HormonesMelatonin

Pediatric hypnotic prescribing in Japan increased over the past decade, with a significant acceleration after the April 2020 COVID-19 state of emergency.

The proportion of children and adolescents prescribed hypnotics in Japan rose from 0.4% in 2014 to 1.0% in 2023. Interrupted time-series analysis showed a significant post-emergency slope increase of 3.64 prescriptions per 100,000 population per month (95% CI, 2.69 to 4.58; P < 0.001), though pre-existing trends were already evident.

Last updated: Jul 23, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Ten-year trends in pediatric hypnotic prescribing before and during the COVID-19 pandemic in Japan.

observational

Matsuyama N, Iwamoto K, Miyata S, Imai T, Ikeda M · Sleep medicine (2026)

Participants: N/A
Duration: 10 years (2014-2023)
Intervention: Observational study of hypnotic prescribing trends before and during the COVID-19 pandemic, with a focus on the April 2020 state of emergency.
Outcome: Proportion of children and adolescents prescribed hypnotics, prescription rates per 100,000 population per month, and changes by age, sex, and pharmacological class.
Effect Size: Slope change of 3.64 prescriptions per 100,000 population per month (95% CI, 2.69 to 4.58; P < 0.001)
Population: Children and adolescents aged 2-18 years in Japan, drawn from the JMDC Claims Database (2014-2023).

Result:

PubMed: 42392020DOI: 10.1016/j.sleep.2026.109108

Mechanism Graph

Pre-existing trends in pediatric hypnotic prescribing were already increasing before 2020
↓
COVID-19 pandemic and April 2020 state of emergency led to additional acceleration
↓
New pharmacological options (melatonin receptor agonists, orexin receptor antagonists) became available
↓
Result: Overall prescribing rate increased significantly, especially among adolescents and females

Limitations

  • ⚠Observational study design cannot establish causality between pandemic and prescribing changes
  • ⚠Sensitivity analyses showed that post-emergency increases were attenuated when excluding melatonin, suggesting results are partially driven by a specific drug class

Frequently Asked Questions

What was the overall increase in pediatric hypnotic prescribing in Japan from 2014 to 2023?▼

The proportion increased from 0.4% (2800 of 673,141) in 2014 to 1.0% (23,977 of 2,401,028) in 2023.

Did the COVID-19 pandemic cause a sudden jump in hypnotic prescriptions for children?▼

No, the immediate level change after April 2020 was not statistically significant, but the slope of increase significantly accelerated by 3.64 prescriptions per 100,000 per month.

Which demographic groups showed the largest increases?▼

Larger increases were observed among adolescents and females.

What types of hypnotics changed in prescribing patterns?▼

Benzodiazepines and benzodiazepine receptor agonists decreased, while melatonin receptor agonists and orexin receptor antagonists increased.

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References

  1. 1.Matsuyama N, Iwamoto K, Miyata S, Imai T, Ikeda M. "Ten-year trends in pediatric hypnotic prescribing before and during the COVID-19 pandemic in Japan.." Sleep medicine, 2026. PMID: 42392020 DOI: 10.1016/j.sleep.2026.109108
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.