A new study has raised concerns about the commonly prescribed sleeping pill quetiapine, warning that it can impair alertness and driving performance the following day. Researchers from Flinders University in Australia found that while low-dose quetiapine modestly improved sleep quality and reduced obstructive sleep apnea severity, it significantly affected next-day functioning.
The clinical trial, published in the Annals of the American Thoracic Society, involved 15 adults with sleep apnea who spent two nights in a sleep laboratory—one after taking 50mg of quetiapine and one after a placebo. Participants were monitored overnight and completed a driving simulator and vigilance test the next morning.
Results showed that quetiapine led to slower reaction times, more lapses in attention, and poorer steering control during the driving simulation—all markers linked to real-world crash risk. Lead author Dr Cricket Fauska noted, “Although participants slept longer and woke less overnight, their reaction times were slower, and their simulated driving performance was noticeably worse the next morning.”
Quetiapine is approved for schizophrenia and bipolar disorder but is increasingly prescribed off-label at low doses for insomnia and anxiety. Dr Fauska added, “There’s a growing belief that low-dose quetiapine is a relatively harmless way to help people sleep... Our results show it’s not that simple.”
The study also found a mismatch between subjective feelings and objective performance: some participants did not feel sleepy despite performing worse on tests. “That mismatch between how people feel and how they actually function poses a serious safety risk, especially when it comes to driving,” Dr Fauska said.
Researchers are calling for a shift towards tailored treatments for sleep disorders, targeting underlying causes rather than defaulting to sedating medications. Professor Danny Ecker from Flinders University emphasised, “Treatment needs to be tailored – using the right approach, or combination of approaches, for the individual.”
