Background: Obstructive sleep apnea syndrome (OSAS) and insomnia are two of the most common sleep disorders that coexist frequently having distinctive clinical features and therapeutic domain. Methodology: Patients presenting to our pulmonary medicine department with either the symptoms of OSAS or referred with risk factors were evaluated with insomnia severity index (ISI) and overnight polysomnography after a detailed history, clinical examination, calculation of pretest probability score and relevant pre-requisite workup. Results: Enrolled 100 patients were diagnosed case of OSAS, of these 65% were males and 35% were females. The mean age of the study group was 49.88 years (SD = 12.15). The youngest patient studied was 7 years old and the oldest was 74 years. The average BMI of our patients was 33.35 kg/m². Epworth sleepiness score (ESS) was normal in 24% of patients, 15% had mild, 25% had moderate, and 36% had severe excessive daytime sleepiness. As per the apnea-hypopnea index (AHI), mild OSAS was seen in 31%, 25% had moderate, and 44% had severe OSAS. The ISI revealed that 34% of patients had no clinically significant insomnia while 35% had subthreshold insomnia, 11% had moderate clinical insomnia, and 20% had severe clinical insomnia. A statistically significant association was seen between AHI and ESS, ISI with AHI, and ESS with ISI. Conclusion: ISI is a simple, reliable, and valid instrument to detect cases of insomnia and there is an increased prevalence of insomnia in OSAS patients. High prevalence leads to increased severity of OSAS and significant neurobehavioral morbidity and early detection aids in distinctive therapeutic domain.

Background: Medical professionals are often subjected to long working hours and intensive academic teaching programs. This leads to altered sleep timings, duration, and quality. This study was carried out to assess the quality of sleep in medical intern's at a tertiary care teaching hospital. Methodology: This was a cross-sectional, observational, descriptive study conducted among medical intern's who were posted in various departments of a medical college in North India. A prestructured, pretested questionnaire incorporated into Google Forms was designed and circulated, containing questions on the Pittsburgh Sleep Quality Index (PSQI). All the data were collected in a single day. Results: A total of 130 intern's participated in the study, where the mean global score (PSQI) was 6 with ± 2.82 values, and the global score ranged from 0 to 16. More than 70% of the students had a bad sleep quality (score 6–21). A majority of intern's (70%) slept late at night (12–2.59 a.m.), and most (73%) woke up between 7 and 9 a.m. Around half of the people could fall asleep within 15 minutes of lying in bed, which increased to three-quarters within 30 minutes. Conclusion: A large proportion of medical intern's have poor sleep quality and delayed sleep phase syndrome, which can increase their morbidity and also affect the quality of patient care.

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.

A young male doctor presented with complaints of excessive daytime sleepiness and loud snoring, which had even led to a near-fatal driving accident. A level I polysomnography was done, which showed severe obstructive sleep apnea (OSA) hypopnea syndrome, and the patient was advised continuous positive airway pressure (CPAP) therapy. On follow-up, the patient's compliance with his positive airway pressure (PAP) therapy was nearly 12 hours per day, including during the daytime in the awake state. A detailed evaluation of the patient helped in gaining insight into the etiology of the same.

Chronobiology, stemming from the Greek roots “chrónos” and “biology,” delves into the intricate temporal dimensions of life. The circadian rhythm is at the heart of this inquiry, a meticulously studied biological cycle persisting over approximately 24 hours. Governed by the circadian axis, with the suprachiasmatic nucleus (SCN) as its pivot, this complex system integrates sensory input from retinal photoreceptors to coordinate essential rhythmic outputs crucial for circadian regulation. Melatonin, a prominent circadian-regulated hormone, possesses the remarkable ability to synchronize biological rhythms. Disruptions to this finely tuned mechanism, induced by sudden shifts in routine or seasonal changes, negatively affect circadian integrity. These disturbances can trigger affective disorders, including minor depressive episodes and Winter Blues, underscoring the close relationship between circadian rhythms and mental well-being. Furthermore, individuals with mood disorders often experience a myriad of irregularities in their sleep–wake cycles, highlighting the intricate interplay between biological rhythms and psychological equilibrium. By unraveling the complexities of these rhythms and elucidating the environmental factors influencing them, novel avenues emerge for developing therapeutic interventions aimed at correcting or even preventing disruptions in biological rhythms. This multifaceted approach holds promise for enhancing our understanding of circadian biology and fostering innovative strategies to promote holistic health and well-being.