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Sleep medication use during ICU stay is strongly associated with continued prescription at hospital discharge in critically ill patients in Japan

Among 1,595,351 ICU patients, 30.8% received sleep medications during their ICU stay. Sleep medication use during ICU stay was strongly associated with sleep medication prescription at hospital discharge (odds ratio: 6.90; 95% CI: 6.59-7.23), with 47.0% of users versus 11.3% of nonusers receiving prescriptions at discharge.

Last updated: Jul 30, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Prescription patterns of sleep medications for critically ill patients: A nationwide retrospective observational cohort study in Japan.

observational

Iwasaki Y, Ohbe H, Kaiho Y, Ikumi S, Yabuki S, Wagatsuma Y, Yamauchi M, Fushimi K, Yasunaga H · Australian critical care : official journal of the Confederation of Australian Critical Care Nurses (2026)

Participants: 1595351
Duration: April 2012 to March 2021
Intervention: Sleep medication use (benzodiazepines, Z-drugs, orexin receptor antagonists, melatonin receptor agonists) during ICU stay
Outcome: Sleep medication prescription at hospital discharge
Effect Size: OR=6.90, 95% CI 6.59-7.23
Population: Adult patients who stayed in the ICU for more than 1 day in Japan (2012-2021)

Result: Among 1,595,351 ICU patients, 30.8% received sleep medications during their ICU stay. Sleep medication use during ICU stay was strongly associated with sleep medication prescription at hospital discharge (odds ratio: 6.90; 95% CI: 6.59-7.23), with 47.0% of users versus 11.3% of nonusers receiving prescriptions at discharge.

PubMed: 42492347DOI: 10.1016/j.aucc.2026.101648

Mechanism Graph

Sleep medications are administered to ICU patients for sleep disturbance
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These medications may be continued at discharge without systematic review
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Lack of deprescribing protocols leads to unnecessary continuation
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Result: Strong association between ICU use and discharge prescription

Limitations

  • ⚠Retrospective observational design cannot establish causality
  • ⚠Database may not capture all confounders (e.g., severity of illness, non-pharmacological interventions)

Frequently Asked Questions

What percentage of ICU patients received sleep medications in this study?▼

30.8% of 1,595,351 ICU patients received sleep medications during their ICU stay.

Which sleep medications showed increased use over the study period?▼

Orexin receptor antagonists (OXs) increased from 0% to 18.0%, and melatonin receptor agonists (MLTs) increased from 1.3% to 10.7% from 2012 to 2020.

How strong is the association between ICU sleep medication use and discharge prescription?▼

The odds ratio was 6.90 (95% CI: 6.59-7.23), indicating a strong association.

What is the clinical implication of this finding?▼

The strong correlation highlights the need for careful medication review and deprescribing to prevent unnecessary continuation of sleep medications after ICU care.

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References

  1. 1.Iwasaki Y, Ohbe H, Kaiho Y, Ikumi S, Yabuki S, Wagatsuma Y, Yamauchi M, Fushimi K, Yasunaga H. "Prescription patterns of sleep medications for critically ill patients: A nationwide retrospective observational cohort study in Japan.." Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, 2026. PMID: 42492347 DOI: 10.1016/j.aucc.2026.101648
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.