Co-Morbid Insomnia and Sleep Apnea (COMISA): Prevalence, Consequences, Methodological Considerations, and Recent Randomized Controlled Trials (original) (raw)
Related papers
COMISA (Comorbid Insomnia and Sleep Apnea): a Practical Approach
Current Sleep Medicine Reports, 2018
Purpose of Review Comorbid insomnia and sleep apnea (COMISA) is prevalent and carries significant morbidity but lacks a standardized diagnostic and therapeutic approach. Through a critical evaluation of the literature, we propose a novel approach to COMISA that incorporates the underlying etiology and existence of different phenotypes in this disorder. Recent Findings A low arousal threshold and/or hyperarousability may underlie the development of COMISA. Pretreatment symptoms may serve as baseline predictors of response to positive airway pressure therapy in COMISA and differentiate insomnia secondary to OSA from independent insomnia. A variety of therapeutic strategies for COMISA have been put forward with evidence supporting the use of monotherapy or combined therapy in the appropriate clinical setting. Summary Patients with either OSA or insomnia must be effectively screened for both disorders based on presenting symptoms and response to therapy. Recognition of the underlying etiology of COMISA and the different COMISA phenotypes can guide therapy.
Current Problems of Psychiatry
Introduction: Insomnia and obstructive sleep apnea are among the most common sleep-wake disorders. A relatively new category of disorders, studied more thoroughly for only a few years, is the occurrence of symptoms of both obstructive sleep apnea and insomnia in one patient and treating it as a different disease entity. This phenomenon is increasingly referred to as COMISA (Co-morbid insomnia and sleep apnea). The aim of this paper is to: 1) draw attention to this interesting issue, 2) show treatment differences of COMISA from isolated insomnia or obstructive sleep apnea and to help choose better therapy by general practitioners, pulmonologists, and psychiatrists for these patients. Materials and methods: The literature review was based on a search of articles in Medline, PubMed, and Google Scholar from 2012 to 2023 using the keywords: obstructive sleep apnea; insomnia; cognitive behavioral therapy for insomnia; continuous positive airway pressure; COMISA. The analysis included orig...
Comorbid Insomnia and Obstructive Sleep Apnea (COMISA): Current Concepts of Patient Management
International Journal of Environmental Research and Public Health
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 (CBTi) 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 ...