A comprehensive analysis of over 8 million Korean adults with insomnia reveals dramatic shifts in sleep medication prescribing during the pandemic. Antidepressant prescriptions for sleep disorders increased by nearly 40% in early 2020, far exceeding the rise in traditional sleep aids like benzodiazepines (5-6% increase). Women and elderly patients received disproportionately higher prescription rates across all medication categories.
This prescribing pattern shift suggests clinicians increasingly favored off-label antidepressants over conventional hypnotics during peak pandemic stress. The preference may reflect growing awareness of dependency risks with benzodiazepines, combined with antidepressants' dual benefits for anxiety and sleep disturbances that characterized pandemic-era insomnia. However, this trend raises questions about appropriate medication selection, as antidepressants carry their own side effect profiles and limited evidence for primary insomnia treatment. The data underscores how global health crises can rapidly reshape clinical practice patterns, potentially creating long-term changes in sleep medicine approaches. Future research should examine whether these prescribing shifts improved patient outcomes or created new therapeutic challenges in sleep disorder management.
