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Reported November 23, 2012

‘Falling’ Asleep


(Ivanhoe Newswire) – Next time doctors reach for a pharmaceutical sleep aid for patients, they may want to reconsider. A drug commonly prescribed to help patients sleep in hospitals has been associated with an increased risk of falls.
"Patient falls are a significant patient safety issue in hospitals, and one that has been quite difficult to tackle, despite considerable efforts,” said the clinic's Chief Patient Safety Officer Dr. Timothy I. Morgenthaler, who specializes in sleep disorders and pulmonary and critical care.
“Ensuring that people get enough sleep during their hospital stay is very important, but it can also prove very challenging."
The drug, called zolpidem, quadrupled the risk of patients falling during their hospital stay, according to sleep specialists from the Mayo Clinic. They also found that the drug posed a greater risk at any dosage than age, cognitive impairment, delirium or insomnia.
"As a result of our study, we are now phasing out zolpidem and moving toward sleep enhancement techniques that are not based on drugs and which we believe are safer and probably as effective," Morgenthaler said.
Zolpidem was administered to more than 30 percent of patients who were prescribed it, which was about 12 percent of all Mayo Clinic admissions in 2010, and just over three percent of the patients on zolpidem fell during their in-patient hospital stay, compared with 0.7 percent of the patients who did not take zolpidem.
Zolpidem use continued to be associated with an increased fall risk when other key factors, including health, length of hospital stay and assessed fall risk, were taken into consideration, according to the study.
Mergenthaler said his hospitals have an overall fall rate of about 2.5 per 1,000 patient days – a number lower than many national benchmarks. However they have been unable to further improve that number.
“We calculate that for every 55 patients who received zolpidem, there was one additional fall that may have been avoided by not administering the drug," Morgenthaler said.
"Discovering that zolpidem, which is commonly used in hospitals, is a significant risk factor for patient falls provides us with additional knowledge to help tackle this problem."
Source: Journal of Hospital Medicine

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