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.
Ann Am Thorac SocOct 1, 2026
Cricket Fauska, Tarun Bastiampillai, Georgina Rawson et al.
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In 30 seconds
This randomized controlled trial evaluated the effects of 50 mg quetiapine versus placebo in 15 individuals with obstructive sleep apnea (OSA) and difficulty maintaining sleep. Quetiapine significantly reduced the apnea/hypopnea index (27 vs 20 events/hour, P = .009) and improved sleep efficiency (80% vs 87%, P < .001), but impaired next-day vigilance and driving performance.
Key findings
- Quetiapine reduced the apnea/hypopnea index from 27 to 20 events/hour (P = .009).
- Sleep efficiency improved from 80% to 87% with quetiapine (P < .001).
- Next-morning vigilance reaction time was slower with quetiapine (336 ms vs 382 ms, P = .008).
- Driving simulator performance worsened with quetiapine, showing a steering deviation of 72 cm vs 96 cm (P < .01).
Why it matters
The findings highlight the dual effects of quetiapine in patients with OSA, improving sleep parameters while impairing next-day performance. Clinicians should weigh these benefits against potential risks when considering off-label use for insomnia in this population.