Treatment of insomnia in the institutional setting is generally aimed at correcting underlying medical disorders, reducing environmental sleep disruptions, and lowering anxiety with psychological interventions and relaxation training or pharmacotherapy. Of the available agents, short and intermediate-acting benzodiazepines such as lorazepam and oxazepam have become the most commonly prescribed for this indication.
Benzodiazepines were the most common sedating drugs prescribed.Over 300 sleep disturbance, effective and supplementation scores were completed.Hospitalization can significantly disrupt sleeping patterns. In consideration of the previous reports of insomnia and apparent widespread use of benzodiazepines and other hypnotics in hospitalized patients, we conducted a study to assess quality of sleep and hypnotic drug use in our acute care adult patient population.The primary objectives of this study were to assess sleep disturbance and its determinants including the use of drugs with sedating properties.Twenty-nine (29%) patients received a prescription for a hypnotic drug while in hospital, with no evidence of pre-admission hypnotic use.
The majority of these patients were prescribed zopiclone, lorazepam or another benzodiazepine.In addition to new agents such as zopiclone, zolpidem, and zaleplon, nonprescription products such as diphenhydramine, doxylamine, and melatonin appear to be potential alternatives for short-term use.Sleep quality in a hospitalized patient can be measured by a variety of methods including the use of movement monitoring devices, brain electrical activity, sleep diaries and sleep scales.Adult patients who were admitted to the general medicine or family practice wards during the study period were considered eligible for the study.Inclusion criteria for enrollment included age (18 years or older), ability to complete the sleep assessment questionnaires and a willingness to provide written informed consent.This study was conducted at an 800-bed adult tertiary care, Canadian teaching institution over a 70-day period (February – April 2001).