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Sociodemographic characteristics included age, sex, race/ ethnicity, marital status, educational attainment, and family income.As a measure of respondents' health habits, we considered smoking status (past, current, or never), physical activity, and alcohol intake. Estimates were weighted to account for the unequal probabilities of selection resulting from the complex sample design, non-response, and planned oversampling of selected populations.We defined health care access and network using several proxies including insurance status (Private, Medicare, Medicaid or other government insurance, none/unknown), usual source of care (clinic or health center, doctor's office/health maintenance organization, emergency department, other place NOS, no usual place/unknown), and number of visits to health care providers in the past year (0-1, 2-3, 4-9, ), chronic medical conditions (history of arthritis, cancer, cardiovascular disease, diabetes, liver disease, lung disease), and seen by a mental health professional within past year (yes/no), as a proxy for respondents' medical and psychiatric illness burden. To determine predictors of MCUFI use, we performed multivariate logistic regression.As there were significant missing data for income (n = 2,403) and alcohol intake (n = 4,445) among participants included in the main model (n = 32,328), we performed multiple imputation by chained equations.: age, sex, race/ethnicity, educational level, imputed family income, marital status, insurance status, smoking status, imputed alcohol intake, physical activity level, self-reported health status, chronic medical conditions, having seen a mental health professional in past year, and use of other prescription sedative medication.Among the NHANES 2005-2008 subsample, we explored concurrent use of MCUFIs and self-reported use of medications for sleep.Overall, 906 sampled participants, representing an estimated 3% of the U. population or over 6 million adults, reported using a prescription medication commonly used for insomnia (MCUFI) within the preceding month.Physical activity was based on NHANES' categorization of physical activity levels during the last 30 days and defined as vigorous if participants reported any “vigorous activity for at least 10 minutes that caused heavy sweating or large increases in breathing or heart rate,” moderate if participants reported “moderate activities for at least 10 minutes that cause only light sweating or a slight to moderate increase in breathing or heart rate,” or sedentary if neither vigorous nor moderate activity was reported. We used chi-square tests to compare characteristics between MCUFI users and non-users.Alcohol intake was classified as abstain/rare ( 14 drinks/week for men) adapted from definitions used by the National Institute on Alcohol Abuse and Alcoholism. We calculated the prevalence of use of MCUFIs overall, categories of MCUFIs, and concurrent use of other sedative medications.
Consent was obtained from participants by the NCHS after approval by the NHANES Institutional Review Board/ NCHS Research Ethics Review Board.Lastly, among the subsample participating in NHANES 2005-2008 (n = 10,878) who were also queried specifically about use of pills or medications “to help with sleep,” we quantified prevalence of use of sleep aids (yes/ no) and explored concurrent use of MCUFIs and sleep aids.Of note, specific types of medications used to help with sleep were not elicited.” Those reporting prescription medication use were then asked to show all of their medication containers to the interviewer for recording.If participants could not produce containers, interviewers asked for verbal confirmation of medication name.
We defined MCUFI use as use of any of the following medications in the preceding month: benzodiazepine receptor agonists (eszopiclone, zaleplon, zolpidem, estazolam, flurazepam, quazepam, temazepam, triazolam), barbiturates (amobarbital, amobarbitalsecobarbital, chloral hydrate), doxepin, quetiapine, ramelteon, and trazodone.