnia) Herbal tea or warm milk (8% adults with insomnia) Meditation/prayer (8% adults with insomnia)* *all listed above were taken contemporaneously with professional medical treatment | In-depth semi-structured interviews | 24 | 1, 2,3,4 |
Homsey and O’Connell 2012 | USA | PSQI | Poor sleep/insomnia symptoms | Take antihistamines (22%) Drink liquids at bedtime (22%) Breathe deeply (19%) Take melatonin (16%) Use guided imagery (16%) Practice Progressive Muscle Relaxation (PMR) (16%) Take valerian (9%) Practice yoga (6%) Take Kava Kava (5%)* * 90% of sample had poor sleep/insomnia symptoms according to PSQI. 10% either subjectively considered themselves to have sleep disorders or may have recovered from sleep disorders. All participants reported using the above products or practices for sleep disorders. | Web-based survey | 300 Higher income level (yoga), higher education attainment (guided imagery), being female (valerian and kava kava and guided imagery) | 1, 3 |
Krakow et al. 2014 | USA | Physician diagnosis, International Classification of Sleep Disorders and ISI, apnea-hypopnea index (AHI), respiratory disturbance index (RDI). | Insomnia disorder (ranked as chief concern for all participants) | OTC medications (49% adults with insomnia using any OTC sleep aid and 37% of all participants for sleep) | Medical Records and online questionnaire | 1210 Being female, higher education attainment, being white (vs. Hispanic) | 1, |
Liu et al. 2016 | Hong Kong | DSM-IV and ICD-10, ISI and ESS | Insomnia | OTC medications (16% adults with insomnia) | Cross-sectional mailed questionnaire | 2231 | 1 |
Matthews et al. 2016 | USA | ISI | Traumatic brain injury (TBI), sleep wake disturbance (SWD) using ISI (insomnia symptoms) as measure | Meditation, natural medications/sleep aids, breathing, dietary supplements, melatonin and exercise (prevalence rates not reported). | Semi-structured interviews | 19 | 2,3,4 |
Morin et al. 2006 | Canada | Algorithm based on APA Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and World Health Organization (WHO) ICD-10 classification of mental and behavioral disorder: diagnostic criteria for research | Insomnia | Natural products (36% Adults with insomnia; OR = 3.7 vs. those without insomnia) OTC medications (9%; OR = 2.8 vs. those without insomnia) Relaxation (38% adults with insomnia; OR = 2.6 adults with insomnia vs. those without insomnia) | Telephone interview surveys | 2001 Being female, being older (for regular use of any sleep aid, OTC or prescription vs occasional use = mean age 52 vs. 43), poorer self-reported physical and mental health, living in an urban area, presenting anxiety and depressive symptoms | 1 |
Petrov et al. 2014 | USA | Physician diagnosis for sleep apnea, Berlin Questionnaire | Stroke and sleep apnea | OTC sleep medications (12% of those using OTCs were people with diagnosed sleep apnea and 19% were those at high risk of sleep apnea) | Longitudinal study involving telephone interviews and in-home baseline interviews then 6 monthly follow up interviews via telephone | 21,678 Being white, being female, not having left ventricular hypertrophy, being high risk for sleep apnea, non-smokers, non-diabetics, higher educational attainment* * Not only those with diagnosed sleep apnea but those specifically using OTCs for sleep. | 1 |
Rosenthal et al. 2008 | USA | Previously physician diagnosed | Insomnia | OTC medications taken concurrently with prescribed medication (13% current adults with insomnia or previously diagnosed adults with insomnia). Herbal medicines (8% current adults with insomnia or previously diagnosed adults with insomnia and 6% of those concurrently taking prescription medications). | Telephone interviews | 58 | 1 |
Sánchez-Ortuño et al. 2009 | Canada | ISI and DBAS | Insomnia and insomnia symptoms | ‘Natural’ OTC medications including, chamomile, valerian, lemon balm, lavender, hops, St John’s wort and magnesium. (36%) | Cross-sectional postal survey | 953 Younger age (mean age of exclusive natural product use = 40 vs mean age of exclusive prescription medication use = 53). Being female, higher education level* *these apply to all those using natural products for sleep not just adults with insomnia | 1, 3 |
Suen et al. 2008 | Hong Kong | PSQI | Poor sleep/insomnia symptoms | Poor sleepers more frequently consumed milk drinks prior to sleep than good sleepers. (Mean frequency (standard deviation) and Median over one week (0–7) was 0.67 (1.24), 0 for poor sleepers vs. 0.32 (0.83), 0 for good sleepers). Poor sleepers more frequently set aside time for relaxation/relaxing exercise prior to sleep than good sleepers (mean frequency (standard deviation) and Median over one week (0–7) was 0.93 (1.52), 0 for poor sleepers vs. 0.76 (1.39), 0 for good sleepers. | Self-administered questionnaire | 400 | 1 |
Vallieries et al. 2014 | Canada | ISI, PSQI, ESS, pre-sleep arousal scale (PSAS) | Insomnia symptoms | Insomnia symptoms contributed significantly to the use of prescribed medication, natural products for sleep and OTC medications for sleep (Wald X2 = 11.8, 10.07; Wald X2 = 5.85, all P < 0.02 respectively). | Self-administered questionnaires | 418 Night shift work | 1 |
Venn and Arber et al. 2012 | England | PSQI | Poor sleep/insomnia symptoms, older age | OTC medications including antihistamines and painkillers and herbal supplements and prayer (no prevalence rates) | In-depth semi-structured interviews | 62 | 2,3,4 |
Venn et al. 2013 | England | PSQI | Poor sleep/insomnia symptoms, older age | OTC medications including sleep aids e.g. Nytol, herbal medicine, antihistamines and painkillers (39% poor sleepers). Relaxation techniques. | In-depth semi-structured interviews | 62 Being female | 1, 2, 3, 4 |
Wahner-Roedler et al. 2007 | USA | Clinician diagnosis for Obstructive Sleep Apnea (OSA) and apnea-hypopnea index (AHI) | Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) | Diphenhydramine (7% people with Obstructive-hypopnea syndrome). | Anonymous survey questionnaire | 406 Being female | 1 |
Yeung et al. 2014 | Hong Kong | Chinese version of the Brief Insomnia Questionnaire (BIQ) | Insomnia | Western herbal products (6% of adults with insomnia vs. 1% good sleepers.). Physical exercise (6% adults with insomnia vs. 7% good sleepers). Aromatherapy (3% adults with insomnia vs. 1% good sleepers) Tai Chi (1% adults with insomnia vs. 0% good sleepers) Relaxation (1% adults with insomnia vs. 0% good sleepers) | Telephone survey | 402 | 1,3 |