Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA)

Sweetman, Alexander; Lack, Leon; McEvoy, R. Doug; Smith, Simon; Eckert, Danny J.; Osman, A. Arnold; Carberry, Jayne C.; Wallace, Douglas M.; Nguyen, Phan Anh; Catcheside, Peter

doi:10.1016/j.smrv.2021.101519

Cited by 62 publications

(50 citation statements)

References 123 publications

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“…Subsequently, a series of studies raised the attention around COMISA, portraying its prevalence: 35% of insomnia patients have an Apnea-Hypopnea Index of ≥15, which corresponds to moderate sleep apnea, while 38% of OSA patients meet the criteria of insomnia [3]. Furthermore, there is some evidence to suggest that OSA contributes to the exacerbation of insomnia [4] Based upon recent randomized controlled trials, some issues that should be considered in the future research agenda include [1]:…”

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confidence: 99%

The State of Art on Co-Morbid Insomnia and Sleep Apnea (COMISA)

Gennaro

2021

Brain Sciences

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confidence: 99%

The State of Art on Co-Morbid Insomnia and Sleep Apnea (COMISA)

Gennaro

2021

Brain Sciences

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“…adherence to continuous positive air pressure (CPAP) treatment), COMISA has increasingly become a point of interest in sleep research. 45 Our new finding of EEG spectral patterns of COMISA, which have been rarely investigated, could be used to characterize the comorbidity of this specific disease group. Furthermore, the disorder groups within the 20-40 years age bracket did not show any significant differences in BAI and the electrophysiological pattern (= EEG power spectrum pattern) compared to the healthy sleeper.…”

Section: Disease-specific Features Of Sleep Disorders In Aspects Of Brain Age (Osa Vs Comisa Vs Insomnia)mentioning

confidence: 93%

A novel neuroelectrophysiological age index implicates brain health and sleep disorders

Yook

Park

et al. 2022

Preprint

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Sleep architecture and microstructures alter with aging and sleep disorder-led accelerated aging. We proposed a sleep electroencephalogram (EEG) based brain age prediction model using convolutional neural networks. We then associated the estimated brain age index (BAI) with brain structural aging features, sleep disorders and various sleep parameters. Our model also showed a higher BAI (predicted brain age minus chronological age) is associated with cortical thinning in various functional areas. We found a higher BAI for sleep disorder groups compared to healthy sleepers, as well as significant differences in the spectral pattern of EEG among different sleep disorders (lower power in slow and θ waves for sleep apnea vs. higher power in β and σ for insomnia), suggesting sleep disorder-dependent pathomechanisms of aging. Our results demonstrate that the new EEG-BAI can be a biomarker reflecting brain health in normal and various sleep disorder subjects, and may be used to assess treatment efficacy.

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“…Co-morbid insomnia and sleep apnoea (COMISA) is a prevalent and debilitating sleep disorder that is more difficult to treat compared to either insomnia or OSA alone [2,8]. For example, approximately 30-40% of people with insomnia have co-morbid OSA and 30-50% of sleep clinic patients with OSA report insomnia symptoms [9,10]. COMISA is associated with worse sleep, increased daytime impairments, poorer mental and physical health, and reduced longevity, compared to people with neither disorder or those with insomnia or OSA alone [8,11,12].…”

Section: Introductionmentioning

confidence: 99%

“…SOSD may reflect bi-directional associations between insomnia and OSA [9]. For example, periods of brief sleep and awakenings following respiratory events may be (mis)perceived as periods of prolonged wakefulness [13].…”

Section: Introductionmentioning

confidence: 99%

“…For example, periods of brief sleep and awakenings following respiratory events may be (mis)perceived as periods of prolonged wakefulness [13]. Perceptions of long periods of wakefulness may increase frustration and cognitive arousal, contributing to an increased duration of light sleep [9]. In turn, increased time in light and transitional sleep may increase the likelihood of upper airway collapse [26,27], and exacerbation of each condition [9].…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Cognitive Behavioural Therapy for Insomnia (CBT-I) on Subjective–Objective Sleep Discrepancy in Individuals with Co-Morbid Insomnia and Sleep Apnoea: A Randomised Controlled Trial

et al. 2022

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People with insomnia frequently underestimate the duration of their sleep compared to objective polysomnography-measured sleep duration. Cognitive behavioural therapy for insomnia (CBT-I) is the most effective treatment for insomnia and also reduces the degree of sleep underestimation. Obstructive sleep apnoea (OSA) is a highly prevalent sleep disorder characterised by frequent narrowing (hypopnoea) and closure (apnoea) of the upper airway during sleep. Comorbid insomnia and sleep apnoea (COMISA) is a prevalent and debilitating disorder. No study has investigated subjectively (sleep diary) versus objectively (polysomnography) measured sleep discrepancies (SOSD) in individuals with COMISA before or following CBT-I. This randomised waitlist-controlled trial investigated SOSD in 145 participants with COMISA before and 6-weeks after CBT-I (n = 72) versus control (n = 73). All participants were studied prior to continuous positive airway pressure treatment for sleep apnoea. At baseline, participants underestimated their total sleep time (mean ± SD −51.9 ± 94.1 min) and sleep efficiency (−9.6 ± 18.3%), and overestimated sleep onset latency (34.5 ± 86.1 min; all p = < 0.001). Mixed models indicated a main effect of time on reduction of SOSD in both groups, but no between-group difference in the reduction of any SOSD parameters. These findings may indicate that untreated OSA contributes to a discrepancy between perceived and objective sleep parameters in people with COMISA that is not amenable to CBT-I alone (ACTRN12613001178730).

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Bi-directional relationships between co-morbid insomnia and sleep apnea (COMISA)

Cited by 62 publications

References 123 publications

The State of Art on Co-Morbid Insomnia and Sleep Apnea (COMISA)

The State of Art on Co-Morbid Insomnia and Sleep Apnea (COMISA)

A novel neuroelectrophysiological age index implicates brain health and sleep disorders

The Effect of Cognitive Behavioural Therapy for Insomnia (CBT-I) on Subjective–Objective Sleep Discrepancy in Individuals with Co-Morbid Insomnia and Sleep Apnoea: A Randomised Controlled Trial

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