Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management
Abstract
:1. Introduction
2. Clinical Features and Relationships
2.1. Insomnia and Sleep Apnea
2.2. Patients Phenotypes
3. Pathogenetic Mechanisms and Models
3.1. Systemic Mechanisms
3.2. Molecular Mechanism
4. Diagnostic Evaluation of COMISA and Clinical Implications
5. Current Concepts of Treatment of COMISA
5.1. Positive Airway Pressure Devices
5.2. Oral Appliance and Surgery
5.3. Cognitive-Behavioral Therapy for Insomnia
5.4. Benzodiazepine Agents
5.5. Non-Benzodiazepine Agents
5.6. Anti-Depressive Agents
5.7. Sleep Hygiene Education
5.8. Melatonin and Herbal Therapies
6. COMISA and Other Sleep Disorders
6.1. Sleep Related Movement Disorders
6.2. Epilepsy and Parasomnias
6.3. Central Disorders: Narcolepsy
6.4. Circadian Rhythm Disorders
7. Implications of the Findings and Future Research
8. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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A Chronic Insomnia Disorder Diagnosis Would Apply Only When: |
The insomnia symptoms show some independence in their onset or variation over time from the other symptoms of the co-occurring sleep disorder. When insomnia symptoms persist despite marked symptom improvement of the co-occurring sleep disorder following adequate treatment. A chronic insomnia disorder diagnosis would not apply when effective treatment of the coincident sleep disorder resolves the insomnia symptoms. |
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Ragnoli, B.; Pochetti, P.; Raie, A.; Malerba, M. Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management. Int. J. Environ. Res. Public Health 2021, 18, 9248. https://doi.org/10.3390/ijerph18179248
Ragnoli B, Pochetti P, Raie A, Malerba M. Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management. International Journal of Environmental Research and Public Health. 2021; 18(17):9248. https://doi.org/10.3390/ijerph18179248
Chicago/Turabian StyleRagnoli, Beatrice, Patrizia Pochetti, Alberto Raie, and Mario Malerba. 2021. "Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management" International Journal of Environmental Research and Public Health 18, no. 17: 9248. https://doi.org/10.3390/ijerph18179248
APA StyleRagnoli, B., Pochetti, P., Raie, A., & Malerba, M. (2021). Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management. International Journal of Environmental Research and Public Health, 18(17), 9248. https://doi.org/10.3390/ijerph18179248