Prevalence and associations of co-morbid insomnia and sleep apnoea in an Australian population-based sample

• Published in: Sleep medicine 2021-06, Vol.82, p.9-17
• Main Authors: Sweetman, Alexander, Melaku, Yohannes Adama, Lack, Leon, Reynolds, Amy, Gill, Tiffany K., Adams, Robert, Appleton, Sarah
• Format: Article
• Language: English
• Subjects: Chronic insomnia; Co-morbidity; COMISA; Epidemiology; Obstructive sleep apnoea; Quality of life
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2021.03.023

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. 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. 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