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To examine the robustness of our results, in sensitivity analyses, we further adjusted for additional measures of health-care access (number of visits to health-care provider in the last year and usual source of care).Since BMI is associated with sleep disorders, we repeated our models adding in BMI among the subpopulation of adults also participating in the physical examination component of the NHANES (n = 29,082).Households are selected for face-to-face interviews in English and/or Spanish using a multistage probability sampling design.Low-income persons, persons ≥ 60 years of age, African Americans, and persons of Mexican origin are oversampled.Demographic information is collected on all household members, and at least one household member is selected for the sample person questionnaire, which elicits information on medical conditions, health habits, and prescription medication use.Since 1999, data have been collected continuously and released at 2-year intervals.

We defined “other sedative medications” as prescription medications that are likely to cause clinically important sedating effects and are more often prescribed for non-sleep related than sleep related indications.

Physical activity was based on NHANES' categorization of physical activity levels during the last 30 days and defined as vigorous if participants reported any “vigorous activity for at least 10 minutes that caused heavy sweating or large increases in breathing or heart rate,” moderate if participants reported “moderate activities for at least 10 minutes that cause only light sweating or a slight to moderate increase in breathing or heart rate,” or sedentary if neither vigorous nor moderate activity was reported. We used chi-square tests to compare characteristics between MCUFI users and non-users.

Alcohol intake was classified as abstain/rare ( 14 drinks/week for men) adapted from definitions used by the National Institute on Alcohol Abuse and Alcoholism. We calculated the prevalence of use of MCUFIs overall, categories of MCUFIs, and concurrent use of other sedative medications.

Among the NHANES 2005-2008 subsample, we explored concurrent use of MCUFIs and self-reported use of medications for sleep.

Overall, 906 sampled participants, representing an estimated 3% of the U. population or over 6 million adults, reported using a prescription medication commonly used for insomnia (MCUFI) within the preceding month.

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