Tseng Chien-Yu, Morris Earl J, Sekhon Vishaldeep K, Albrecht Jennifer S, Wickwire Emerson M, Spira Adam P, Gross Alden L, Malhotra Atul, Blinka Marcela D, Kaufmann Christopher N
Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA.
Center for Drug Evaluation and Safety, University of Florida, Gainesville, FL, USA.
Sleep Breath. 2025 Apr 23;29(2):167. doi: 10.1007/s11325-025-03323-1.
Comorbid insomnia and sleep apnea (COMISA) is a prevalent clinical syndrome. We characterized differences in characteristics and medication use patterns between participants with COMISA and those with sleep apnea alone.
Data used came from 2018 Health and Retirement Study, a nationally representative cohort study of U.S. middle-aged and older adults. Participants were asked if "a doctor had ever told them they have a sleep disorder" and which disorder. They also reported frequency of insomnia symptoms (i.e., "falling asleep," "waking during the night," "waking too early,") and how often they "felt rested in the morning." We tested differences in demographic and clinical characteristics as well as medication use between participants with COMISA vs. those with sleep apnea alone by using logistic regression.
Out of N = 1,776 with sleep apnea, 47% had COMISA. Compared to those with sleep apnea alone, participants with COMISA were more likely to be female (p = 0.032), have lower education (p < 0.001), and report lung disease, stroke, psychiatric problems, and dementia/cognitive impairment (all p's < 0.001). They reported difficulty in functioning (i.e., activities of daily living), and greater depressive symptomatology (all p's < 0.001). Finally, they were more likely to report the use of opioids (p = 0.037), stomach (p = 0.028), and sleep medications (p < 0.001).
Compared to those with sleep apnea alone, COMISA participants had a more medically complex health profile and medication use that may exacerbate sleep apnea (e.g., opioids and sleep medications). Future research should focus on managing COMISA in medically complex patients for improved health outcomes.
共病性失眠与睡眠呼吸暂停（COMISA）是一种常见的临床综合征。我们对患有COMISA的参与者与仅患有睡眠呼吸暂停的参与者在特征和药物使用模式上的差异进行了描述。
所使用的数据来自2018年健康与退休研究，这是一项针对美国中年及老年人的具有全国代表性的队列研究。参与者被问及“医生是否曾告知他们患有睡眠障碍”以及是哪种障碍。他们还报告了失眠症状的频率（即“入睡困难”“夜间醒来”“过早醒来”）以及他们“早上感觉休息好”的频率。我们通过逻辑回归测试了患有COMISA的参与者与仅患有睡眠呼吸暂停的参与者在人口统计学和临床特征以及药物使用方面的差异。
在N = 1776名患有睡眠呼吸暂停的参与者中，47%患有COMISA。与仅患有睡眠呼吸暂停的参与者相比，患有COMISA的参与者更可能为女性（p = 0.032）、受教育程度较低（p < 0.001），并报告患有肺部疾病、中风、精神问题和痴呆/认知障碍（所有p值 < 0.001）。他们报告在功能方面（即日常生活活动）存在困难，且抑郁症状更严重（所有p值 < 0.001）。最后，他们更可能报告使用阿片类药物（p = 0.037）、胃药（p = 0.028）和睡眠药物（p < 0.001）。
与仅患有睡眠呼吸暂停的参与者相比，患有COMISA的参与者的健康状况在医学上更为复杂，且药物使用可能会加重睡眠呼吸暂停（如阿片类药物和睡眠药物）。未来的研究应专注于在医学上复杂的患者中管理COMISA，以改善健康结局。
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