Prevalence of chronic insomnia in patients with obstructive sleep apnea

Abstract

Objectives: To investigate the prevalence of and factors associated with chronic insomnia and obstructive sleep apnea (CIOSA) comorbidity in obstructive sleep apnea (OSA) patients. Methods: Between March 2014 and March 2015, we conducted a prospective, cross-sectional study of 238 adults diagnosed with OSA according to polysomnography and International Classification of Sleep Disorders-Third Edition criteria. Results: The prevalence of CIOSA was 29%. There was a trend towards older age in the CIOSA group. Sex was not associated with CIOSA. Sleep-maintenance and sleep-onset insomnia predominated in the sample. Beck's depression and anxiety inventory scores were higher in the CIOSA group. Both depression and anxiety symptoms were associated with CIOSA. The arousal and apneahypopnea indices were lower in the CIOSA group. CIOSA was also associated with age X 60 years and current tobacco use. Severe OSA and alcohol use were negatively associated with CIOSA. Conclusions: Chronic insomnia is prevalent among OSA patients. Our study highlights the need for detailed evaluation of patients with sleep breathing disorders to diagnose other important sleep and mood disorders (such as depression and anxiety), given their frequent association.

International Consensus Statement on Obstructive Sleep Apnea

“…The available literature addressing the prevalence of insomnia in patients with OSA (Table VII.I.1) 588,943–956 suffers from several significant shortcomings. Variable definitions are used for OSA and insomnia and different studies focus on “insomnia symptoms” versus “insomnia disorder.” The former is likely to be more common in OSA patients as it requires the presence of less significant symptoms.…”

“…The available literature addressing the prevalence of insomnia in patients with OSA (Table VII.I.1) 588,[943][944][945][946][947][948][949][950][951][952][953][954][955][956] suffers from several significant shortcomings. Variable definitions are used for OSA and insomnia and different studies focus on "insomnia symptoms" versus "insomnia disorder."…”

Impact of Insomnia on Hypoglossal Nerve Stimulation Outcomes in the ADHERE Registry

“…3 Clinically, patients with COMISA experience greater impairments in daytime functioning and QOL as well as worse emotional and cognitive impairments, including irritability, depression, anxiety, and poor concentration, than those with OSA alone. 5,[27][28][29] HGNS has been increasingly utilized in CPAPintolerant patients, many of whom suffer from COMISA. 12,16,[18][19][20]30 It might be assumed that the additional comorbidity of insomnia in patients with COMISA would negatively affect adherence to HGNS.…”

More than sleepiness: prevalence and relevance of nonclassical symptoms of obstructive sleep apnea

“…In a Brazilian cohort, almost one-third of adult OSA patients fulfilled diagnostic criteria for COMISA. COMISA was more prevalent in older participants, and was associated with a more complicated clinical picture [ 25 ]. In a population-based online survey data from 2044 Australian adults, insomnia occurred more frequently among participants with doctor-diagnosed OSA (22%), compared with those without (14%) [ 26 ].…”