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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\u2010REM or REM sleep, mean peripheral oxygen saturation (SpO\n                      <jats:sub>2<\/jats:sub>\n                      ) during TST, mean SpO\n                      <jats:sub>2<\/jats:sub>\n                      nadir during TST, arousal index (AI), all\u2010cause discontinuation, adverse event\u2010related discontinuation, and incidence of individual adverse events. Effect sizes with 95% confidence intervals were calculated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This systematic review included 32 RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091871, average age\u2009=\u200951.60\u2009years, 62.52% male, mean AHI\u2009=\u200923.60). Our network meta\u2010analysis 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our network meta\u2010analysis 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pcn.70036","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T12:18:42Z","timestamp":1770725922000},"page":"390-397","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparative effects of hypnotic agents on sleep architecture and respiratory outcomes in obstructive sleep apnea: A systematic review and network meta\u2010analysis"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9237-2236","authenticated-orcid":false,"given":"Taro","family":"Kishi","sequence":"first","affiliation":[{"name":"Department of Psychiatry Fujita Health University School of Medicine  Toyoake Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshikazu","family":"Ikuta","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders, School of Applied Sciences University of Mississippi  University Mississippi USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Sakuma","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Fujita Health University School of Medicine  Toyoake Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-878X","authenticated-orcid":false,"given":"Masakazu","family":"Hatano","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Fujita Health University School of Medicine  Toyoake Japan"},{"name":"Department of Pharmacotherapeutics and Informatics Fujita Health University School of Medicine  Toyoake Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuhiko","family":"Kishi","sequence":"additional","affiliation":[{"name":"Kishi Ear Nose Throat Clinic  Ichinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8785-9330","authenticated-orcid":false,"given":"Tsuyoshi","family":"Kitajima","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Fujita Health University School of Medicine  Toyoake Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nakao","family":"Iwata","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Fujita Health University School of Medicine  Toyoake Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.12.044"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6506"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.3514"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.2109080"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200709-155MG"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2020-000656"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27772"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2019.01.004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41030-025-00331-0"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resinv.2021.08.010"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41105-021-00353-6"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-23-0489"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.691495"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12482"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2010.03.012"},{"key":"e_1_2_10_17_1","unstructured":"ASA.Australasian Sleep Association.https:\/\/www.sleepprimarycareresources.org.au\/2025."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.14035"},{"key":"e_1_2_10_19_1","unstructured":"SHF.Sleep Apnoea. 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