Am J Respir Crit Care Med

Hypnotics have limited effect on obstructive sleep apnea severity

January 20, 2025

Hypnotics as a standalone treatment for OSA aren’t recommended due to their minimal impact on OSA severity. However, they may be considered in patients with comorbid insomnia or as part of combination therapy for individuals with very low arousal thresholds.

Study details: This systematic review and meta-analysis examined the effects of common hypnotics on arousal threshold, obstructive sleep apnea (OSA) severity, and genioglossus muscle responsiveness. Researchers analyzed data from 27 studies, including 25 on apnea-hypopnea index (AHI), 11 on arousal threshold, and 4 on genioglossus responsiveness.

Results: Hypnotics slightly increased the arousal threshold (mean difference: 2.7 cmH2O epiglottic pressure swings) but didn’t significantly alter OSA severity (mean difference: -1.4 events/hour). Individual patient data meta-analysis didn’t show a significant association between changes in arousal threshold and AHI, regardless of low arousal threshold subgrouping. Hypnotics didn’t affect genioglossus responsiveness.

Source:

Messineo L, et al. (2024, December 15). Am J Respir Crit Care Med. Hypnotics on Obstructive Sleep Apnea Severity and Endotypes: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/39042859/