{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:56:48Z","timestamp":1793386608466,"version":"4.5.0"},"reference-count":60,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Health and Medical Research"},{"name":"Council of Australia Investigator","award":["1196261"],"award-info":[{"award-number":["1196261"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Quetiapine is commonly prescribed \u201coff-label\u201d to people with insomnia symptoms. People with undiagnosed obstructive sleep apnea (OSA) frequently report insomnia symptoms, particularly difficulty\u00a0maintaining sleep. In 2023, 10.7 million prescriptions were dispensed for quetiapine in the United States. Yet, there is limited information regarding the effects of quetiapine on sleep, breathing, and next-day performance in people with OSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the effects of 50\u2009mg of quetiapine versus placebo on OSA severity and other polysomnographic parameters plus next-day vigilance and driving simulator performance in people with OSA who also reported difficulty maintaining sleep.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a double-blind, randomized, placebo-controlled, cross-over study (NCT05303935) in 15 people with OSA and difficulty maintaining sleep. Participants were studied overnight via polysomnography twice approximately 1\u2009week apart and received either 50\u2009mg of quetiapine or placebo (order randomized) just prior to sleep. A 10-minute psychomotor vigilance task (PVT) and 30-minute driving simulator test were performed each morning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to placebo, quetiapine reduced the apnea\/hypopnea index (primary outcome) (mean\u2009\u00b1\u2009SD: 27\u2009\u00b1\u200916 vs 20\u2009\u00b1\u200912 events\/hour, P\u2009=\u2009.009), arousal index (32\u2009\u00b1\u200916 vs 25\u2009\u00b1\u20099 arousals\/hour, P\u2009=\u2009.012), and increased sleep efficiency (80\u2009\u00b1\u200911 vs 87\u2009\u00b1\u20099%, P\u2009&amp;lt;.001) without worsening hypoxemia (mean overnight oxygen saturation: 94.7\u2009\u00b1\u20091.2% vs 94.5\u2009\u00b1\u20091.5%, P\u2009=\u2009.38). However, next-morning vigilance (median PVT reaction time: 336\u2009\u00b1\u200948 vs 382\u2009\u00b1\u200984\u2009ms, P\u2009=\u2009.008) and driving simulator performance (steering deviation: 72\u2009\u00b1\u200938 vs 96\u2009\u00b1\u200953\u2009cm, P\u2009&amp;lt;.01) were significantly impaired with quetiapine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Consistent with a hypnotic effect, a single night of low-dose quetiapine reduced OSA severity as measured via the apnea\/hypopnea index and increased sleep efficiency without worsening overnight hypoxemia. However, there was evidence of next-day impairment in vigilance and driving simulator performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>NCT05303935<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annalsats\/aaoag092","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T02:12:49Z","timestamp":1776046369000},"page":"1532-1542","source":"Crossref","is-referenced-by-count":3,"title":["Quetiapine modestly improves sleep and breathing but impairs next-day performance in people with obstructive sleep apnea and difficulty maintaining sleep: a randomized controlled trial"],"prefix":"10.1093","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9993-0576","authenticated-orcid":false,"given":"Cricket","family":"Fauska","sequence":"first","affiliation":[{"name":"Flinders University Flinders Health and 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