Prescription patterns of hypnotics for children and adolescents in Japan: a descriptive epidemiologic study using a claims database.

STUDY

OBJECTIVES

To investigate the prescription patterns for hypnotics among patients <18 years in Japan.

METHODS

We conducted a descriptive epidemiologic study using a claims database in Japan. We included patients aged 0-17 years with first-time prescriptions for hypnotics between June 2021 and June 2023. Hypnotics were classified as melatonin, melatonin receptor agonists (MRAs), dual orexin receptor antagonists (DORAs), Z-drugs, and benzodiazepines. We described the types of hypnotics, dosages, prescription duration, comorbidities, and concomitant medications for overall and by age groups.

RESULTS

The study included 21 145 patients; 1983 aged 0-6 years, 3901 aged 7-11 years, 6664 aged 12-14 years, and 8597 aged 15-17 years. The initial prescribed hypnotics were melatonin (33.9%), MRAs (30.9%), DORAs (18.8%), Z-drugs (10.1%), and benzodiazepines (6.3%). Melatonin was more likely to be prescribed to patients age 0-11 years, MRAs to those aged 0-17 years, and DORAs to patients ages 15-17 years. The most common mental health-related comorbidities were autism spectrum disorder (32.5%), depression (23.4%), attention-deficit hyperactivity disorder (19.8%), and anxiety disorder (18.2%).

CONCLUSIONS

Melatonin was most frequently prescribed in children for a longer duration than other hypnotics, while MRAs were prescribed across all age groups and DORAs mainly to adolescents. These age-specific patterns suggest that the drug selection was conducted according to patient's age, since pediatric insomnia might be correlated with psychiatric disorders related to developmental stage. Future research should investigate the long-term effects of hypnotic prescriptions with consideration of comorbid conditions.