This drug class is widely used for insomnia yet increases the risk of falls, delirium and mechanical ventilation.

It is the most common ingredient in over-the-counter sleep aids, but it can cause anticholinergic effects including constipation, urinary retention and cardiac toxicity.

Antihistamine

Caution is advised when giving this medication to patient's with cardiac disease.

This widely prescribed non-benzo sleep aid has been associated with cognitive dysfunction, delirium and falls in hospitalized patients.

Promotes sleep onset and maintenance and phase shifting of circadian rhythms.

One study found that 16% of inpatients aged 65 years and older were given new prescriptions for this class of medications during admission, 77% of which were deemed inappropriate.

Supraphysiologic concentrations of this substance can cause daytime sleepiness, impaired mental and physical performance, hypothermia and hyperprolactinemia.

Serotonin modulator with significant sedation as a side effect.

This anti-hypertensive medication can decrease endogenous melatonin secretion.

A commonly used medication in the ICU that mimics stage N2 non-rapid eye movement sleep, with little associated N3 sleep and no REM sleep.

This drug is thought to activate MT1 and MT2 melatonin receptors selectively.

This newer medication has not been adequately studied in the inpatient setting. Due to it's long half life it can cause significant day-time somnolence.

More research is needed, but there is some evidence that this medication may be able to treat and prevent delirium in elderly post-operative patients.

Orexin Receptor Antagonist