Rationale for the use of hypnotic agents in a general hospital.

A survey at a teaching hospital found that 46% of medical patients had prescriptions written specifically for sleep and 31% received a hypnotic agent at least once during hospitalization. Physicians for 96% of surgical patients ordered hypnotic agents and 88% received such a drug. The rationale for prescribing hypnotic agents was not well documented. Administration did not correlate with requests by patients, with previous use of hypnotic agents, or with recorded indications of sleep disturbance; however, the chance of receiving a hypnotic agent was greater if the patient was on a private instead of a ward service and if nurses were more inclined to fill as-needed prescriptions. Patients who received a hypnotic agent did not rate the quality of their sleep as being any better than those who did not, and they complained of as many awakenings during the night. Further studies are necessary to ascertain the indications and efficacy of hypnotic agents for hospitalized patients.