Evidence map›Paper›PMID 41665171›Full record

SynthesisPsychiatry and clinical neurosciences2026

Comparative effects of hypnotic agents on sleep architecture and respiratory outcomes in obstructive sleep apnea: A systematic review and network meta-analysis.

Taro Kishi, Toshikazu Ikuta, Kenji Sakuma, Masakazu Hatano, Tatsuhiko Kishi, Tsuyoshi Kitajima, Nakao Iwata

Abstract readNetwork Meta-AnalysisSystematic ReviewComparative Study
In one paragraph

Synthesis in Psychiatry and clinical neurosciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Taro KishiDepartment of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan.ORCID https://orcid.org/0000-0002-9237-2236
Toshikazu IkutaDepartment of Communication Sciences and Disorders, School of Applied Sciences, University of Mississippi, University, Mississippi, USA.
Kenji SakumaDepartment of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan.
Masakazu HatanoDepartment of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan.ORCID https://orcid.org/0000-0001-7032-878X
Tatsuhiko KishiKishi Ear Nose Throat Clinic, Ichinomiya, Japan.
Tsuyoshi KitajimaDepartment of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan.ORCID https://orcid.org/0000-0002-8785-9330
Nakao IwataDepartment of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan.

Funding

Japan Society for the Promotion of Science 25K10874
6 · The paper itself

Abstract

aimThis network meta-analysis of randomized controlled trials (RCTs) aimed to investigate which hypnotics are associated with the most favorable sleep architecture and respiratory outcomes in adults with obstructive sleep apnea.

methodsPrimary outcomes included total sleep time (TST) and apnea-hypopnea index (AHI) during TST. Other outcomes were rapid eye movement (REM) sleep time, latency to persistent sleep (LPS), wake after sleep onset (WASO), sleep efficiency (SE), AHI during non-REM or REM sleep, mean peripheral oxygen saturation (SpO

resultsThis systematic review included 32 RCTs (n = 1871, average age = 51.60 years, 62.52% male, mean AHI = 23.60). Our network meta-analysis evaluated brotizolam, daridorexant, eszopiclone, flurazepam, lemborexant, nitrazepam, ramelteon, temazepam, triazolam, zaleplon, zolpidem, zopiclone, and placebo. Compared with placebo, lemborexant increased TST, REM sleep time, and SE and decreased LPS and WASO, whereas both daridorexant and zolpidem increased TST and SE and decreased WASO. These three medications demonstrated respiratory safety and discontinuation profiles similar to those of placebo. Eszopiclone increased TST and SE and decreased LPS, WASO, AHI during TST, and AI, but its effects on LPS, WASO, AHI during TST, and AI disappeared in the sensitivity analysis, excluding continuous positive airway pressure titration studies.

conclusionOur network meta-analysis identified different effects of various hypnotics on sleep architecture and respiratory parameters; however, the lack of data prevented a formal synthesis of subjective outcomes. Therefore, these results should be interpreted with caution in clinical practice.

Indexed as

Hypnotics and SedativesOutcome Assessment, Health CareSleep Apnea, ObstructiveHumansRandomized Controlled Trials as TopicSleep DurationHypnotics and Sedativeshypnoticsobstructive sleep apnearespiratory outcomesleep architecturesystematic review and network meta‐analysis

Identifiers

PMID41665171
PMCPMC13139812

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.