Time‐dependent risk of falls associated with hypnotic use in hospitalized patients

作者：Kazuhiro Shishida, Yutaro Shimomura, Masayuki Murayama, Kimio Yoshimura, Hiroyuki Uchida, Masaru Mimura, Hiroyoshi Takeuchi · 发表于：Psychiatry and Clinical Neurosciences · 年份：2026 · DOI：10.1111/pcn.70057 · 被引用次数：1 · 研究领域：Sleep and related disorders、Sleep and Work-Related Fatigue、Balance, Gait, and Falls Prevention

AIM: Falls are a common and serious problem among hospitalized patients. While hypnotics are a known risk factor, it remains unclear whether fall risk varies by time of day. This study examined the time-dependent risk of falls associated with different classes of hypnotics. METHODS: We conducted a retrospective cohort study of patients aged ≥20 years who had their first admission to our hospital and were discharged between April 2016 and March 2018. Time-to-fall was analyzed using stepwise Cox proportional hazards models across four time periods (0:00-5:59, 6:00-11:59, 12:00-17:59, 18:00-23:59). Covariates included hypnotic use (Z-drugs, short-acting benzodiazepines, long-acting benzodiazepines, ramelteon, suvorexant, trazodone), age, sex, body mass index (BMI), length of stay, activities of daily living score, emergency admission, and surgery. RESULTS: Among the 22,458 patients included in the study, 268 falls occurred, with 73, 65, 56, and 74 in each time period, respectively. Association between hypnotic use and fall risk varied by time. Z-drugs were associated with falls during 18:00-23:59 (adjusted hazard ratio [aHR] 2.65, 95% confidence interval [CI] 1.29-5.45). Short-acting benzodiazepines were associated with falls during 00:00-05:59 (aHR 2.06, 95% CI 1.07-3.97). Long-acting benzodiazepines were associated with falls during 06:00-11:59 (aHR 3.37, 95% CI 1.20-9.26). No significant associations were observed for ramelteon, suvorexant, or trazodone. CONCLUSIONS: Fall ris...