An Implementation Guide to Promote Sleep and Reduce Sedative-Hypnotic Initiation for Noncritically Ill Inpatients

JAMA Intern Med. 2019 Jul 1;179(7):965-972. doi: 10.1001/jamainternmed.2019.1196.


Sedative-hypnotic medications are frequently prescribed for hospitalized patients with insomnia, but they can result in preventable harm such as delirium, falls, hip fractures, and increased morbidity. Furthermore, sedative-hypnotic initiation while in the hospital carries a risk of chronic use after discharge. Disrupted sleep is a major contributor to sedative-hypnotic use among patients in the hospital and other institutional settings. Numerous multicomponent studies on improving sleep quality in these settings have been described, some demonstrating an associated reduction of sedative-hypnotic prescriptions. This selected review summarizes effective interventions aimed at promoting sleep and reducing inappropriate sedative-hypnotic initiation and proposes an implementation strategy to guide quality improvement teams.

Publication types

  • Review

MeSH terms

  • Humans
  • Hypnotics and Sedatives*
  • Inappropriate Prescribing / prevention & control*
  • Inpatients*
  • Sleep Initiation and Maintenance Disorders / therapy*
  • Sleep*


  • Hypnotics and Sedatives