NEW DELHI: Sleeping pills may increase the chances of falling and getting hurting, a new study published in the Journal of Hospital Medicine says. Sleep specialists from the Mayo Clinic found that the fall rate among the 4,962 patients who took the commonly prescribed sedative zolpidem during their hospital stay was more than four times as high as the 11,358 who did not take the drug.
"Ensuring that people get enough sleep during their hospital stay is very important, but it can also prove very challenging," says the Clinic's Chief Patient Safety Officer Dr. Timothy I. Morgenthaler, who specializes in sleep disorders and pulmonary and critical care.They also found that the risk posed by the drug was greater than the risks posed by factors such as age, cognitive impairment, delirium or insomnia, regardless of the dosage used.
Falling down is one of the most common injuries suffered, especially by the elderly. Each year, one in every three adults age 65 and older falls, according to the Centers for Disease Control in the US. Falls can cause moderate to severe injuries, such as hip fractures and head injuries, and can increase the risk of early death. Among senior citizens (those 65 or older), falls are the leading cause of injury death and the most common cause of nonfatal injuries and hospital admissions for trauma, according to studies.
CDC data from US shows that in 2010, 2.3 million nonfatal fall injuries among older adults were treated in emergency departments. Direct medical costs of falls, adjusted for inflation, was $30.0 billion.
The researchers reported that they studied 16,320 patients admitted to hospitals in 2010, of which just under 39 percent were prescribed zolpidem. Most of the prescriptions were "as needed basis".
Zolpidem was administered to 30.4 percent of patients who were prescribed it and to 11.8 percent of all Mayo Clinic admissions in 2010. 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 the drug. Zolipdem 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.
"Our hospitals have an overall fall rate of about 2.5 per 1000 patient days, which is lower than many national benchmarks. However, we have not been able to significantly reduce this rate in recent years. Now, 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," says Dr. Morgenthaler.
As a result of our study, the doctors are now phasing out zolpidem and moving toward sleep enhancement techniques that are not based on drugs and which they believe are safer and probably as effective, he added.
"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."
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