Insomnia Prescribing Rises: What Does a New Study Show?
Quick Facts
What did the Catalonia insomnia study find?
Researchers examined electronic primary care records from 2018 through 2024. Recorded insomnia prevalence reached 11.17%, a relative increase of 43.4%. Among patients with insomnia, the proportion receiving pharmacological treatment rose from 47.88% to 55.11%. These figures describe different denominators: the adult population and patients diagnosed with insomnia. [Published study abstract](https://www.lifescience.net/publications/2178184/insomnia-and-associated-pharmacological-prescripti/).
This retrospective observational design identifies trends rather than their causes. A reasonable methodological caution is that changing recognition or documentation could influence recorded prevalence. Prescription records also cannot, by themselves, establish whether patients took a medicine, benefited from it, or received inappropriate care.
Why is cognitive behavioral therapy recommended for chronic insomnia?
The American Academy of Sleep Medicine strongly recommends multicomponent cognitive behavioral therapy for insomnia, or CBT-I, for adults with chronic insomnia. Its guideline draws on randomized trials, providing treatment evidence that prescribing records cannot supply. CBT-I combines approaches such as rebuilding the association between bed and sleep, adjusting time in bed, and addressing anxiety about sleeping. [AASM behavioral treatment guideline](https://pmc.ncbi.nlm.nih.gov/articles/PMC7853203/).
Advice about caffeine, bedroom conditions, and regular routines can support treatment, but the guideline advises against sleep hygiene as the only therapy for chronic insomnia. CBT-I generally involves several structured sessions and monitoring with sleep diaries. Some components can initially increase sleepiness, so treatment needs adaptation for people with safety-sensitive work or certain medical conditions. The practical implication is that expanding access requires trained support and follow-up, beyond handing patients a sleep-tips leaflet.
When should insomnia medication be reviewed?
Medication can have a role when someone cannot participate in CBT-I, has persistent symptoms despite it, or needs a temporary addition to behavioral treatment. The AASM pharmacological guideline emphasizes individualized decisions rather than treating all sleep medicines as interchangeable. A useful review considers the sleep problem being targeted, response to treatment, other medicines, and whether continued prescribing still offers sufficient benefit. [AASM medication guideline](https://pmc.ncbi.nlm.nih.gov/articles/PMC5263087/).
Benzodiazepines require particular care. The FDA warns that physical dependence can develop during prescribed use and that combining these medicines with opioids or alcohol increases serious risks. Dependence means the body has adapted to a medicine; it does not automatically mean addiction. Anyone taking a benzodiazepine regularly should discuss changes with their prescriber because abrupt discontinuation or rapid dose reduction can cause dangerous withdrawal, including seizures. When discontinuation is appropriate, the taper should be individualized. [FDA benzodiazepine safety communication](https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class).
Frequently Asked Questions
No. Increasing prescribing warrants investigation, but determining whether an individual prescription was appropriate requires clinical context, including symptoms, treatment response, and available alternatives.
No. CBT-I is a structured treatment combining behavioral and cognitive techniques. Sleep hygiene can be included, but the AASM advises against using sleep hygiene alone for chronic insomnia.
Do not stop a regularly taken benzodiazepine abruptly. Discuss its benefits and risks with your prescriber; if stopping is appropriate, an individualized gradual reduction helps manage withdrawal risk.
References
- Bertrans Vilaró B, Miró Catalina Q, Vidal-Alaball J. Insomnia and associated pharmacological prescription in the adult population in primary care in Central Catalonia from 2018 to 2024. Family Medicine and Community Health. 2026;14(3). [Published abstract reproduced by Life Science Network](https://www.lifescience.net/publications/2178184/insomnia-and-associated-pharmacological-prescripti/).
- Edinger JD, Arnedt JT, Bertisch SM, et al. [Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline](https://pmc.ncbi.nlm.nih.gov/articles/PMC7853203/). Journal of Clinical Sleep Medicine. 2021;17(2):255–262.
- Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. [Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline](https://pmc.ncbi.nlm.nih.gov/articles/PMC5263087/). Journal of Clinical Sleep Medicine. 2017;13(2):307–349.
- U.S. Food and Drug Administration. [FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class](https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class). September 23, 2020.