Hypnotics should never be used in patients with sleep apnea.

Although benzodiazepine medication is generally considered to be inappropriate for patients with obstructive sleep apnea, further investigation is required to evaluate this. Non-benzodiazepine hypnotics may improve sleep quality without causing respiratory depression. In central sleep apnea, hypnotics not only improve sleep but also decrease apnea frequency probably by reducing arousals and elevating arterial PCO2. Consequently, I submit that the statement 'hypnotics should not be used in patients with sleep apnea' should be changed to 'hypnotics may sometimes be used in patients with sleep apnea'.