The effect of non-benzodiazepine hypnotics on sleep quality and severity in patients with OSA: a meta-analysis.
OBJECTIVE
Although there is a high co-occurrence of insomnia and obstructive sleep apnea (OSA), the administration of sedative hypnotics in patients with OSA is still inconsistent. The aim is to study the effect of non-benzodiazepine hypnotics (non-BZDs) on sleep quality and severity in patients with OSA.


METHODS
We conducted a systemic search for controlled clinical trials in multiple databases and pooled analysis of the impact of non-BZDs on objective sleep quality and the severity of OSA, including the apnea-hypopnea index (AHI) and mean and nadir arterial oxygen saturation (SaO2) in patients with OSA. Sensitivity analysis was carried out to explore the robustness of results.


RESULTS
Eight relevant placebo-controlled clinical trials involving 448 patients were included. Objective sleep quality, including sleep latency, sleep efficiency, and wake time after sleep onset, was significantly improved in patients taking non-BZDs compared with those taking placebo (p<0.01). The weighted estimate indicated that the administration of non-BZDs prior to bedtime had no significant effect on AHI or SaO2 in OSA patients (p>0.05).


CONCLUSIONS
The administration of non-BZDs at the commonly recommended dose has been shown to improve objective sleep quality in OSA patients without worsening sleep apnea. It suggests that OSA patients with a complaint of insomnia symptoms may benefit from taking non-BZDs.
Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin Er Road, Shanghai, 200025, China.
Xiu Juan
XJ
Zhang
Qing Yun
QY
Li
Yan
Y
Wang
Hua Jun
HJ
Xu
Ying Ni
YN
Lin
D018849:Controlled Clinical Trials as Topic; D018592:Cross-Over Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000627:therapeutic use*; D010100:Oxygen / Q000097:blood; D012890:Sleep / Q000187:drug effects*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000188:drug therapy*; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000188:drug therapy*
D006993:Hypnotics and Sedatives; D010100:Oxygen