1 École de psychologie, Université Laval, 2325 rue des Bibliothèques, Québec, Québec, G1V 0A6, Canada; Centre d'étude des troubles du sommeil, Université Laval, 2325 rue des Bibliothèques, Québec, Québec, G1V 0A6, Canada. Electronic address: cmorin@psy.ulaval.ca.
2 École de psychologie, Université Laval, 2325 rue des Bibliothèques, Québec, Québec, G1V 0A6, Canada; Centre d'étude des troubles du sommeil, Université Laval, 2325 rue des Bibliothèques, Québec, Québec, G1V 0A6, Canada.
3 Department of Psychology, Toronto Metropolitan University, 350 Victoria Street, Toronto, Ontario, M5B 2K3, Canada.
4 Department of Pediatrics, University of Ottawa, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada; Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, Ontario, K1H 8L1, Canada.
5 Department of Health, Kinesiology and Applied Physiology, Concordia University, 7141 Sherbrooke Street West, Montréal, Québec, H4B 1R6, Canada; Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), CIUSSS du Centre-Sud-de-l'île-de-Montréal, 4565 Queen Mary Road, Montréal, Québec, H3W 1W5, Canada.
6 Department of Psychology, Queen's University, 62 Arch Street, Kingston, Ontario, K7L 3N6, Canada.
7 École de psychologie, Université Laval, 2325 rue des Bibliothèques, Québec, Québec, G1V 0A6, Canada.
8 Département de psychologie, Université de Sherbrooke, 2500, boul. de l'Université, Sherbrooke, Québec, J1K 2R1, Canada.
9 Akwesasne Medical Clinic, 101 Tewesateni Road, Akwesasne, Ontario, K6H 0G5, Canada; Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, Montréal, Québec, H3S 1Z1, Canada.
10 School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, Ontario, K1N 6N5, Canada; Sleep Research Unit, University of Ottawa Institute of Mental Health Research at the Royal, 1145 Carling Avenue, Ottawa, Ontario, K1Z 7K4, Canada.

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.