All-Cause Mortality in People with Co-Occurring Insomnia Symptoms and Sleep Apnea: Analysis of the Wisconsin Sleep Cohort

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dc.contributor.authorLechat, B.
dc.contributor.authorLoffler, K.A.
dc.contributor.authorWallace, D.M.
dc.contributor.authorReynolds, A.
dc.contributor.authorAppleton, S.L.
dc.contributor.authorScott, H.
dc.contributor.authorVakulin, A.
dc.contributor.authorLovato, N.
dc.contributor.authorAdams, R.
dc.contributor.authorEckert, D.J.
dc.contributor.authorCatcheside, P.G.
dc.contributor.authorSweetman, A.
dc.date.issued2022
dc.description.abstractPurpose: Insomnia symptoms and sleep apnea frequently co-occur and are associated with worse sleep, daytime function, mental health and quality of life, compared to either insomnia or obstructive sleep apnea (OSA) alone. This study aimed to investigate the association of symptoms of co-morbid insomnia and sleep apnea (COMISA) with all-cause mortality. Patients and Methods: Wisconsin Sleep Cohort data were analysed to assess potential associations between COMISA symptoms and all-cause mortality. Nocturnal insomnia symptoms were defined as difficulties initiating sleep, maintaining sleep, and/or early morning awakenings “often” or “almost always”, and/or regular sedative-hypnotic medicine use. OSA was defined as an apneahypopnea index ≥5/hr sleep. Participants were classified as having neither insomnia symptoms nor OSA, insomnia symptoms alone, OSA alone, or COMISA symptoms. Associations between the four groups and all-cause mortality over 20 years of follow-up were examined via multivariable adjusted Cox regression models. Results: Among 1115 adult participants (mean ± SD age 55 ± 8 years, 53% males), 19.1% had COMISA symptoms. After controlling for sociodemographic and behavioral factors, COMISA symptoms were associated with an increased risk of all-cause mortality compared to no insomnia symptoms or OSA (HR [95% CI]; 1.71 [1.00–2.93]). OSA alone (0.91 [0.53, 1.57]) and insomnia symptoms alone (1.04 [0.55, 1.97]) were not associated with increased mortality risk. Conclusion: Co-morbid insomnia symptoms and sleep apnea is associated with increased all-cause mortality risk. Future research should investigate mechanisms underpinning COMISA and the effectiveness of different treatment approaches to reduce mortality risk for this common condition.
dc.description.statementofresponsibilityBastien Lechat, Kelly A Loffler, Douglas M Wallace, Amy Reynolds, Sarah L Appleton, Hannah Scott, Andrew Vakulin, Nicole Lovato, Robert Adams, Danny J Eckert, Peter G Catcheside, Alexander Sweetman
dc.identifier.citationNature and Science of Sleep, 2022; 14:1817-1828
dc.identifier.doi10.2147/nss.s379252
dc.identifier.issn1179-1608
dc.identifier.issn1179-1608
dc.identifier.orcidAppleton, S.L. [0000-0001-7292-9714]
dc.identifier.orcidAdams, R. [0000-0002-7572-0796]
dc.identifier.urihttps://hdl.handle.net/2440/136855
dc.language.isoen
dc.publisherDove Medical Press
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1116942
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1196261
dc.rights© 2022 Lechat et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms. php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php)
dc.source.urihttps://doi.org/10.2147/nss.s379252
dc.subjectsleep disordered breathing; Wisconsin Sleep Cohort; COMISA; obstructive; sleep apnea; insomnia; respiratory
dc.titleAll-Cause Mortality in People with Co-Occurring Insomnia Symptoms and Sleep Apnea: Analysis of the Wisconsin Sleep Cohort
dc.typeJournal article
pubs.publication-statusPublished

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