The Effect of Recommending Lemborexant as the First-Line Medication for Insomnia on Inpatient Falls

Yuko Takahashi, Arata Uegaki, Haruna Honda, Sae Tanaka, Yutaro Okazaki, Masanobu Fukukawa, Yukio Hayashi

Citation: Yuko Takahashi, Arata Uegaki, Haruna Honda, Sae Tanaka, Yutaro Okazaki, Masanobu Fukukawa, Yukio Hayashi, "The Effect of Recommending Lemborexant as the First-Line Medication for Insomnia on Inpatient Falls", Universal Library of Medical and Health Sciences, Volume 04, Issue 03.

Copyright: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Falls in hospital inpatients are a common and important issue. Sine ?-aminobutyric acid-A receptor (GABA) agonists are known to be associated with an increased risk of falls, our Committee of Medical Quality Management and Patient Safety recommended lemborexant as the first-line medication for insomnia beginning in October, 2021. This retrospective before-after study was designed to clarify whether this recommendation contributed to a reduction in the inpatient falls rate in our hospitals. Methods: This study was conducted at Yoka Municipal Hospital in Yabu-city, Hyogo, Japan between October 2020 and September 2022. We extracted subjects who were reported to have falls in our hospital’s incident report system, which provided records of all falls during the study period. All medications for insomnia were collected from the electronic prescription system in our pharmacy during the study period, and we examined changes in prescriptions for insomnia medications before and after the recommendation. This retrospective before-after study compared the number and rate of inpatients falls before and after the recommendation. Furthermore, we examined the association between the first-line medication for insomnia and falls. Results: The number of prescriptions of GABA agonists and suvorexant significantly deceased after the recommendation, while prescriptions of lemborexant significantly increased. However, this did not reduce the rate of inpatients falls. There was a significant association between suvorexant and falls (odds ratio: 1.41; 95% CI: 1.11~1.79), whereas no significant association was observed between brotizolam, zolpidem or lemborexant and inpatients falls. Conclusion: Our recommendation of lemborexant as the first-line medication for insomnia did not reduce the number or rate of inpatients falls. On the other hands, suvorexant was significantly associated with inpatients falls, whereas brotizolam, zolpidem and lemborexant were not in our study population.


Keywords: Fall; Inpatients; Medications; Orexin Receptor Antagonists; Benzodiazepines and Z Drugs.

Download doi https://doi.org/10.70315/uloap.ulmhs.2026.0403004