Night-Time Exposure to Road, Railway, Aircraft, and Recreational Noise Is Associated with Hypnotic Psychotropic Drug Dispensing for Chronic Insomnia in the Paris Metropolitan Area.

Urban environmental noise represents a major public health issue contributing to chronic sleep disturbances, mainly from road, aircraft, and railway traffic. Night-time recreational noise from cafés, bars, and restaurants has emerged as a frequent source of sleep complaints but remains poorly understood, along with the influence of sociodemographic and economic factors. We addressed this gap by conducting a large-scale ecological study across the Paris Metropolitan Area (~10.5 million inhabitants) examining associations between the Average Energetic Index of night-time noise (AEI Ln) from road, aircraft, railway, and recreational sources and the prevalence of adults aged 18-79 reimbursed for hypnotic psychotropic drugs prescribed for chronic insomnia between 2017 and 2019, stratified by sex, age, and socioeconomic status. The AEI Ln represents the population-weighted average energy noise level within each territory at night (22:00-06:00 in France), calculated at the IRIS level (~2487 inhabitants per IRIS). The dispensing of hypnotic psychotropic drugs concerned 513,276 inhabitants (65.4 per 1000 inhabitants [‱]) on average per year. About 8 million inhabitants (75.7%) are exposed to night-time road traffic noise exceeding WHO health guidelines, followed by railway (~1.2 million, 11.6%), recreational (~1.2 million, 11.5%), and aircraft noise (~1.0 million, 9.8%). Each 5 dB(A) increase in AEI Ln was significantly associated (p < 0.001) with higher dispensing of hypnotic psychotropic drugs, strongest for road noise (+1.0‱), followed by recreational (+0.8‱), aircraft (+0.5‱), and railway noise (+0.3‱). Effects were significantly greater among individuals aged >50 (+8.3‱), women (+2.0‱), and those in the most socioeconomically deprived areas (+2.5‱). These results support proactive public policies aimed at reducing noise from transportation and recreational activities in densely urban areas to mitigate chronic insomnia.