Sleeping Pills and Nursing Home Falls: Are They Related?

As a Virginia attorney who represents nursing home residents, I admit it’s rare that I will hear about someone getting good medical care in a nursing home setting.

Instead, here’s what I see:

  • Out-numbered, over-worked, and under-paid staff trying to care for too many patients;  
  • Corporate ownership more focused on squeezing out a few extra dollars of profit over caring for the elderly and infirm.

So, with my biases clearly disclosed, I want to talk about sleeping pills.  As we age it can become more difficult to get to sleep and to stay asleep during the nighttime hours.  Interestingly, it is also the nighttime hours that most nursing homes drastically reduce their staffing levels.

Is there a link between nursing home falls at night and sleeping pills?

Night shifts might one nurse and/or aide will be caring for 25 patients – and that’s a big problem for residents. 

But unfortunately nursing homes don’t want to hire more nighttime nurses to watch out for the residents who are night owls, so nursing homes often make sure residents stay asleep by over-prescribing sleeping aiding medications.

What can be wrong with getting a good night’s sleep you ask?  Use of sleeping pills significantly increases the risk of falls during night time wandering. 

Common Sleeping Pills: One of the more frequently used sleeping medications is zolpidem. This medication is a sedative, also called a hypnotic. It affects chemicals in your brain that may become unbalanced and cause sleep problems (insomnia).  The immediate-release forms of zolpidem are Ambien, Intermezzo, Edluar, and Zolpimist, which are used to help you fall asleep. The extended-release form of zolpidem is Ambien CR, which has a first layer that dissolves quickly to help you fall asleep, and a second layer that dissolves slowly to help you stay asleep.  Ambien, Edluar, and Zolpimist are used to help you fall asleep when you first go to bed. Intermezzo, is used to help you fall back to sleep if you wake up in the middle of the night and then have trouble sleeping.

Risk of Falls: A fall in a nursing home can seriously injure and even kill the elderly.  This increased risk was recently discussed in a study conducted by the Mayo Clinic and published online in the Journal of Hospital Medicine.  Although the test was conducted in a hospital setting, there is no reason to question the conclusions would equally apply to nursing homes.  In short, the study concluded that patients who received zolpidem were three times more likely to fall than those who did not receive this sleep medication.

My Take:  If your loved one is having trouble getting to sleep or staying asleep, explore other treatment options with your doctor or Medical Director before starting this potentially dangerous medication.

Dan Frith
Dan Frith

Dan Frith has over 25 years of experience representing individuals and families in cases of medical malpractice throughout Virginia. He has been named "Best Medical Malpractice Attorney" by Roanoker Magazine and is a member of the Million Dollar Advocates Forum. To speak with Dan, contact him by email at