EduAsiaNews, Tokyo — For years, physicians have been hesitant to prescribe sleep medications to patients also suffering from obstructive sleep apnea (OSA) — a breathing disorder during sleep that affects millions of people worldwide. Now, a latest study from Japan offers a more nuanced picture. Researchers from the Department of Psychiatry at Fujita Health University School of Medicine, led by Professor Taro Kishi, conducted a systematic review and network meta-analysis to identify which hypnotic drugs can deliver quality sleep without compromising respiratory safety in adult OSA patients. The study was published in the journal Psychiatry and Clinical Neurosciences in early 2026.
The meta-analysis included only randomized controlled trials and covered four major categories of hypnotic drugs recognized by the US Food and Drug Administration (FDA) for the treatment of primary insomnia: benzodiazepines, Z-drugs, melatonin receptor agonists, and dual orexin receptor antagonists (DORA). The findings challenge the long-held assumption that all sleep medications are harmful to OSA patients.
Overall, the study found no broad evidence that hypnotic drugs uniformly worsen patients’ respiratory conditions. Key indicators such as the apnea-hypopnea index (AHI) did not differ significantly from placebo for most of the drugs analyzed.
Professor Tsuyoshi Kitajima of Fujita Health University, one of the research team members, emphasized that insomnia in OSA patients is not uniform. Some patients have difficulty initiating sleep, while others wake up in the middle of the night or too early in the morning. Therefore, recommending the appropriate medication based on specific insomnia symptoms can help address the problem more effectively.
Professor Nakao Iwata, also from Fujita Health University, concluded that this is the first network meta-analysis to comprehensively compare various hypnotic drugs in terms of both sleep architecture and respiratory parameters in adult OSA patients. He added that the findings highlight an urgent need to tailor treatment based on each patient’s specific insomnia symptoms. Through these new findings, physicians are encouraged not to avoid sleep medications altogether, but rather to select them carefully based on the individual profile and specific symptoms of each patient. (**)
