Worldwide and regional prevalence rates of co-occurrence of insomnia and insomnia symptoms with obstructive sleep apnea: A systematic review and meta-analysis

Zhang, Ye; Ren, Rong; Lei, Fei; Zhou, Junying; Zhang, Jihui; Wing, Yun‐Kwok; Sanford, Larry D.; Tang, Xiangdong

doi:10.1016/j.smrv.2019.01.004

Cited by 148 publications

(104 citation statements)

References 93 publications

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“…A similar pattern was observed for sleep apnea, which also likely reflects its increasing prevalence fueled by the obesity epidemic. However, both conditions are linked in that insomnia symptoms are frequently observed in those with sleep apnea 37 , and therefore the increase in insomnia search queries may be partially explained by concomitant searches for sleep apnea.…”

Section: Discussionmentioning

confidence: 99%

Google Trends reveals increases in internet searches for insomnia during the 2019 coronavirus disease (COVID-19) global pandemic

Zitting

Holst

Yuan

et al. 2021

Journal of Clinical Sleep Medicine

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Journal of Clinical Sleep Medicine is dedicated to advancing the science of clinical sleep medicine. In order to provide subscribers with access to new scientific developments as early as possible, accepted papers are posted prior to their final publication in an issue. These papers are posted as received-without copyediting or formatting by the publisher. In some instances, substantial changes are made during the copyediting and formatting processes; therefore, the final version of the paper may differ significantly from this version. Unless indicated otherwise, all papers are copyright of the American Academy of Sleep Medicine. No paper in whole or in part may be used in any form without written permission from the American Academy of Sleep Medicine.

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Section: Discussionmentioning

confidence: 99%

Google Trends reveals increases in internet searches for insomnia during the 2019 coronavirus disease (COVID-19) global pandemic

Zitting

Holst

Yuan

et al. 2021

Journal of Clinical Sleep Medicine

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“…The formulation of a working hypothesis on the complex interaction between these two entities is likewise hampered by conceptual limitations. In recent systematic reviews, available studies were compared with respect to prevalence of co-occurrence of insomnia and OSA [10] and treatment of comorbid insomnia and OSA [24]. Both studies draw attention to the limited number of high-quality publications and to the inconsistency of the methodology.…”

Section: Methodological Issuesmentioning

confidence: 99%

“…Several publications have addressed the co-occurrence of chronic insomnia disorder and OSA. In a recent systematic review and meta-analysis, ZHANG et al [10] have evaluated published data on the co-occurrence prevalence of insomnia and insomnia symptoms with OSA. A total of 37 studies were included in their analysis.…”

Section: Co-occurrence Of Insomnia and Osamentioning

confidence: 99%

Management of insomnia in sleep disordered breathing

et al. 2019

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Both obstructive sleep apnoea (OSA) and chronic insomnia disorder are highly prevalent in the general population. Whilst both disorders may occur together by mere coincidence, it appears that they share clinical features and that they may aggravate each other as a result of reciprocally adverse pathogenetic mechanisms. Comorbidity between chronic insomnia disorder and OSA is a clinically relevant condition that may confront practitioners with serious diagnostic and therapeutic challenges. Current data, while still scarce, advocate an integrated and multidisciplinary approach that seems superior over the isolated treatment of each sleep disorder alone.

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“…Between 2013 and 2018, a number of large cluster analyses of OSA samples also identified that 32%-54% of OSA patients indicate symptoms of 'disturbed sleep', characterized by nocturnal insomnia symptoms, more frequent use of sedative-hypnotic medications, and lower use of CPAP therapy [26,27,41,42]. Most recently, Zhang and colleagues conducted a systematic review and meta-analysis including 37 studies investigating the co-morbidity of insomnia and OSA, and reported that 35% of insomnia patients have an AHI of ≥5, and 29% have an AHI of ≥15, while 38% of OSA patients meet insomnia criteria [43]. Interestingly, this meta-analysis excluded studies investigating veterans and samples comprised of trauma patients, in which even higher COMISA prevalence rates have been reported [44,45].…”

Section: Comisa Prevalencementioning

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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Worldwide and regional prevalence rates of co-occurrence of insomnia and insomnia symptoms with obstructive sleep apnea: A systematic review and meta-analysis

Cited by 148 publications

References 93 publications

Google Trends reveals increases in internet searches for insomnia during the 2019 coronavirus disease (COVID-19) global pandemic

Google Trends reveals increases in internet searches for insomnia during the 2019 coronavirus disease (COVID-19) global pandemic

Management of insomnia in sleep disordered breathing

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

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