Pattern of Hypnotic Drug Prescription in South Korea: Health Insurance Review and Assessment Service-National Patients Sample

Background and Objective This study aimed to characterize patterns of hypnotic drug prescription based on age and gender using data from the Health Insurance Review and Assessment Service-National Patients Sample (HIRA-NPS) of South Korea. Methods Using HIRA-NPS data, the “number of tablets of equivalent hypnotic drugs (TEQ)” was defined herein as the number of tablets of triazolam, zolpidem immediate-release form, or zolpidem extended-release form. Results The proportion of hypnotic medication prescriptions, including triazolam and zolpidem, was 1.47% in the sample population. The proportion was significantly higher among women than men (1.63% vs. 1.29%; p < 0.01). In addition, the proportion of subjects who were prescribed hypnotic drugs increased with age. The mean TEQ per year was significantly higher among women in the 30–39 year old group (p = 0.02), but lower in women of the 70–79 year old group compared to men (p = 0.04). Of the subjects prescribed the drugs, 14.53% were prescribed at least 0.5 TEQ per day, while 5.0% were given at least 1.0 TEQ per day 0.6% at least 2.0 TEQ per day. Such cases were most common among middle-aged patients (30–59 years old). Conclusions The proportion of hypnotic drug prescriptions increased with patient age and in females. However, the total amount of hypnotics prescribed per year was greatest among males and middle-aged patients

Post-Traumatic Narcolepsy Associated with Thalamic/Hypothalamic Injury

The hypothalamus is an important structure that regulates sleep via hypocretin neurotransmission. Central nervous system disorders such as tumors and vascular legions involving the hypothalamus can cause secondary narcolepsy. In addition, brain trauma can contribute to post-traumatic narcolepsy despite lack of any definite brain lesion. Here, we present a case of a 37-year-old man suffering from a hypothalamus-to-thalamus hemorrhage after a traffic accident. After this trauma, he suffered from excessive daytime sleepiness and was diagnosed with post-traumatic narcolepsy by polysomnography and multiple sleep latency tests. He was positive for human leukocyte antigen (HLA)-DQB1*03:01 and HLA-DQB1*06:01 antigens

The Sleeping Pill Prescription Rate for Inpatients at a General Hospital

Background and Objective Hospitalized patients often suffer from sleep disturbance. Impaired sleep for inpatients is a multifactorial phenomenon, comprised of medical, environmental, and behavioral influences imposed by hospitalization. In such situation, inpatients are frequently prescribed sleeping pills. The aim of this study was to explore the pattern of sleeping pill prescription for hospitalized patients in a general hospital. Methods Located in Seoul, Korea, Asan Medical Center is a general hospital that oversees about 2100 to 2300 inpatients per day. We estimated the proportion of patients who were prescribed sleeping pills at admission and discharge from the hospital, excluding pediatric care units. In addition, we quantified the number of patients taking prescribed sleeping pills on the first day of each month of 2014. Results Among 118475 patients admitted to Asan Medical Center in 2014, 4205 (3.54%) were taking sleeping pills at the time of admission. In addition, 4652 (3.93%) patients were prescribed sleeping pills as a discharge medication, of which 2256 (1.90%) initiated hypnotics intake during hospital stay. Surveyed on the first day of every month of 2014, 7.3% to 10.0% of inpatients were observed to be taking sleeping pills. Conclusions The number of prescriptions of sleeping pills was found to increase with hospital stay. A palpable need for sleep hygiene education and the implementation of a hypnotics reduction program for inpatients is warranted