P086 The insomnia severity index is related to the respiratory arousal threshold in people with Co-Morbid Insomnia and Sleep Apnoea (COMISA)

Zheng, J; Tong, B; Sweetman, Alexander; Eckert, Danny J.; Osman, A. Arnold

doi:10.1093/sleepadvances/zpac029.156

Cited by 3 publications

(10 citation statements)

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“…People with a low respiratory arousal threshold are more likely to be unsuccessful with existing treatments for OSA [75][76][77]. Recent simplified techniques to identify people with a low respiratory arousal threshold may be important, and should be validated in people with COMISA [22,23,78,79]. The relationship between insomnia and the respiratory arousal threshold is not consistent [22,80,81 & ].…”

Section: Emerging and Future Researchmentioning

confidence: 99%

“…For example, partial sleep deprivation associated with insomnia disorder may compromise upper airway muscle tone and lead to airway collapse during sleep, thereby exacerbating OSA severity [16 ▪▪ ]. Insomnia characterized by heightened cognitive and physiological arousal may also interact with the respiratory arousal threshold (a key nonanatomical trait that contributes to OSA pathophysiology) to exacerbate OSA severity in patients with a preexisting anatomical compromise [16 ▪▪ ,22,23].…”

Section: Comisa Prevalencementioning

confidence: 99%

“…Recent simplified techniques to identify people with a low respiratory arousal threshold may be important, and should be validated in people with COMISA [22,23,78,79]. The relationship between insomnia and the respiratory arousal threshold is not consistent [22,80,81 ▪ ]. One study reported a positive relationship between ISI and the AT (determined using gold-standard techniques) in people with COMISA presenting moderate symptoms (ISI≥15) [22].…”

Section: Emerging and Future Researchmentioning

confidence: 99%

“…The relationship between insomnia and the respiratory arousal threshold is not consistent [22,80,81 ▪ ]. One study reported a positive relationship between ISI and the AT (determined using gold-standard techniques) in people with COMISA presenting moderate symptoms (ISI≥15) [22]. A recent study by Yanagimori and colleagues [81 ▪ ] found no association between insomnia (ISI≥15) and the respiratory arousal threshold endotype (determined from polysomnography characteristics) in a sample of people with OSA (AHI≥15).…”

Section: Emerging and Future Researchmentioning

confidence: 99%

See 3 more Smart Citations

Co-morbid insomnia and sleep apnea (COMISA): recent research and future directions

Sweetman,

Osman,

Lack

et al. 2023

Current Opinion in Pulmonary Medicine

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Purpose of review Insomnia and obstructive sleep apnea have previously been viewed as completely independent conditions. However, there is now increasing recognition that insomnia and sleep apnea frequently co-occur. Co-morbid insomnia and sleep apnea (COMISA) is a highly prevalent condition that is associated with impairment of sleep, daytime function, mental health and physical health outcomes, and mortality risk. This review aims to provide an update on COMISA prevalence, consequences, treatment approaches, and future research directions. Recent findings People with COMISA experience worse sleep, mental health, physical health, quality of life and longevity compared to people with neither condition, and often compared to those with insomnia alone and sleep apnea alone. Emerging evidence suggests that cognitive behavioral therapy for insomnia is an effective treatment in the presence of treated and untreated sleep apnea, that may also improve manifestations and subsequent management of sleep apnea. Future research is required to understand the etiology of COMISA, and to develop and implement tailored treatment approaches. Summary It is important for sleep and respiratory technicians, researchers and clinicians to be aware of the high co-morbidity rates, consequences, and treatment requirements of patients with co-morbid insomnia and sleep apnea.

