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Do Chronic Hypnotics Users Truly Develop Tolerance?

Amit Green*, Merav Bensky, Lilach Kemer, Orit Stein, Yaron Dagan

Study Objectives: Insomnia is a common sleep disorder with a prevalence of 10-15% in the population. The primary aim of our study is to assess the development of tolerance to chronic hypnotic administration in patients with insomnia. An additional aim is to describe the prevalence of hypnotic treatment among patients with insomnia.

Methods: This is a retrospective study including all members of Maccabi Health Services above the age of 18 years, of data collected between 2011 and 2014. A chronic user was defined as a person who purchased 180 and more sleeping pills per year.

Results: Only 20% of the insomnia patients treated with hypnotics were chronic users. Between 2011 and 2014, we observed a constant increase of 2.5% per year in the number of chronic users. The number of hypnotics taken by chronic users was not different between the genders or between types of hypnotics. A positive correlation was found between age and number of hypnotics among chronic users. The majority of the long-term chronic patients either did not change or decreased the number of sleeping pills they consumed.

Conclusion: Our results suggest that chronic insomnia patients do not develop tolerance to treatment with hypnotics.