Use of Hypnotic Drugs by Hospital Patients

Recent research into the nature of sleep and dreams has increased our understanding of the effects of hypnotic drugs. While hypnotics in common use are “effective” in inducing sleep and reducing night awakenings when taken occasionally, many do not permit the normal pattern of the stages of sleep. They may also induce tolerance and cease to be effective after use for only a few consecutive nights. Further, some produce dependence with symptoms which include disturbed sleep and dreams on cessation of the drug. Thus their effects tend to encourage their continued use. To obtain some idea of the proportion of the population taking these drugs, a survey was carried out to determine which hypnotics were being used, and how often, by medical and surgical patients in the wards of the Alfred Hospital and at home. Of all patients aged between 20 and 80 years, 33% of males and 41% of females were taking hypnotics “frequently” or “occasionally” at home. The frequency of use increased with age. In hospital wards, 75% of males of all ages and 80% of females were given hypnotics at some time. At home more barbiturates were being taken than non-barbiturates, but the reverse situation has developed in recent years in hospital. The condition of many patients, whose insomnia is being treated with barbiturates, would probably improve if these drugs were withdrawn while they continued to take a non-barbiturate hypnotic such as nitrazepam. Treatment of longterm insomnia with drugs is not satisfactory at present, and further research is needed.