Are Hypnotics Safe in Untreated OSA? Insights for Clinicians

About this episode

The episode discusses the safety of hypnotics in patients with untreated obstructive sleep apnea and explores recent research and clinical implications.

In this episode of Talking Sleep, host Dr. Seema Khosla welcomes Dr. Mark Boulos, Dr. Khullar, and Dr. Mak for an in‑depth discussion on a topic that has challenged clinicians for decades: Are hypnotics safe for patients with untreated obstructive sleep apnea (OSA)? As new therapeutic options emerge and our understanding of comorbid insomnia and sleep apnea (COMISA) evolves, clinicians are increasingly confronted with nuanced decisions about when—and whether—to use hypnotic medications. The guests unpack the latest evidence and share insights from recent studies, including research evaluating dual orexin receptor antagonists (DORAs) such as lemborexant in individuals with sleep apnea. The conversation begins with a review of hypnotic medication classes and explores which agents may be safer in untreated OSA, and which still raise concerns. The panel discusses a recent lemborexant study, its design, population characteristics (including BMI and OSA severity considerations), and whether industry sponsorship played a role. They clarify that while the study did not focus specifically on COMISA, it sheds light on how DORAs perform in people with sleep apnea—particularly in terms of…

People in this episode

Host: Dr. Seema Khosla

Guests: Dr. Mark Boulos, Dr. Khullar, Dr. Mak

Topics covered

• hypnotics
• obstructive sleep apnea
• insomnia
• clinical decision-making
• dual orexin receptor antagonists

Keywords

• hypnotics
• untreated OSA
• DORAs
• lemborexant
• CBT-I
• sleep apnea
• clinical guidelines

Mentioned in this episode

Organizations: AASM

More episodes of Talking Sleep

• Fixed PAP vs APAP: Impact on Blood Pressure and Autonomic Response · June 5, 2026 · 39 min
• Insomnia Combination Treatment: New AASM Guidelines · May 22, 2026 · 51 min
• OSA and Parkinson’s Risk: Can CPAP Change Outcomes? · May 8, 2026 · 40 min
• Community PAP Therapy: Engineering Better Sleep Apnea Care · April 24, 2026 · 1h 0m
• Comparing Hypoglossal Nerve Stimulators for OSA · April 10, 2026 · 57 min
• Microplastics, PAP Therapy, and What the Science Shows · March 27, 2026 · 35 min