Sleep-related medication use, particularly concurrent use of multiple classes, was associated with recurrent inpatient falls, so these medications should be reviewed at hospital admission and reassessed after an index fall, with particular attention to their indications and concurrent use.
Of 1830 inpatients with falls, 436 were recurrent fallers and 1394 were single fallers.
Benzodiazepine use at the first fall was associated with a higher risk of recurrent falls.
Non-benzodiazepine hypnotics (Z-drugs) were associated with recurrent falls.
Orexin receptor antagonist use was associated with recurrent falls.
Ramelteon was not significantly associated with recurrent falls.
Any sleep-related medication use was associated with recurrent falls.
Concurrent use of two or more sleep-related medication classes was associated with the highest risk of recurrent falls.
The authors conclude that sleep-related medications should be reviewed at admission and reassessed after an index fall.
This study looked at five years of fall records at one university hospital in Japan, covering 1830 patients who fell a total of 2587 times. About one in four of these patients (436) fell more than once. The researchers compared those who fell repeatedly with those who fell only once, focusing on which sleep-related medications they were taking when they first fell. Patients taking benzodiazepines, Z-drug sleeping pills, or orexin receptor antagonists were about 40–55% more likely to fall again, even after accounting for age, sex, what they were doing when they fell, dementia, and the total number of medications they took. Ramelteon did not show a clear link. Taking any sleep-related medication was linked to roughly 50% higher risk, and taking two or more classes together was linked to about 83% higher risk. This research suggests that sleep medications, especially several used together, may be worth reviewing when patients are admitted and again after a fall. Because this was a retrospective, single-hospital study, it shows association rather than proof that the drugs cause repeat falls, and sicker patients may be more likely to receive these medications.
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Upload Your LabsImai N, Homma D, Shobugawa Y, Sato K, Horigome Y, Kawashima H. (2026). Association Between Sleep-Related Medication Use and Recurrent Falls Among Inpatients: A Five-Year Retrospective Observational Study at a University Hospital.. Medical sciences (Basel, Switzerland). https://doi.org/10.3390/medsci14060693