Hypnotics did not worsen a prognosis of patients receiving long-term oxygen and/or noninvasive ventilation

Background: Most hypnotics are generally contraindicated for patients with severe chronic respiratory failure. Some patients however complain insomnia and request hypnotics. Our previous study showed hypnotics improve their sleep quality. The long-term effect of hypnotics on PaCO 2 , clinical stability, and prognosis are necessary to examine. Methods: We have started a 5-years prospective, multi-center, observational study including 355 patients receiving LTOT and/or long-term NIV. ABGs, respiratory deterioration rates, and their prognosis were examined for an interim report of two years. Results: 118 patients took some hypnotics frequently (more than ten times per month) at start of investigation. There were no differences in two years trend of PaCO 2 between those using hypnotics and the others in all 355, 258 LTOT alone, and 97 NIV+LTOT patients. In all patients, the respiratory deterioration rates per year in patients using hypnotics vs the others were 0.94 vs 0.74 (p=0.32) in a previous year, 0.98 vs 0.74 (p=0.06) in 1st year, and 1.17 vs 0.89 (p=0.12) in 2nd year, respectively. There was no differences in survival rates between patients taking hypnotics vs the others in all (p=0.53), LTOT alone (p=0.65), and NIV+LTOT patients (p=0.53), respectively. Conclusions: Hypnotics did not accelerate hypercapnia and did not decrease survival rates in our patients, although respiratory deterioration rate was slightly high in patients taking hypnotics. Since hypnotics improve subjective sleep quality, administration of those drugs, if cautiously prescribed, might be permitted in patients receiving LTOT and/or long-term NIV.