Solelhac Geoffroy, Wachinou Ablo Prudence, Goyal Abhishek, Imler Théo, Pakhare Abhijit, Sen Amit Kumar, Haba-Rubio Jose, Heiniger Gregory, Waeber Adrien, Vollenweider Peter, Marques-Vidal Pedro, Van Den Broecke Sandra, Johnson Roch Christian, Preux Pierre-Marie, Marchi Nicola Andrea, Heinzer Raphaël
Center for Investigation and Research in Sleep, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin.
Sleep Med. 2025 Jul;131:106526. doi: 10.1016/j.sleep.2025.106526. Epub 2025 Apr 18.
COMISA is defined as a comorbid condition comprising insomnia and obstructive sleep apnea (OSA). This study aims to assess the prevalence of COMISA and its association with cardiovascular risk factors within three population-based cohorts from Benin (BeSAS, n = 1733), Switzerland (HypnoLaus, n = 1999), and India (BLESS, n = 958).
OSA was assessed by nocturnal recordings, while the presence of insomnia symptoms was assessed by questionnaires in the three cohorts. Adjusted logistic regression models were employed to assess the associations of COMISA with hypertension, diabetes and metabolic syndrome. These associations were also examined using different COMISA definitions based on insomnia subtypes (initiation difficulties and early morning awakenings/maintenance difficulties).
The crude prevalence of COMISA was 11.4 % in HypnoLaus, 9.1 % in BLESS and 1.7 % in BeSAS. In HypnoLaus, COMISA showed a trend towards an association with hypertension (OR: 1.34, p = 0.09) and metabolic syndrome (OR: 1.37, p = 0.09), which was statistically significant when insomnia was defined by sleep initiation difficulties. In BLESS, COMISA was significantly associated with both hypertension (OR: 3.30, p < 0.001) and metabolic syndrome (OR: 1.1.71, p = 0.008). No significant associations were observed in BeSAS.
COMISA has a high prevalence worldwide and may be associated with hypertension and metabolic syndrome.
共病性失眠呼吸暂停综合征（COMISA）被定义为一种包含失眠和阻塞性睡眠呼吸暂停（OSA）的共病情况。本研究旨在评估来自贝宁（BeSAS，n = 1733）、瑞士（HypnoLaus，n = 1999）和印度（BLESS，n = 958）的三个基于人群的队列中COMISA的患病率及其与心血管危险因素的关联。
在三个队列中，通过夜间记录评估OSA，通过问卷调查评估失眠症状的存在情况。采用调整后的逻辑回归模型评估COMISA与高血压、糖尿病和代谢综合征的关联。还使用基于失眠亚型（入睡困难和早醒/维持睡眠困难）的不同COMISA定义来检查这些关联。
COMISA的粗患病率在HypnoLaus中为11.4%，在BLESS中为9.1%，在BeSAS中为1.7%。在HypnoLaus中，COMISA显示出与高血压（比值比：1.34，p = 0.09）和代谢综合征（比值比：1.37，p = 0.09）相关的趋势，当通过入睡困难定义失眠时，这种关联具有统计学意义。在BLESS中，COMISA与高血压（比值比：3.30，p < 0.001）和代谢综合征（比值比：1.71，p = 0.008）均显著相关。在BeSAS中未观察到显著关联。
COMISA在全球范围内患病率较高，可能与高血压和代谢综合征相关。
