The Utilization of Health Services and Self-Care by Older Women With Sleeping Problems: Results From a Nationally Representative Sample of 9,110 Women

Abstract

Health professionals, particularly GPs, may need to actively inquire with older patients in their care with sleeping problems about the use of herbal medicines, to ensure their sleeping problems are being directly and effectively treated, particularly in light of increased risks associated with sleeping problems for this age cohort.

A critical review of self-care for sleep disturbances: prevalence, profile, motivation, perceived effectiveness and medical provider communication

“…Sleep disturbances such as insomnia symptoms (IS)-characterized by difficulty in initiating or maintaining sleep (Morin et al 2006;Ohayon 2001)-can affect up to a third of the population internationally (Léger et al 2007;Ohayon 2002) and up to 56% in the USA (Léger et al 2007). Older people and women are particularly susceptible, the intersection of these characteristics causing prevalence estimates of IS to rise to between 49 and 72% (Byles et al 2005;Meredith et al 2017;Meredith et al 2019) within nationally representative cohorts of older women in Australia. Distinct from IS, insomnia disorder (ID), as well as including difficulties initiating or maintaining sleep, is also characterized by dissatisfaction with sleep quality or duration and with significant distress and impairments of daytime functioning (Morin et al 2015).…”

“…There is evidence to suggest many people with sleep disturbances avoid seeking professional medical help partly due to aforementioned concerns, and as a way for people to maintain a feeling of control over their health (Knauert et al 2015;Venn et al 2013). Adults with sleep disturbances sometimes consider self-care products (such as natural herbs or OTC pharmaceuticals such as Diphenhydramine or Doxylamine) effective alternatives to seeking professional medical help (Meredith et al 2017;Abraham et al 2017) as well as self-care practices including relaxation techniques, yoga and tai chi (Bertisch et al 2009).…”

“…Popular self-care products and practices for sleep disturbances include, drinking chamomile tea or a hot milk before sleep, taking OTC medications such as antihistamines, herbal medicines, Chinese medicines, melatonin (as reported in countries in which it is considered an OTC), engaging in meditation and relaxation techniques (Meredith et al 2017;Bertisch et al 2009;Boon et al 2013;Cherniack et al 2008;Fouladbakhsh and Stommel 2010;Frawley et al 2015;Furihata et al 2011;Liu et al 2016;Moore et al 2011;Pearson et al 2006;Tsai et al 2008;Williams et al 2014).…”

“…Although in some cases these options are promoted as safer options compared to prescription treatments for certain sleep disturbances, with reduced or no side effects (Fernández-San-Martín et al 2010), there is limited evidence of efficacy and safety, with specific concern about OTC products taken without medical advice (Meredith et al 2017;Abraham et al 2017) particularly in the context of undisclosed concurrent use with medical drugs (Leach and Page 2015). Nonetheless, research suggests that self-care products and practices are utilized more frequently than prescription medications by people with sleep disturbances (Morin et al 2006;Sivertsen et al 2009;Sánchez-Ortuño et al 2009;Worthington and Melia 2006).…”

“…Empirical research indicating the prevalence of use of health services-including self-care for the treatment of sleep disturbances-has become increasingly available over the last 10 years (Meredith et al 2017;Sandberg et al 2014). Whilst there is a significant body of research focusing exclusively on the heightened use of conventional medical services for people with sleep disturbances (Blay et al 2008;Moloney et al 2011;Novak et al 2004;Sarsour et al 2011;Kaufmann et al 2013;Bin et al 2012), prevalence information on the use of self-care, including OTC medicine use is scattered with articles focusing mostly on just one or two aspects of use (e.g.…”