Sleep medication use in psychiatric emergency ward and factors associated with administration of multiple sleep medications: a single-center, university hospital-based, cross-sectional study

Insomnia is a common sleep disorder and is usually treated with long-term administration of benzodiazepine receptor agonists, which have concerning adverse effects. Although various measures for psychotropic drug administration are available, in clinical practice, cases of sleeping pill overdose have been reported. In this study, which was based on medical record review, we report our real-world experience on sleep medication use among patients admitted to the psychiatric emergency ward of Showa University Northern Yokohama Hospital between January 2014 and December 2021. Herein, we discuss factors associated with polydrug use among patients who use sleeping pills. We recorded the age, sex, diagnosis, and duration of illness of the patients. We compared patients with and without sleeping pill prescriptions and performed multivariate logistic regression analysis of the group that was prescribed two or more sleeping pills. In ＞50％ of patients, sleeping pills were written on their last prescription. Compared with the single drug group, the multiple drug group had longer durations of illness and treatment, more frequent hospitalizations, higher rates of alcohol consumption and smoking, and greater use of disability pensions. Patients with bipolar disorder were prescribed a relatively large number of sleeping pills. The number of hospitalizations, prevalence of bipolar disorder and attention deficit hyperactivity disorder （ADHD）, and discharge to the patient’s home were positively associated with the use of two or more sleep medications. This study suggests that smoking, number of hospitalizations, bipolar disorder, ADHD, and discharge to home are associated with sleeping pill polypharmacy among patients who are admitted to the psychiatric emergency ward.