Obstructive sleep apnoea is a common condition where a person’s breathing repeatedly stops and starts during sleep because the airway becomes blocked. These pauses in breathing can lower oxygen levels in the body and often wake the person up, even if they do not realise it. As a result, sleep becomes broken and less restful. Over time, this condition can affect overall health and has been linked to issues such as heart problems, metabolic conditions, and a reduced quality of life.
Many people with obstructive sleep apnoea also struggle with insomnia, meaning they have trouble falling asleep, staying asleep, or waking too early. When both conditions happen together, it is known as COMISA. This combination can make treatment more difficult. One common treatment for sleep apnoea is a machine that helps keep the airway open during sleep. Still, people with insomnia may find it harder to use this treatment regularly or comfortably.
Doctors often recommend a type of therapy that helps people change their sleep habits and thoughts about sleep as the first approach for insomnia. However, in everyday practice, many people are prescribed sleeping pills instead. While these medications can help with sleep, there are concerns that some of them might make breathing problems worse during the night, which could be risky for people with sleep apnoea.
To better understand this issue, a group of researchers in Japan carried out a large study. They reviewed many previous studies and compared different types of sleep medications to see how well they worked and how safe they were for people with sleep apnoea. In total, they looked at 32 studies covering 12 different sleep medicines, as well as a comparison with no medication. They examined a wide range of outcomes, including how the medications affected sleep patterns, breathing during sleep, and how well people tolerated the treatments.
The results showed that sleep medications do not all work in the same way. Some may be more helpful for people who have trouble falling asleep, while others may be better for those who wake up during the night or too early in the morning. This suggests that choosing the right medication should depend on the specific sleep problem a person is experiencing, rather than using a one-size-fits-all approach.
Importantly, the study did not find strong evidence that most sleep medications made breathing problems worse overall. For many of the drugs studied, breathing measures were similar to those seen with no treatment. However, one medication was found to lower oxygen levels during sleep, which raises concerns. Because of this, the researchers advise doctors to be careful when prescribing these medicines. Treatment should be tailored to each individual, with close monitoring to ensure both sleep and breathing remain safe and well managed.
More information: Taro Kishi et al, Comparative effects of hypnotic agents on sleep architecture and respiratory outcomes in obstructive sleep apnea: A systematic review and network meta-analysis, Psychiatry and Clinical Neurosciences. DOI: 10.1111/pcn.70036
Journal information: Psychiatry and Clinical Neurosciences Provided by Fujita Health University
