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Evaluation Video

Oral Presentation

Session: Mental Health: Treatment Comparative Effectiveness, Dose, Discontinuation, Use and Trends

Medications to treat insomnia in children and adolescents (2016-2023) in France: a time series analysis of trends

Wednesday, August 28, 2024

2:15 PM – 2:30 PM CEST

Location: Room III

Co-Author(s)

ZV

Zaba Valtuille, MSc (she/her/hers)

Biostatistician
Center of Clinical Investigations, Inserm CIC1426, Robert Debré University Hospital, APHP.Nord, Paris, France, France
EA

Eric Aquaviva, MD, PhD

Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France, France
VT

Vincent Trebossen, MD, PhD

Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France, France
NO

Naim Ouldali, MD, PhD

Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France, France
AB

Aurelie Bourmaud, MD, PhD

Clinical Epidemiology Unit, INSERM CIC1426, Robert Debré University Hospital, APHP.Nord, Paris Cité University- Paris, France, France
SS

Stephane Sclison

IQVIA – Consulting Services & Analytics Department, France
AG

Alexandre Gomez

IQVIA – Consulting Services & Analytics Department, France
AR

Alexis Revet, MD, PhD

Department of Child and Adolescent Psychiatry, Toulouse University Hospital, Toulouse, France, France
HP

Hugo Peyre, MD, PhD

Autism Reference Centre of Languedoc-Roussillon CRA-LR, Excellence Centre for Autism and Neurodevelopmental disorders CeAND, Montpellier University Hospital, MUSE University, France, France
RD

Richard Delorme, MD, PhD

Department of Child and Adolescent Psychiatry, Robert Debré University Hospital, APHP.Nord, Paris Cité University, Paris, France, France

Presenting Author(s)

FK

Florentia Kaguelidou, MD, PhD

Center of Clinical Investigations, Inserm CIC1426, Robert Debré University Hospital, APHP.Nord, Paris, France, France

Slides

Background: The COVID-19 pandemic affected daily life with unprecedented disruptions. Several studies have described the pandemic’s impact on children’s mental health, including increasing reports of poor sleep quality and disturbances.

Objectives: We aimed to evaluate changes in rates and trends in the utilization of medications to treat insomnia in children and adolescents in France following the onset of the COVID-19 pandemic.

Methods: We conducted an interrupted time-series analysis on national dispensing data (X-ponent database, IQVIA). We analyzed all prescription medications to treat insomnia (melatonin, alimemazine, hydroxyzine, zolpidem, and zopiclone) dispensed to individuals aged 6 to 17 years between January 2016 and December 2023 in France. Monthly rates of prescriptions per 1,000 children and adolescents were analyzed before and after the onset of the COVID-19 pandemic (March 2020) using a quasi-Poisson regression accounting for seasonality. Estimated prescription rates were compared to the expected rates forecast using pre-pandemic data only, calculating rate ratios (RR) with 95%CI. Analyses were further stratified by specific medication and age group (children: 6-11 years; adolescents: 12-17 years).

Results: We analyzed a total of 2,675,142 prescriptions dispensed during the study period. In January 2016, the estimated rate of prescriptions was 1.85 per 1,000 children and adolescents. Before the pandemic onset, the prescription rate presented no significant trend (0%; 95%CI: -0.1 to 1%). At the onset of the COVID-19 pandemic, we found an immediate increase of 15.3% in the prescription rate (95%CI: 5.8 to 25.7%). In the period following the pandemic onset, the trend significantly changed and the rate increased by 2.7% (95%CI: 2.4 to 3.0%) per month, reaching 6.8 prescriptions per 1,000 children and adolescents in December 2023. Following the pandemic onset, model-estimated rates exceeded the expected by 123% (RR: 2.23; 95%CI: 2.17 to 2.59). Significant increases in prescription rates were observed for all medications but were more pronounced for prescription melatonin. Changes in prescription rates were more pronounced in adolescents and highly varied with regards to specific medications.

Conclusions: Prescribing of medications to treat insomnia in children and adolescents significantly and persistently increased in the two years following the onset of the pandemic. Future research should focus on identifying and addressing underlying factors of sleep disturbances in young people.