OBJECTIVES: The purpose of this study was to investigate use sedative/hypnotic drugs in a generally ambulatory population of persons 65+ years of age. Clinical literature suggests that use of these agents is accompanied by physical and mental functioning declines that pose particular concerns for non-institutionalized older individuals. METHODS: Retrospective analysis of sedative/hypnotic claims from a database. Persons with at least one prescription for a sedative/hypnotic in a 12-month study period (January 1, 2001-December 31, 2001), who were 65 years of age or older and were continuously enrolled in the 6 months prior to the end of the study period were included. Sedative/hypnotic agents included barbiturate and non-barbiturate sedative hypnotics alone or in combinations. Claims histories were used to identified naïve users; current use was categorized as acute, limited, or continuous based on days supply and refill patterns. RESULTS: Eight and a half percent of the 313,038 persons meeting inclusion criteria had at least one claim for sedative/hypnotic agents. Of these 38% (n=10,010) were classified as naïve users. For these patients the mean number of days of therapy for the initial prescription was 28.0±15.1. Only 9% of naïve users received an initial prescription for less than a 10 day supply; 8% received initial prescriptions for >31 days; some up to a 90-day supply. Short-term use was identified in less than 1/3 of naïve users; 15% continued sedative/hypnotic use for greater than 3 months. Twenty eight percent of naïve users received prescriptions for agents identified as potentially inappropriate in elderly patients (21% received a "never-use" drug). CONCLUSIONS: Sedative/hypnotic utilization patterns in elderly ambulatory patients, particularly the evidence of non-adherence to clinical prescribing recommendations related to initial drug selection and days of therapy, should be of concern.