Citation Information :
Khara NV, Prajapati D, Thumar K, Apte A, Kshatriya R, Raval G, Patel S. The Confluence of Sleep Apnea and Insomnia: A Brief Review of Comorbid Insomnia and Sleep Apnea. Indian Sleep Med 2024; 19 (3):42-44.
Comorbid insomnia and sleep apnea (COMISA) represents the confluence of two prevalent sleep disorders: obstructive sleep apnea (OSA) and chronic insomnia. This review explores the intricate epidemiology, multifaceted pathophysiology, clinical manifestations, diagnostic conundrums, and therapeutic strategies associated with COMISA. The interplay between OSA and insomnia complicates both diagnosis and management, necessitating a nuanced and multidisciplinary approach. Despite advances in understanding COMISA, significant challenges remain in optimizing patient care and improving outcomes.
Krakow B, Melendrez D, Ferreira E, et al. Prevalence of insomnia symptoms in patients with sleep-disordered breathing. Chest 2001;120(6):1923–1929. DOI: 10.1378/chest.120.6.1923.
Sweetman A, Lack L, Catcheside P. Co-morbid insomnia and sleep apnea: Mechanisms and implications of an under-recognized and misinterpreted sleep disorder. Sleep Medicine Reviews 2020;51:101276.
Baglioni C, Battagliese G, Feige B, et al. Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies. Journal of Affective Disorders 2016;135 (1–3):10–19. DOI: 10.1016/j.jad.2011.01.011.
Young T, Peppard PE, Gottlieb DJ. Epidemiology of obstructive sleep apnea: A population health perspective. Am J Respir Crit Care Med 2002;165(9):1217–1239. DOI: 10.1164/rccm.2109080.
Riemann D, Spiegelhalder K, Espie C, et al. Chronic insomnia: Clinical and research challenges—An agenda. Pharmacopsychiatry 2010;43(1):1–14. DOI: 10.1055/s-0030-1267978.
Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet 2015;383(9918):736–747. DOI: 10.1016/S0140-6736(13) 60734-5.
Riemann D, Berger M, Voderholzer U. Sleep and depression—Results from psychobiological studies: An overview. Biological Psychology 2001;57(1-3):67–103. DOI: 10.1016/s0301-0511(01)00090-4.
Morin CM, Rodrigue S, Ivers H. Role of stress, arousal, and coping skills in primary insomnia. Psychosom Med 2003;65(2):259–267. DOI: 10.1097/01.psy.0000030391.09558.a3.
Vallières A, Ivers H, Bastien CH, et al. Variability and predictability in sleep patterns of chronic insomniacs. J Sleep Res 2013;9(12): 1247–1255. DOI: 10.1111/j.1365-2869.2005.00480.x.
Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. J Clin Sleep Med 2012;8(5):597–619. DOI: 10.5664/jcsm.2172.
Morin CM, Belleville G, Bélanger L, et al. The insomnia severity index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep 2011;34(5):601–608. DOI: 10.1093/sleep/34.5.601.
Ancoli-Israel S, Cole R, Alessi C, et al. The role of actigraphy in the study of sleep and circadian rhythms. Sleep 2003;26(3):342–392. DOI: 10.1093/sleep/26.3.342.
Espie CA, Kyle SD, Hames P, et al. The sleep condition indicator: A clinical screening tool to evaluate insomnia disorder. BMJ Open 2012;4(3):e004183. DOI: 10.1136/bmjopen-2013-004183.
Marshall NS, Barnes M, Travier N, et al. Continuous positive airway pressure reduces daytime sleepiness in mild to moderate obstructive sleep apnoea: A meta-analysis. Thorax 2006;61(5):430–434. DOI: 10.1136/thx.2005.050583.
Weaver TE, Grunstein RR. Adherence to continuous positive airway pressure therapy: The challenge to effective treatment. Proc Am Thorac Soc 2008;5(2):173–178. DOI: 10.1513/pats.200708-119MG.
Morin CM, Culbert JP, Schwartz SM. Nonpharmacological interventions for insomnia: A meta-analysis of treatment efficacy. Am J Psychiatry 1994;151(8):1172–1180. DOI: 10.1176/ajp.151.8.1172.
Edinger JD, Carney CE, Wohlgemuth WK. Pretherapy cognitive dispositions and dysfunctional sleep beliefs predict success in cognitive behavior therapy for insomnia. Behav Ther 2008;39(4): 406–416. DOI: 10.1016/j.beth.2007.12.001.
Riemann D, Baglioni C, Bassetti C, et al. European guideline for the diagnosis and treatment of insomnia. J Sleep Res 2017;26(6):675–700. DOI: 10.1111/jsr.12594.
Bastien CH, Vallières A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med 2001;2(4):297–307. DOI: 10.1016/s1389-9457(00)00065-4.
Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193–213. DOI: 10.1016/0165-1781(89) 90047-4.
Taylor DJ, Lichstein KL, Durrence HH, et al. Epidemiology of insomnia, depression, and anxiety. Sleep 2005;28(11):1457–1464. DOI: 10.1093/sleep/28.11.1457.
Sawyer AM, Gooneratne NS, Marcus CL, et al. A systematic review of CPAP adherence across age groups: Clinical and empiric insights for developing CPAP adherence interventions. Sleep Med Rev 2011;15(6):343–356. DOI: 10.1016/j.smrv.2011.01.003.
Eckert DJ, White DP, Jordan AS, et al. Defining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets. Am J Respir Crit Care Med 2013 15;188(8):996–1004. DOI: 10.1164/rccm.201303-0448OC.
Perlis ML, Giles DE, Buysse DJ, et al. Self-reported sleep disturbance as a prodromal symptom in recurrent depression. J Affect Disord 1997;42(2-3):209–212. DOI: 10.1016/s0165-0327(96)01411-5.