WEDNESDAY, Sept. 9, 2026 (HealthDay News) -- Patients who receive a longer initial Z-drug prescription are more likely to fill additional prescriptions after the index fill year, including up to seven years later, according to a research letter published online Sept. 3 in JAMA Network Open.
Jonathan N. Cloughesy, from the University of Southern California in Los Angeles, and colleagues examined the association between the number of days of an initial Z-drug prescription supply and subsequent long-term use. The analysis included 129,287 patients with a filled prescription for zolpidem, eszopiclone, or zaleplon from Jan. 1, 2007, to Feb. 29, 2024, identified from the Optum Clinformatics Data Mart Database.
The researchers found that the mean initial number of days of supply was 27.0. Among patients who initially received a one- to 14-day supply, 15.6 percent filled a Z-drug prescription in the first year after the index fill year versus 25.1 percent who received a 15- to 24-day supply, 38.1 percent who received a 25- to 34-day supply, and 49.5 percent who received a supply of ≥35 days (adjusted risk difference [aRD] for 25 to 34 versus one to 14 days, 22.4 percentage points [pp]). Over time, fill rates declined in all groups, and differences by initial supply narrowed substantially. At seven years, 7.9 percent who received a prescription for one to 14 days, 11.5 percent who received 15 to 24 days, 15.6 percent who received 25 to 34 days, and 18.9 percent who received ≥35 days filled a Z-drug prescription (aRD for 25 to 34 versus one to 14 days, 7.6 pp). Both at one and seven years, patients with larger initial supplies also were more likely to receive at least a 180-day supply (aRD for 25 to 34 versus one to 14 days, 11.1 pp and 4.5 pp, respectively). With larger initial supplies, the mean annual days supplied were also greater.
"The first prescription may play an important role in shaping long-term use of sleep medications," Cloughesy said in a statement. "It’s a strong indication of why doctors and patients should be cautious when starting [patients] on these medications."
