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Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management

Author

Listed:
  • Beatrice Ragnoli

    (Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy)

  • Patrizia Pochetti

    (Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy)

  • Alberto Raie

    (Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy)

  • Mario Malerba

    (Respiratory Unit, S. Andrea Hospital, 13100 Vercelli, Italy
    Department of Traslational Medicine, University of Eastern Piedmont, 28100 Novara, Italy)

Abstract

Obstructive sleep apnea (OSA) and insomnia are the two most common sleep disorders among the general population, and they may often coexist in patients with sleep-disordered breathing (SDB). The higher prevalence of insomnia symptoms in patients with OSA (40–60%) compared to that observed in the general population has thus led researchers to identify a new disorder named comorbid insomnia and OSA (COMISA), whose true burden has been so far largely underestimated. The combined treatment of COMISA patients with positive-airway pressure ventilation (PAP) with cognitive behavioral therapy for insomnia (CBT i ) has shown a better patient outcome compared to that obtained with a single treatment. Furthermore, recent evidence has shown that an innovative patient-centered approach taking into consideration patient characteristics, treatment preferences and accessibility to treatment is recommended to optimize clinical management of COMISA patients. However, in this complex mosaic, many other sleep disorders may overlap with COMISA, so there is an urgent need for further research to fully understand the impact of these therapies on outcomes for OSA patients with comorbidity. In light of this need, this review focuses on the major sleep disorders comorbid with OSA and the recent advances in the management of these insomniac patients.

Suggested Citation

  • Beatrice Ragnoli & Patrizia Pochetti & Alberto Raie & Mario Malerba, 2021. "Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management," IJERPH, MDPI, vol. 18(17), pages 1-15, September.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:17:p:9248-:d:627396
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    References listed on IDEAS

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    1. Eduardo Ferracioli-Oda & Ahmad Qawasmi & Michael H Bloch, 2013. "Meta-Analysis: Melatonin for the Treatment of Primary Sleep Disorders," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-6, May.
    2. Patrizia Pochetti & Danila Azzolina & Beatrice Ragnoli & Paolo Amedeo Tillio & Vincenzo Cantaluppi & Mario Malerba, 2020. "Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study," IJERPH, MDPI, vol. 17(14), pages 1-12, July.
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    Cited by:

    1. An-Che Cheng & Gwo-Jang Wu & Chi-Hsiang Chung & Kuo-Hsiang Wu & Chien-An Sun & I-Duo Wang & Wu-Chien Chien, 2021. "Effect of Obstructive Sleep Apnea on the Risk of Injuries—A Nationwide Population-Based Cohort Study," IJERPH, MDPI, vol. 18(24), pages 1-13, December.

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