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The effect of non-benzodiazepine hypnotics on sleep quality and severity in patients with OSA: a meta-analysis

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Abstract

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.

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Acknowledgments

The authors would like to thank Bai Song Wang for his help in statistical analysis.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin Er Road, Shanghai, 200025, China

    Xiu Juan Zhang, Qing Yun Li, Yan Wang, Hua Jun Xu & Ying Ni Lin

  2. Huashan Hospital, Shanghai Fudan University School of Medicine, Shanghai, 200040, China

    Xiu Juan Zhang

Authors
  1. Xiu Juan Zhang
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  2. Qing Yun Li
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  3. Yan Wang
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  4. Hua Jun Xu
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Corresponding author

Correspondence to Qing Yun Li.

Glossary

AHI

Apnea-hypopnea index

CI

Confidence interval

CPAP

Continuous positive airway pressure

γ-GABAA

Benzodiazepine/γ-aminobutyric acid A

MD

Mean difference

BZDs

Benzodiazepine hypnotics

OSA

Obstructive sleep apnea

PSG

Polysomnography

SaO2

Arterial oxygen saturation

WASO

Wake after sleep onset

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Zhang, X.J., Li, Q.Y., Wang, Y. et al. The effect of non-benzodiazepine hypnotics on sleep quality and severity in patients with OSA: a meta-analysis. Sleep Breath 18, 781–789 (2014). https://doi.org/10.1007/s11325-014-0943-7

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  • DOI: https://doi.org/10.1007/s11325-014-0943-7

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