Concerns About Quetiapine as a Sleep Aid
A widely used sleeping pill, quetiapine, might linger in the system longer than expected, leading to issues with alertness and driving abilities the next day, according to recent research.
There has been increasing worry about the common off-label use of sedatives for sleep issues like insomnia.
Some studies indicate that taking these medications, which weren’t originally designed for sleep-related problems, could result in cognitive dullness the next day, dependency concerns, and worsened breathing during sleep.
In a groundbreaking clinical trial, researchers looked into how low doses of quetiapine affect sleep, breathing, and performance the following day.
Scientists from Flinders University in Australia discovered that while low-dose quetiapine improved sleep quality and reduced the severity of obstructive sleep apnea (OSA), it also significantly impacted alertness and driving abilities the next morning. These findings were published in the Annals of the American Thoracic Society.
“We found that next morning’s vigilance and performance on a driving simulator were notably affected by quetiapine,” the researchers noted.
Though quetiapine is officially approved for treating schizophrenia and bipolar disorder, it’s increasingly being prescribed at lower doses for insomnia and anxiety due to its sedative properties.
“There’s a growing perception that using low doses of quetiapine is a harmless way to aid sleep… but our results indicate that it’s more complex,” remarked Cricket Fauska, the study’s lead author from Flinders University.
Dr. Fauska added, “Participants did sleep longer and woke up less frequently overnight, but their reaction times slowed, and their simulated driving skills were notably impaired the next morning.”
The idea that better sleep equates to improved daytime performance is now being questioned, particularly in relation to quetiapine use.
During the trial, researchers focused on patients with sleep apnea who had trouble staying asleep.
Fifteen adults spent two nights in a sleep lab—one after taking 50 milligrams of quetiapine and the other after a placebo. They were monitored overnight and the following day, completing a driving simulator task and a vigilance test to assess alertness objectively.
While quetiapine reduced the frequency of breathing interruptions and enhanced sleep efficiency compared to the placebo, it also resulted in slower reaction times, more attention lapses, and poorer steering control in the driving simulation. These factors are closely related to real-world crash risks.
“One troubling aspect is that some participants didn’t feel particularly drowsy the next day, even though objective tests showed they performed poorly,” Dr. Fauska noted. “This disconnect between feeling and actual function presents serious safety concerns, particularly when driving is involved.”
Researchers are advocating for changes in managing sleep disorders like sleep apnea. Rather than relying on blanket treatment solutions, there is a growing belief that addressing the root causes of sleep issues can improve treatment effectiveness and patient outcomes.
“What we are discovering is that treatments should be personalized—tailoring approaches for each individual instead of automatically resorting to sedative medications,” noted Danny Ecker, a sleep health professor at Flinders University.
