Next Article in Journal
A Comprehensive sLORETA Study on the Contribution of Cortical Somatomotor Regions to Motor Imagery
Previous Article in Journal
Helicobacter pylori, Vascular Risk Factors and Cognition in U.S. Older Adults
Previous Article in Special Issue
Driving After Drinking Alcohol Associated with Insufficient Sleep and Insomnia among Student Athletes and Non-Athletes
Open AccessReview

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

1
The Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, Box 6 Mark Oliphant Building, 5 Laffer Drive, Bedford Park, Flinders University, Adelaide 5042, South Australia, Australia
2
The Adelaide Institute for Sleep Health: A Flinders Centre of Research Excellence, College of Education Psychology and Social Work, Flinders University, Adelaide 5042, South Australia, Australia
3
School of Psychology, Félix-Antoine-Savard Pavilion, 2325, rue des Bibliothèques, local 1012, Laval University, Quebec City, QC G1V 0A6, Canada
*
Author to whom correspondence should be addressed.
Brain Sci. 2019, 9(12), 371; https://doi.org/10.3390/brainsci9120371
Received: 15 November 2019 / Revised: 9 December 2019 / Accepted: 10 December 2019 / Published: 12 December 2019
(This article belongs to the Special Issue Insomnia: Beyond Hyperarousal)
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. View Full-Text
Keywords: COMISA; insomnia; obstructive sleep apnea; sleep-disordered breathing; cognitive behavior therapy for insomnia; continuous positive airway pressure COMISA; insomnia; obstructive sleep apnea; sleep-disordered breathing; cognitive behavior therapy for insomnia; continuous positive airway pressure
Show Figures

Figure 1

MDPI and ACS Style

Sweetman, A.; Lack, L.; Bastien, C. Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials. Brain Sci. 2019, 9, 371.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop