# Benzodiazepine Misuse Among Health Care Workers: The Effect of Sleep Disorders on Work Performance

## TL;DR

Healthcare workers in Spain commonly misuse benzodiazepines for sleep and anxiety, leading to poor work performance and mental health issues.

## Contribution

This study reveals high rates of benzodiazepine misuse and self-medication among healthcare workers, linked to sleep disorders and mental health.

## Key findings

- 23.8% of healthcare workers reported using sleep medication, with 27.8% using it without a prescription.
- Benzodiazepine use was associated with insomnia, anxiety, depression, and reduced work performance.
- Night-shift work increased hypnotic medication use in men but not in women.

## Abstract

Background: Benzodiazepines (BZDs), commonly used to treat insomnia and anxiety, are increasingly used in Spain, raising concerns due to their potential for abuse and dependence. This study investigates the use of BZDs and other psychotropic medications among healthcare workers, exploring their prevalence, associated factors, and their relationship with mental health issues following the COVID-19 pandemic. Methods: An anonymous online survey was conducted among healthcare workers at the Salamanca University Healthcare Complex (CAUSA) from March 2023 to January 2024. Of 1121 participants, 685 provided complete responses, which were analysed. Insomnia, anxiety, and depression were assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-4 (PHQ-4). Results: Of the respondents, 23.8% reported using sleep medication, with 27.8% doing so without a prescription. Additionally, 14.7% used medication for depression or anxiety, with only 0.6% without a prescription. Hypnotic medicine use was associated with older age, insomnia, anxiety, depression, psychological or psychiatric treatment, COVID-19 after-effects, and diagnosed sleep disorders. Night-shift work was associated with increased hypnotic medication use in men but not in women. The use of these medications was linked to a reduced quality of life and impaired work performance. Conclusions: The use of BZD and self-medication are prevalent among healthcare professionals, exceeding the rates observed in the general population. These findings highlight the urgent need for targeted interventions to address psychotropic medication use, promote other pharmacological and non-pharmacological alternatives for insomnia, and enhance mental health support for this vulnerable population.