We evaluated Japanese tendencies regarding prescription of hypnotics and anxiolytics. Four common features were recognized: (1) high-dose polypharmacy of hypnotics and anxiolytics is common in sleep and anxiety disorders; (2) the prevalence of prescriptions for elderly patients is especially high; (3) more than half of the prescriptions are written by physicians; and (4) the prescription of long-term benzodiazepines is still widespread in spite of international clinical guidelines recommending benzodiazepine treatment to be limited to only a few weeks. All these features should be considered when clinicians prescribe hypnotics and anxiolytics. The prescription of minimal dosages is essential both for obtaining clinical benefit and avoiding adverse events, such drug-dependency, falls and hip fractures, and withdrawal symptoms.