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NEUROLOGY

Racial Differences in Sleep Medication Use: A Cross-Sectional Study of the Johnston County Osteoarthritis Project

Assistant Research Professor, Health Services Research and Development Service, Durham Veterans Affairs Medical Center and Department of Medicine, Duke University Medical Center, Durham, NC

Jordan B Renner, MD

Professor, Radiology and Allied Health Sciences, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC

Brenda DeVellis, PhD

Professor, Departments of Health Behavior and Health Education and Psychology, University of North Carolina at Chapel Hill

Charles G Helmick, MD

Medical Epidemiologist, Centers for Disease Control and Prevention, Atlanta, GA

Joanne M Jordan, MD MPH

Director, Thurston Arthritis Research Center; Associate Professor, Departments of Medicine and Orthopedaedics, University of North Carolina at Chapel Hill

Reprints: Dr. Allen, HSR&D (152), VAMC, 508 Fulton St., Durham, NC 27705, fax 919/416-5836, Kelli.Allen{at}duke.edu

BACKGROUND: Little is known about racial differences in the use of sleep medications.

OBJECTIVES: To compare sleep medication use among African Americans and whites with self-reported current sleep problems.

METHODS: Participants were 1910 individuals (69% female, 34% African American, 66% white) from the Johnston County Osteoarthritis Project. We examined racial differences in self-reported current use of prescription, nonprescription, herbal, and other medications for sleep. Multivariable logistic regression models controlled for age, sex, education, health insurance, symptomatic hip or knee osteoarthritis, depressive symptoms, obesity, fair or poor general health, and self-reported annual days of sleep problems. Models were conducted separately for the whole sample and for men and women.

RESULTS: Among participants with current sleep problems, 31% were using one or more types of sleep medication: 17% prescription, 12% nonprescription, 1% herbal, and 3% other products. African Americans were less likely than whites to be using any sleep medication (25% vs 35%; p < 0.001), prescription sleep medication (14% vs 19%; p = 0.003), and nonprescription sleep medication (10% vs 13%; p = 0.048). These racial differences persisted in multivariable models. In sex-stratified analyses, there were significant racial differences in sleep medication use only among women.

CONCLUSIONS: African Americans were less likely than whites to report current use of prescription and nonprescription sleep medications; these results appeared to be largely driven by racial differences among women. Additional research should study possible underlying factors and determine whether these racial differences impact clinical outcomes.

Key Words: race, sex, sleep medication

Published Online, July 15, 2008. www.theannals.com, DOI 10.1345/aph.1L111