JMIR Publications

ABSTRACT

Background:

Online communities and message boards, such as Reddit, serve as a space where people can share their health-related experiences and treatments, including the experience of insomnia. Natural language processing (NLP) tools can be leveraged to understand the terms that are used in online spaces to discuss insomnia and insomnia treatments.

Objective:

To understand the language used in discussing insomnia on online message boards and evaluate trends in discussion of treatments over time.

Methods:

We performed an NLP analysis of the r/insomnia subreddit. Using the Pushshift API, we obtained all subreddit comments from the history of r/insomnia up to the end of 2022. A Bag of Words model was used to identify the top 1,000 most frequently used terms, which were manually reduced to 35 terms related to treatment and medication use. Regular expressions analysis (RE) was used to identify and count comments containing specific words, and sentiment analysis was used to predict the sentiment of comments. Data from 2013 to 2022 were visually examined for trends.

Results:

There were 340,130 comments on r/insomnia from the beginning of the subreddit to 2022. Of the 35 top treatment and medication terms that were identified, melatonin, Cognitive Behavioral Therapy for insomnia (CBT-I), and Ambien were the most frequently used. When frequency of individual terms was compared over time, terms related to CBT-I increased over time and terms related to non-prescription over-the-counter sleep aids (such as Benadryl) decreased over time. Terms with the most positive sentiment included “hygiene”, “valerian”, and “CBT”.

Conclusions:

Individuals use Reddit r/insomnia to discuss insomnia treatment. This analysis suggests that language related to CBT-I (with a spike in 2017 following recommendations by the American College of Physicians), benzodiazepines, trazadone, and antidepressant medication use has increased from 2013 to 2022. Over-the-counter or alternative therapies, such as melatonin, cannabidiol, and marijuana, have also exhibited fluctuations over time. These findings indicate frequency and trends in the use of language surrounding treatment and medication terms that may be useful to practitioners and researchers alike.