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Despite consensus recommendations regarding need for caution and careful management, sedative hypnotic insomnia therapies remain commonly prescribed among older adults. Further, sleep medications are often prescribed in the absence of a thorough sleep history or evaluation. However, little is known about delivery of sleep-related care following prescription of insomnia medications. Thus, the purpose of this study was to characterize the course of sleep-related care following a prescription fill for insomnia medication among older adults. Methods Our data source was a random 5% sample of Medicare administrative claims data from 2006-2013. Insomnia medications were identified by searching the Part D prescription drug claims and included FDA-approved insomnia-related medication classes and drugs. Sleep disorders were operationalized using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Descriptive analyses were performed to estimate the number of insomnia medication users who received sleep disorder diagnoses. Results A total of 33,252 Medicare beneficiaries without prior history of sleep disorders received at least one FDA-approved insomnia medication fill between 2006-2013. Of these, 43.2% (n=14,354) eventually received a sleep disorder diagnosis. Among those receiving a sleep diagnosis after being prescribed insomnia medication, insomnia was the most common disorder (71.0%; n=10,198). Further, 15.0% (n=2,149) of individuals who were prescribed insomnia medication received an obstructive sleep apnea diagnosis, 6.6% (n=947) were diagnosed with sleep disturbances, and 5.9% (n=845) were diagnosed with restless legs syndrome. Of those who received a sleep disorder diagnosis, 95.1% (n=13,649) were diagnosed with one sleep disorder, 4.5% (n=639) were diagnosed with two sleep disorders, and 0.4% (n=66) were diagnosed with three or more sleep disorders. Conclusion Fewer than half of Medicare beneficiaries prescribed FDA-approved sedative hypnotic insomnia medications ever received a formal sleep-related diagnosis. These results suggest that clinicians prescribe sedative hypnotics without thoroughly evaluating sleep complaints. Support This research was supported by an AASM Strategic Research Award from the AASM Foundation to the University of Maryland, Baltimore (PI: EMW).

0538 What Happens After Prescription of Insomnia Medication Among Older Adults?