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Table 1 Research-based studies of self-care for adults for sleep disturbances, 2006–2016

From: A critical review of self-care for sleep disturbances: prevalence, profile, motivation, perceived effectiveness and medical provider communication

 CountrySleep Assessment Tool/sCondition/profile focusPopular self-care products and practicesMethodSample/predictors of useThemes
Allen et al. 2008USAMedical Outcomes Study (MOS) sleep questionnaireOsteoarthritis, insomnia symptoms, insufficient sleepOver-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 survey1910
Being female white American versus female African American
Andrews et al. 2013USAPSQI, Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) and Sleep Heart Health Study (SHHS) Sleep Habits Questionnaire, ESSHeart failure and InsomniaSt 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 questionnaires111, 2, 3, 4
Bin et al. 2012AustraliaThe Assessment of Quality of Life (AQOL) instrument, cross-validated against commonly used indicators of insomniaInsomniaHerbs, 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 interviews88411,
Braley et al. 2015USAISI, ESS, STOP-BANG questionnaire (for sleep apnea), ISI, RLS diagnostic criteriaInsomnia/OSA/RLSOTCs. 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 questionnaires1901
Cheung et al. 2014AustraliaClinician Diagnosis and ISI.InsomniaValerian and supplementsSelf-administered questionnaire and individual in-depth, semi-structured interviews262,3,4
Daley et al. 2009CanadaPSQI, 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 researchInsomnia and insomnia symptomsOTC 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 databases9531
Henry et al. 2013USAPhysician confirmed diagnosisInsomniaOTC 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 interviews241, 2,3,4
Homsey and O’Connell 2012USAPSQIPoor sleep/insomnia symptomsTake 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 survey300
Higher income level (yoga), higher education attainment (guided imagery), being female (valerian and kava kava and guided imagery)
1, 3
Krakow et al. 2014USAPhysician 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 questionnaire1210
Being female,
higher education attainment,
being white (vs. Hispanic)
Liu et al. 2016Hong KongDSM-IV and ICD-10, ISI and ESSInsomniaOTC medications (16% adults with insomnia)Cross-sectional mailed questionnaire22311
Matthews et al. 2016USAISITraumatic brain injury (TBI), sleep wake disturbance (SWD) using ISI (insomnia symptoms) as measureMeditation, natural medications/sleep aids, breathing, dietary supplements, melatonin and exercise (prevalence rates not reported).Semi-structured interviews192,3,4
Morin et al. 2006CanadaAlgorithm 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 researchInsomniaNatural 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 surveys2001
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
Petrov et al. 2014USAPhysician diagnosis for sleep apnea, Berlin QuestionnaireStroke and sleep apneaOTC 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 telephone21,678
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.
Rosenthal et al. 2008USAPreviously physician diagnosedInsomniaOTC 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 interviews581
Sánchez-Ortuño et al. 2009CanadaISI and DBASInsomnia and insomnia symptoms‘Natural’ OTC medications including, chamomile, valerian, lemon balm, lavender, hops, St John’s wort and magnesium. (36%)Cross-sectional postal survey953
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. 2008Hong KongPSQIPoor sleep/insomnia symptomsPoor 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 questionnaire4001
Vallieries et al. 2014CanadaISI, PSQI, ESS, pre-sleep arousal scale (PSAS)Insomnia symptomsInsomnia 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 questionnaires418
Night shift work
Venn and Arber et al. 2012EnglandPSQIPoor sleep/insomnia symptoms, older ageOTC medications including antihistamines and painkillers and herbal supplements and prayer (no prevalence rates)In-depth semi-structured interviews622,3,4
Venn et al. 2013EnglandPSQIPoor sleep/insomnia symptoms, older ageOTC medications including sleep aids e.g. Nytol, herbal medicine, antihistamines and painkillers (39% poor sleepers).
Relaxation techniques.
In-depth semi-structured interviews62
Being female
1, 2, 3, 4
Wahner-Roedler et al. 2007USAClinician 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 questionnaire406
Being female
Yeung et al. 2014Hong KongChinese version of the Brief Insomnia Questionnaire (BIQ)InsomniaWestern 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 survey4021,3