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Objectives: To estimate the prevalence of insomnia and the use of sleep aids among Canadian adults.

Methods: Data were derived from a phone interview conducted (April to October 2023) with a stratified, population-based sample of 4037 adults (57.6 % females; mean age 50.6 ± 18.4; range 18-102 years old) living in Canada. Post-stratified survey weights were included in the analysis to ensure the representativity of the adult Canadian population.

Results: The prevalence estimate of insomnia disorder was 16.3 % (95 % CI 15.1-17.6), with higher rates in females (risk ratio [RR] 1.24, 95 % CI 1.06-1.45), Indigenous peoples (RR 1.77, 95 % CI 1.27-2.47), and individuals with poorer mental or physical health. Overall, 14.7 % of respondents reported having used prescribed sleep medications in the previous 12 months, 28.7 % used natural products or over-the-counter (OTC) sleep aids, 15.6 % used cannabis-derived products and 9.7 % used alcohol for sleep in the last 12 months. Higher proportions of females used prescribed medication (RR 1.79, 95 % CI 1.31-2.43) and natural products or OTC medication (RR 1.41, 95 % CI 1.16-1.71), while more males used cannabis (RR 1.33, 95 % CI 1.03-1.72) and alcohol (RR 1.67, 95 % CI 1.16-2.33) for sleep. Higher proportions of older adults (=65 years) were taking prescribed medications, while more young adults (18-35 years) used natural products or OTC medications, cannabis, and alcohol as sleep aids.

Conclusions: Insomnia is a highly prevalent condition in Canada and there is widespread and increasing use of various medications and substances to cope with this health issue. These findings highlight the need for public health interventions to promote healthy sleep and for wider dissemination of evidence-based treatments for insomnia, such as cognitive behavioral therapy which is the first-line treatment for insomnia in practice guidelines, to reduce sleep health disparities.