Abstract
This study investigated regional variations in the use of sedative psychotropic medications, often prescribed for insomnia, by comparing Italy and the culturally distinct Autonomous Province of Bolzano, South Tyrol. Using daily defined dose (DDD) data per 1000 inhabitants per day, benzodiazepines, Z-drugs, sedative antidepressants, and melatonin consumption from 2019 to 2023 were examined. The findings indicate a notably lower utilization of benzodiazepines in South Tyrol compared to the national Italian average, alongside a significant increase in sedative antidepressant use, particularly mirtazapine. These disparities likely stem from regional prescribing preferences influenced by cultural, linguistic, and healthcare system factors. While Z-drug consumption remained comparable across regions, melatonin use exhibited a gradual upward trend, albeit less pronounced in South Tyrol. These insights emphasize the necessity for region-specific strategies in optimizing insomnia treatment, balancing pharmacological approaches with non-pharmacological alternatives such as cognitive behavioral therapy for insomnia. Understanding these prescribing trends can inform healthcare policies aimed at reducing long-term sedative use while enhancing patient-centered care in sleep medicine.