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Section: Emerging and Future Researchmentioning

confidence: 99%

Section: Comisa Prevalencementioning

confidence: 99%

Section: Emerging and Future Researchmentioning

confidence: 99%

Section: Emerging and Future Researchmentioning

confidence: 99%

See 2 more Smart Citations

Co-morbid insomnia and sleep apnea (COMISA): recent research and future directions

Sweetman,

Osman,

Lack

et al. 2023

Current Opinion in Pulmonary Medicine

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“…Several emerging studies aim to investigate the respiratory arousal threshold in people with COMISA [44][45][46]. The respiratory arousal threshold is a non-anatomical trait that contributes to OSA pathophysiology in approximately one-third of patients with OSA.…”

Section: Bi-directional Relationships Between Insomnia and Osamentioning

confidence: 99%

Co-morbid Insomnia and Sleep Apnoea (COMISA): Latest Research from an Emerging Field

Sweetman

2023

Curr Sleep Medicine Rep

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Purpose of Review Insomnia and sleep apnoea are the two most prevalent sleep disorders and frequently co-exist. Co-morbid insomnia and sleep apnoea (COMISA) is increasingly recognised as a highly prevalent condition that is associated with worse sleep, daytime function, physical and mental health compared to either disorder alone. Compared to people with sleep apnoea alone, those with COMISA are less likely to accept and use positive airway pressure therapy, the most effective treatment for sleep apnoea. Given the high prevalence, morbidity and complexities in effectively managing COMISA, it is critical to develop a better understanding of the aetiology, consequences and effective treatments for this condition. This report aims to provide an overview of recent COMISA research. Recent Findings This report presents an overview of emerging areas of COMISA research over the past 5 years, including (1) mental and physical health associations of COMISA, (2) bi-directional relationships between insomnia and sleep apnoea, (3) positive airway pressure therapy for COMISA and (4) cognitive behavioural therapy for COMISA. Future research directions are discussed, including tailored treatment approaches and implementation programs to improve recognition and management of COMISA. Summary COMISA is a highly prevalent and debilitating condition in sleep clinic and population-based settings. Emerging research aims to develop and implement more effective and tailored treatment approaches for COMISA, to improve sleep, mental health, physical health and quality of life in people with COMISA.

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Respiratory arousal threshold among patients with isolated sleep apnea and with comorbid insomnia (COMISA)

Yanagimori

Fernandes

Garcia

et al. 2023

Sci Rep

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Insomnia and obstructive sleep apnea (OSA) are common sleep disorders and frequently coexist (COMISA). Arousals from sleep may be a common link explaining the frequent comorbidity of both disorders. Respiratory arousal threshold (AT) is a physiologic measurement of the level of respiratory effort to trigger an arousal from sleep. The impact of COMISA on AT is not known. We hypothesized that a low AT is more common among COMISA than among patients with OSA without insomnia. Participants referred for OSA diagnosis underwent a type 3 sleep study and answered the insomnia severity index (ISI) questionnaire and the Epworth sleepiness scale. Participants with an ISI score ≥ 15 were defined as having insomnia. Sleep apnea was defined as an apnea hypopnea index (AHI) ≥ 15 events/h. Low AT was determined using a previously validated score based on 3 polysomnography variables (AHI, nadir SpO2 and the frequency of hypopneas). OSA-only (n = 51) and COMISA (n = 52) participants had similar age (61[52–68] vs 60[53–65] years), body-mass index (31.3[27.7–36.2] vs 32.2[29.5–38.3] kg/m2) and OSA severity (40.2[27.5–60] vs 37.55[27.9–65.2] events/h): all p = NS. OSA-only group had significantly more males than the COMISA group (58% vs 33%, p = 0.013. The proportion of participants with a low AT among OSA-only and COMISA groups was similar (29 vs 33%, p = NS). The similar proportion of low AT among COMISA and patients with OSA suggests that the respiratory arousal threshold may not be related to the increased arousability of insomnia.

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P086 The insomnia severity index is related to the respiratory arousal threshold in people with Co-Morbid Insomnia and Sleep Apnoea (COMISA)

Cited by 3 publications

References 0 publications

Co-morbid insomnia and sleep apnea (COMISA): recent research and future directions

Co-morbid insomnia and sleep apnea (COMISA): recent research and future directions

Co-morbid Insomnia and Sleep Apnoea (COMISA): Latest Research from an Emerging Field

Respiratory arousal threshold among patients with isolated sleep apnea and with comorbid insomnia (COMISA)

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