A short course of the hypnotic eszopiclone (not available in UK) increases adherence to continuous positive airway pressure (CPAP).

CPAP is used in treatment of obstructive sleep apnoea; however short-term adherence to the procedure is often poor due to intolerance, and this may predict poor long-term adherence. The authors of this study aimed to determine whether a short course (14 nights) of a hypnotic during initial treatment would improve short-term and longer-term (six months) adherence. Patients were from an academic sleep disorder centre and were to start CPAP for newly diagnosed obstructive sleep apnoea; they were randomised to 14 nights eszopiclone or placebo and followed-up at 1, 3, and 6 months. Primary outcome was adherence to CPAP measured every two weeks.

Of 160 patients randomised, 150, 136, and 120 completed the 1, 3 and 6-month follow-up. Those in the eszopiclone group were more likely to use the CPAP, using it for 20.8% more nights (95% CI, 7.2% to 34.4%; P = 0.003). They also used it for longer periods, and were less likely to discontinue use. Adverse events were similar in both groups.

The authors conclude that a short course of a hypnotic, eszopiclone, during the first two weeks of CPAP improved adherence compared to placebo and led to fewer patients discontinuing therapy.