Taiwan to Enhance Management of Sleeping Pill Use for High-Risk Groups Amid Rising Demand

Taiwan is facing a surge in sleeping pill usage as it transitions into a super-aged society. National Health Insurance Administration (NHIA) data from 2021 to 2025 reveals that around 1.9 million people use sleeping pills each year, with a significant 40% being individuals aged 65 and above.

The NHIA highlighted concerns about the long-term or multiple use of sedative-hypnotic medications, which can elevate the risk of falls, fractures, and cognitive impairment. In response, the administration announced a plan to integrate with the "Three Highs Chronic Disease 888 Plan" to strengthen medication management and sleep health care for high-risk populations.

International data from the International Narcotics Control Board (INCB) in 2024 indicated that Taiwan's daily dosage for certain BZD and Z-drug sleeping pills exceeds that of South Korea and Australia, underscoring the need for careful attention to sleeping pill use. NHIA official Chang Hui-ping emphasized that the new measures aim to improve medication safety and promote rational prescribing, not to restrict access.

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The measures are not intended to restrict people's access to sleeping pills, but rather to enhance medication safety and the concept of rational prescribing.

The enhanced management will target three high-risk groups: individuals over 65, those using three or more types of long-acting or short-acting sleeping pills concurrently, and those whose cumulative medication use exceeds six months within a year. Research suggests that using multiple sleeping pills increases the risk of falls and fractures, and often lacks sufficient medical evidence, prompting recommendations for specialist evaluation and medication adjustment.

Beyond medical oversight, the NHIA is incorporating sleep health assessments into the "Three Highs Chronic Disease 888 Plan." Citizens can complete lifestyle assessment questionnaires via the "National Health Insurance Mobile App - Health Pass" to provide data for physicians. Those identified with sleep issues can receive consultations, health education, or referrals from healthcare teams.

The NHIA plans to regularly analyze health insurance data to identify high-risk individuals for healthcare providers and conduct professional reviews when necessary. The ultimate goal is not to prohibit sleeping pill prescriptions but to guide patients toward correct sleep concepts, reduce over-reliance on medication, and enhance overall medication safety through case management and professional assessment.

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Using three or more sleeping pills concurrently increases the risk of falls and fractures, and lacks sufficient evidence in medical practice. Therefore, we recommend specialist physicians conduct further evaluations and adjustments rather than continuously increasing the types of medication.