Comorbid Insomnia With Obstructive Sleep Apnea: Clinical Characteristics and Risk Factors

Cho, Yong Won; Kim, Keun Tae; Moon, Hye-Jin; Korostyshevskiy, Valeriy R.; Motamedi, Gholam K.; Yang, Kwang Ik

doi:10.5664/jcsm.6988

Cited by 73 publications

(57 citation statements)

References 54 publications

(72 reference statements)

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“…In 2017, we reviewed a large number of studies which indicated an additive and substantial impairment to sleep, daytime functioning, depressive and psychiatric symptoms, and quality of life among COMISA patients [40]. Since 2017, a number of other studies have confirmed associations between COMISA and increased depressive and anxiety symptoms, daytime sleepiness, reduced quality of life, neurocognitive performance, and sleep quality compared to patients with either insomnia or OSA alone [46][47][48][49][50][51][52]. Hence, a large body of evidence has left little doubt that COMISA is a common disorder, which is associated with substantial impairments to nocturnal sleep, daytime functioning, and quality of life.…”

Section: Consequences Of Comisamentioning

confidence: 99%

Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials

2019

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Co-morbid insomnia and sleep apnea (COMISA) is a highly prevalent and debilitating disorder, which results in additive impairments to patients' sleep, daytime functioning, and quality of life, and complex diagnostic and treatment decisions for clinicians. Although the presence of COMISA was first recognized by Christian Guilleminault and colleagues in 1973, it received very little research attention for almost three decades, until the publication of two articles in 1999 and 2001 which collectively reported a 30%-50% co-morbid prevalence rate, and re-ignited research interest in the field. Since 1999, there has been an exponential increase in research documenting the high prevalence, common characteristics, treatment complexities, and bi-directional relationships of COMISA. Recent trials indicate that co-morbid insomnia symptoms may be treated with cognitive and behavioral therapy for insomnia, to increase acceptance and use of continuous positive airway pressure therapy. Hence, the treatment of COMISA appears to require nuanced diagnostic considerations, and multi-faceted treatment approaches provided by multi-disciplinary teams of psychologists and physicians. In this narrative review, we present a brief overview of the history of COMISA research, describe the importance of measuring and managing insomnia symptoms in the presence of sleep apnea, discuss important methodological and diagnostic considerations for COMISA, and review several recent randomized controlled trials investigating the combination of CBTi and CPAP therapy. We aim to provide clinicians with pragmatic suggestions and tools to identify, and manage this prevalent COMISA disorder in clinical settings, and discuss future avenues of research to progress the field.

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Section: Consequences Of Comisamentioning

confidence: 99%

Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials

2019

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“…Insomnia is the most common sleep disturbance associated with anxiety disorders [ 34 ] and poor sleep quality is frequent in adults with anxiety disorders [ 44 ], who experience disturbances in the sleep-onset or sleep maintenance and insomnia. The association of insomnia and OSA is frequent (29.2%) and stands as a cumulative risk factor for cardiovascular diseases [ 45 ] while favoring arousal-inducing sleep-related behaviors, higher levels of pre-sleep arousal, anxiety, and depression more than OSA alone [ 46 ].…”

Section: Sleep-mental Health Interplaymentioning

confidence: 99%

Sleep and Mental Health in Truck Drivers: Descriptive Review of the Current Evidence and Proposal of Strategies for Primary Prevention

Garbarino

Guglielmi

Sannita

et al. 2018

IJERPH

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Background: Professional truck drivers (TDs) are exposed to stressful working (and living) conditions and are vulnerable. They report physical and mental health problems and psychological distress more frequently than the general population and their problems can affect safety on the roads. Actions to improve TDs’ health and reduce the risks of (co-)morbidity or unsafe driving are imperative. Methods: The published studies dealing with the TDs’ sleep habits and mental health were reviewed to define the scenario and organize the preventive strategies proposed thus far. Results: Awareness among TDs of the high risk for health and safety due to (often co-existing) untreated sleep and mental health problems is critical. Alcohol and prescribed or illicit drugs are often misused to compensate for depression, anxiety, job strain, fatigue, and social isolation. Polypharmacy and dependence increase the chance of unsafe behaviors on the road. The TDs’ access to healthcare services is scant, and participation in industry-sponsored wellness programs is limited. Conclusions: Primary prevention is a first unavoidable step to deal with sleep and mental health problems. Educational programs, online support and tele-health assessment/monitoring would help improve the well-being, safety and health of professional TDs and increase safety on the road.

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“…Furthermore, it provides the opportunity to study the influence of comorbid (sleep) disorders. For example, comorbid insomnia and OSA are gaining attention 46 47. However, in datasets collected in population studies or second-line sleep clinics, there are limited data available on this comorbid condition.…”

Section: Discussionmentioning

confidence: 99%

Protocol of the SOMNIA project: an observational study to create a neurophysiological database for advanced clinical sleep monitoring

et al. 2019

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IntroductionPolysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation. Here, we describe the methods of the Sleep and Obstructive Sleep Apnoea Monitoring with Non-Invasive Applications (SOMNIA) project, yielding a database combining clinical PSG with advanced unobtrusive sleep monitoring modalities in a large cohort of patients with various sleep disorders. The SOMNIA database will facilitate the validation and assessment of the diagnostic value of the new techniques, as well as the development of additional indices and biomarkers derived from new and/or traditional sleep monitoring methods.Methods and analysisWe aim to include at least 2100 subjects (both adults and children) with a variety of sleep disorders who undergo a PSG as part of standard clinical care in a dedicated sleep centre. Full-video PSG will be performed according to the standards of the American Academy of Sleep Medicine. Each recording will be supplemented with one or more new monitoring systems, including wrist-worn photoplethysmography and actigraphy, pressure sensing mattresses, multimicrophone recording of respiratory sounds including snoring, suprasternal pressure monitoring and multielectrode electromyography of the diaphragm.Ethics and disseminationThe study was reviewed by the medical ethical committee of the Maxima Medical Center (Eindhoven, the Netherlands, File no: N16.074). All subjects provide informed consent before participation.The SOMNIA database is built to facilitate future research in sleep medicine. Data from the completed SOMNIA database will be made available for collaboration with researchers outside the institute.

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Comorbid Insomnia With Obstructive Sleep Apnea: Clinical Characteristics and Risk Factors

Cited by 73 publications

References 54 publications

Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials

Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials

Sleep and Mental Health in Truck Drivers: Descriptive Review of the Current Evidence and Proposal of Strategies for Primary Prevention

Protocol of the SOMNIA project: an observational study to create a neurophysiological database for advanced clinical sleep monitoring

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