PURPOSE Although there is a high co-occurrence of insomnia and obstructive sleep apnea(OSA), the administration of sedative hypnotics in patients with OSA is still inconsistent.The aim is to study the effect of non-benzodiazepine hypnotics (non-BZDs) on sleep quality and severity in patients with OSA.METHODS We conducted a systemic search for controlled clinical trials in multiple databases and pooled analysis of the impact of non-BZDs on objective sleep quality and the severity of OSA, including the apnea-hypopnea index (AHI) and mean and nadir arterial oxygen saturation (SaO2) in patients with OSA.Sensitivity analysis was carried out to explore the robustness of results.RESULTS Eight relevant placebo-controlled clinical trials involving 448patients were included.Objective sleep quality, including sleep latency, sleep efficiency, and wake time after sleep onset, was significantly improved in patients taking non-BZDs compared with those taking placebo (p < 0.01).The weighted estimate indicated that the administration of non-BZDs prior to bedtime had no significant effect on AHI or SaO2 in OSA patients (p > 0.05).