Advance in Evaluation of the Clinical Efficacy of Non-benzodiazepine Drugs in Treating Comorbid Insomnia and Sleep Apnea

Comorbid insomnia and sleep apnea is a highly prevalent disorder characterized by both insomnia and sleep apnea, leading to more severe impairment of daytime function and quality of life than in patients with either insomnia or obstructive sleep apnea (OSA) alone. Non-benzodiazepine drugs (NBZDs) are frontline medications for insomnia treatment, as they can improve insomnia symptoms and enhance sleep quality. However, they are not recommended for OSA treatment due to their potential to increase the apnea-hypopnea index (AHI) and worsen the severity of sleep-disordered breathing. Currently, the therapeutic effects of NBZDs on COMISA are not well-established and require further investigation. Therefore, this article adopts a systematic review approach to compile relevant literature on the use of NBZDs in patients with OSA and COMISA, analyzing the impact of NBZDs on various indicators such as AHI, oxygen desaturation index, and sleep quality. It evaluates the clinical efficacy and safety of medications including zopiclone, eszopiclone, zolpidem, and zaleplon in the treatment of COMISA, aiming to provide guidance on the rational use of NBZDs for these patients.