Subjectively reported sleep improvement with antipsychotic medications in clinical practice: A systematic review, meta-analysis and meta-regression of moderating factors.

This article systematically reviews and meta-analyzes the efficacy of antipsychotic medications (APs), including first- and second-generation antipsychotics (SGAs), on subjective sleep quality in patients with neuropsychiatric disorders. The analysis of 43 studies, including 21 randomized controlled trials, found that APs improve subjective sleep quality more than placebo, with greater effects observed for antihistaminergic APs (e.g., quetiapine), in anxiety disorders, among females and younger individuals, and in longer-duration trials. Age and sex moderated treatment response, with older males showing less benefit. Adverse drug reactions commonly included sedation and dry mouth, while metabolic side effects were not prominently reported, likely due to short study durations. These findings highlight the potential role of APs, particularly SGAs with antihistaminergic properties, in managing sleep disturbances associated with psychiatric conditions, though further research is needed on long-term effects and clinical guidelines.