Skip to main content

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

  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