Purpose: 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.