A study in the July 15 issue of the Journal of Clinical Sleep Medicine reports that a high percentage of patients with insomnia use sleep medications off-label in the middle of the night to resume sleep. The study involved telephone interviews to assess patterns of prescription hypnotic use in a national sample of 1,927 commercial health plan members receiving prescription hypnotics within 12 months of study. Results show that 20 percent of respondents reported using a sleep medication in the middle of the night, only a minority on advice from their physician. Nearly half of these middle-of-the-night users report taking hypnotics twice in the same night.
The authors noted the concern that the middle-of-the-night use of sleeping pills may compromise psychomotor and cognitive functioning the following day. Only one hypnotic, Intermezzo (zolpidem tartrate sublingual tablets), has been approved by the FDA for use as needed to treat sleep maintenance insomnia. The authors encouraged prescribing physicians to warn patients about the risks of using sleep medications in the middle of the night. “Physician efforts to help patients understand the rationale for discouraging off-label hypnotic use could lead to substantial reductions,” they concluded.