Comparative effects of hypnotic agents on sleep architecture and respiratory outcomes in obstructive sleep apnea: A systematic review and network meta-analysis - PubMed
3 months ago
- #obstructive sleep apnea
- #hypnotics
- #meta-analysis
- A network meta-analysis of 32 RCTs (n=1871) evaluated hypnotics' effects on sleep architecture and respiratory outcomes in obstructive sleep apnea (OSA).
- Primary outcomes included total sleep time (TST) and apnea-hypopnea index (AHI), with secondary measures like REM sleep time, sleep efficiency (SE), and oxygen saturation.
- Lemborexant improved TST, REM sleep, SE, and reduced latency to persistent sleep (LPS) and wake after sleep onset (WASO) compared to placebo.
- Daridorexant and zolpidem also increased TST and SE while reducing WASO, with respiratory safety profiles similar to placebo.
- Eszopiclone showed benefits in TST, SE, LPS, WASO, AHI, and arousal index, but effects diminished in sensitivity analysis excluding CPAP titration studies.
- The study highlights varying effects of hypnotics on OSA but notes limitations in subjective outcome synthesis, urging cautious clinical interpretation.