基于澳大利亚人群样本的共病失眠和睡眠呼吸暂停的患病率及其相关性。
Prevalence and associations of co-morbid insomnia and sleep apnoea in an Australian population-based sample.
机构信息
The Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, SA, 5042, Australia; National Centre for Sleep Health Services Research: A NHMRC Centre of Research Excellence, Flinders University, Adelaide, SA, Australia.
The Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, SA, 5042, Australia.
出版信息
Sleep Med. 2021 Jun;82:9-17. doi: 10.1016/j.sleep.2021.03.023. Epub 2021 Mar 31.
INTRODUCTION
Insomnia and obstructive sleep apnoea (OSA) are the two most prevalent sleep disorders, and frequently co-occur (COMISA) in sleep clinic samples. However, few studies have investigated the prevalence or associations of COMISA in the general population.
METHODS
We used population-based online survey data from 2044 Australian adults. The prevalence and associations of insomnia, OSA and COMISA were investigated according to symptom-level, and disorder-level definitions. Insomnia was defined according to chronic difficulties initiating and/or maintaining sleep (DIMS; symptom-level), and ICSD-3 chronic insomnia disorder (disorder-level). OSA was defined according to self-reported frequent obstructive events, snoring or doctor-diagnosed OSA (symptom-level), and doctor-diagnosed OSA (disorder-level). COMISA was defined if both conditions were met (for symptom-level, and disorder-level threshold). Associations with other conditions, and general health were investigated with Poisson regression analyses.
RESULTS
Chronic insomnia occurred more frequently among participants with doctor-diagnosed OSA (22.3%), compared to those without (14.3%, p = 0.010). Doctor-diagnosed OSA was more common among participants with chronic insomnia (10.2%) compared to those without (6.2%; p = 0.010). DIMS also occurred more frequently among participants with OSA symptoms (66.6%), compared to those without (47.2%; p < 0.001). Participants with symptom-level COMISA reported increased co-morbid conditions, and worse general health compared to participants with symptoms of insomnia-alone, OSA-alone, or neither insomnia/OSA.
CONCLUSIONS
COMISA at symptom and disorder level were common and associated with increased medical and psychiatric co-morbidity, as well as poor general health. More investigation is required to understand bi-directional associations underpinning the high co-morbidity, and improve diagnostic and treatment approaches for COMISA to reduce associated morbidity.
简介
失眠和阻塞性睡眠呼吸暂停（OSA）是两种最常见的睡眠障碍，并且经常在睡眠诊所样本中同时发生（COMISA）。然而，很少有研究调查一般人群中 COMISA 的患病率或相关性。
方法
我们使用了来自 2044 名澳大利亚成年人的基于人群的在线调查数据。根据症状水平和疾病水平的定义，研究了失眠、OSA 和 COMISA 的患病率和相关性。失眠根据慢性入睡困难和/或维持睡眠困难（DIMS；症状水平）和 ICSD-3 慢性失眠障碍（疾病水平）来定义。OSA 根据自我报告的频繁阻塞事件、打鼾或医生诊断的 OSA（症状水平）和医生诊断的 OSA（疾病水平）来定义。如果满足两种情况，则定义为 COMISA（用于症状水平和疾病水平阈值）。使用泊松回归分析研究了与其他疾病和一般健康的关联。
结果
与没有 OSA 的参与者（14.3%，p=0.010）相比，有医生诊断的 OSA 的参与者更频繁地出现慢性失眠（22.3%）。与没有 OSA 的参与者（6.2%；p=0.010）相比，有慢性失眠的参与者更常见有 OSA 症状。与没有 OSA 症状的参与者（47.2%；p<0.001）相比，有 OSA 症状的参与者 DIMS 更频繁发生。与仅患有失眠症状、仅患有 OSA 症状或两者均无的参与者相比，患有症状性 COMISA 的参与者报告了更多的合并疾病，且总体健康状况更差。需要进一步研究以了解潜在双向关联，从而改善 COMISA 的诊断和治疗方法，以降低相关发病率。
Zotero 插件