Developing a successful treatment for co-morbid insomnia and sleep apnoea

Co‐morbid OSA and insomnia increases depression prevalence and severity in men

“…42,43 Treating OSA with continuous positive airway pressure therapy or surgery to eliminate breathing pathology in OSA does not always alleviate DIMS-F complaints. 44 Whilst recent studies have begun to focus on advancing optimal management strategies for COMISA, 5,42,44,45 further work is clearly warranted.…”

“…Obstructive sleep apnoea (OSA) 1 and insomnia 2,3 are the two most prevalent sleep disorders and as such frequently coexist in patients. 4,5 OSA is characterized by recurrent episodes of complete (apnoea) and partial (hypopnoea) closure of the upper airway during sleep whilst insomnia is characterized by subjective problems falling or staying asleep (difficulty initiating/ maintaining sleep (DIMS)) resulting in a loss of vitality, or feelings of fatigue during the day. Co-morbid insomnia and OSA is reported in 42-55% of OSA patients attending sleep 4 or primary care 6 clinics.…”

Connecting insomnia, sleep apnoea and depression

“…Continuous positive airway pressure (CPAP) therapy for OSA has also been shown to improve depression symptoms . The presence of insomnia among OSA patients has been shown to reduce CPAP adherence, suggesting that when insomnia is present, it should be treated alongside OSA . Of note, the use of sedative/hypnotics has been suggested as a potential therapy for apnoea, either to raise the arousal threshold or to facilitate CPAP adherence .…”

Comorbid insomnia and sleep apnea: a prevalent but overlooked disorder

“…This inconsistency creates confusion and further highlights the variability that exists in diagnosing comorbid insomnia and OSA. The recently used acronym "COMISA" for comorbid insomnia and sleep apnea conveys the presence of both conditions in a memorable and potentially unifying term [10].…”